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By Terry Orr
As a
Type-2 Diabetic – my healthcare professionals (primary care, foot, eye, and
dentist) each are fully aware of my health-related issues and we pass along any
new information regarding diabetes and any changes in my condition or
medications. One positive benefit from
doing research on diabetes this month, finding new resource, web/blog-sites and
some new information to share and use myself.
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Once again, we were able to find an excellent resource
that you should bookmark and review when time permits. The Institute for Preventive Foot Health
(IPFH) has an exceptional wealth of excellent, current and easy to understand
information regarding foot health.
Below are some important excerpts from IPFH.ORG website.
According to the American Diabetes Association…
- Nearly
26 million children and adults in the United States have diabetes;
- Another
79 million Americans have pre-diabetes and are at risk for developing type 2
diabetes;
- The
estimated total national cost of diagnosed diabetes in the United States is
$174 billion.
IPFH strongly advocates that people with diabetes take
extra care to help prevent damage to the feet that can result in ulceration and
amputation. Here’s why:
- According
to the National Institutes of Health, 60% to 70% of people with diabetes have
some form of neuropathy (nerve problems / loss of sensation);
- Neuropathy
and other circulatory conditions (such as peripheral arterial disease or PAD)
that affect the lower limbs put people with diabetes at high risk for ulceration
and amputation;
- According
to IPFH's National Foot Health Assessment 2012, the incidence of diabetes in
the U.S. adult population is 11%, but that incidence nearly doubles in people
age 50 and over (19%);
- IPFH's
National Foot Health Assessment also reported that fewer than half (46%) of
people with diabetes have regular foot screenings with their doctor;
- IPFH's
National Foot Health Assessment further reported that only 11% of people with
diabetes said that they were properly measured and fitted each time they
purchase new shoes (poorly fitted shoes contribute to the formation of sores
and lesions on the feet that can lead to ulceration and amputation in people
with diabetes).
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Daily Foot Care for People with Diabetes
If you have diabetes, you are at increased risk of foot
problems and amputation. Therefore, it is very important that you check your
feet—top, bottom, sides, between the toes, toenails—at least once a day.
The best time to inspect your feet is after a bath or
shower. When your feet are dry (including between the toes), sit in a well-lit
room. If you have trouble seeing the bottom or sides of your feet, use a mirror
with an extended handle or any mirror that permits you to see your whole foot.
Look and feel for:
- Bumps,
lumps, blisters or bruises.
- Cuts,
sores, or cracked skin. Even the tiniest crack can become infected.
- Patches
of thin or shiny skin (which can signal lack of blood flow) or areas of redness
(especially red streaks, which can signal the presence of infection).
- Temperature
differences (one part warm, another cold). This can signal lack of blood flow.
- Pain,
tingling, numbness or no feeling at all. These can signal nerve problems.
- Ingrown
toenails with red, puffy skin along the nail and tenderness or pain.
- Loss of
hair on foot or leg, which also can signal reduced blood flow.
If you have any of these signs or symptoms,
seek medical care immediately. Your foot is at risk.
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Pedicure Every Two Weeks
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Foot self-care:
- In
addition to doing daily foot inspections, see a foot care professional for regular
foot examinations and preventive foot care.
- If you
have numbness, tingling or loss of feeling in your feet, be extra cautious.
Make sure there are no sharp objects such as broken glass, nails, or exposed
sharp edges on floors or in carpeting. Never walk or move around barefoot, even
inside your house.
- Wash
feet daily using lukewarm, never hot, water. Use your elbow to test water
temperature. After washing, dry feet
thoroughly and keep them supple by applying lotion only to the tops and bottoms
of the feet. Don’t apply lotion between the toes, since this can create a moist
environment that favors fungal growth.
- Do not
attempt to cut toenails if you have neuropathy or other foot problems related
to diabetes. See a podiatrist or a foot
care nurse regularly for toenail care and foot examinations. Never attempt to cut or file calluses or
other protrusions on your feet.
- Never
use wart removers or other harsh chemicals on your feet.
On your feet:
- IPFH
suggests wearing only properly selected and fitted, as part of an integrated
approach, padded socks with shoes with non-slip outsoles and any inserts or
orthotics prescribed or recommended by a doctor or foot health
professional. Peer-reviewed, published
studies have shown that wearing clinically tested padded socks can help prevent
injuries to the skin/soft tissue of the foot, a major cause of diabetic
ulcerations.
- Padded
Socks made from acrylic and acrylic blends have been demonstrated by clinical
research to be best for the diabetic foot; 100% “natural” fibers (cotton, wool
and silk) retain moisture and make feet vulnerable to irritation, lesions,
athlete’s foot, blisters and other foot conditions.
- Don’t
wear the same pair of shoes every day (if possible, rotate between at least two
pairs). Change your padded socks daily—more often if you are active.
- Never
depend on shoes to “fit better after they’re worn for a while.” Trust the foot health professional who
analyzes your gait and sizes your feet.
New footwear may “feel” large, but if all components are properly fitted
as a system—padded socks, insert/orthotic, shoes—they will provide better
protection.
- Check
inside shoes daily for sharp points, sharp edges, seams or other rough areas or
foreign objects that may lead to cuts, wounds or abrasions on your feet.
- Don’t
cross your legs for extended periods, as this can reduce blood flow and create
pressure points. For the same reason, don’t sit for more than an hour or two
without changing positions.
- Walk as
much as possible; doing so enhances circulation to the feet and helps with
weight and blood sugar control.
Buy shoes based on
the way they feel, not by size:
- You
should be able to move your toes comfortably
- There
should be a space the width of your thumb nail between your longest toe and the
end of the shoe.
- The
heel should fit comfortably, with minimal slippage.
- The
ball of your foot should fit comfortably into the widest part of the shoe
without feeling pinched or tight.
- You
should not feel any rubbing or chafing. Remember that your feet tend to get larger
from the exertion of daily activities, so make sure there is sufficient room
for them to expand and still go through their full range of motion. If
possible, shop for shoes near the end of the day, when your feet are larger.
Other significant websites to visit for current,
excellent information and resources are the National Institute of Health (NIH) National
Diabetes Education Program (NDEP) and the Centers for Disease Control and
Prevention.
- Feet
Can Last a Lifetime – “A Health Care Provider’s Guide to Preventing Diabetes
Foot Problems” is an excellent read and full of good information.
- A Guide
for People with Diabetes – Take Care of Your Feet for a Lifetime; and
- ‘Preventive
Foot Care in People with Diabetes’ by the American Diabetes Association.
That is a lot of information to absorb so please bookmark
it and return another time to refresh your memory. Also, if you are not taking care of your feet
daily – now is a good time to start.
Do you have any good
information to share? Please let us know
– we are always looking for something new.
Thank you.
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Happy Feet
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References
and Links:
