Anybody who has diabetes (either Type I or II) will undoubtedly know that they need regular checkups of their feet (and hands too, but that’s a bit easier, if only because you see them more). But why?
What’s so important about footcare for diabetics?
Well, first and foremost, in some people who are diabetic, skin which becomes damaged does not heal as well or as quickly, which can lead to complications such as ulcers, and as such are prone to potentially severe infection. Poor healing is caused by a reduced blood flow to the feet, due to a narrowing of the arteries caused by fatty deposits building up around the inside of blood vessels. This is known as Peripheral Vascular Disease.
In addition to this, patients with diabetes are at increased risk of damaging the skin on their feet due to a complication called Diabetic Peripheral Neuropathy. This is a condition in which the nerves of the feet (most commonly) are damaged due to a raised blood sugar level, and so sensation and pain is reduced. If this happens, patients may be unaware of damaged caused to the feet, from blisters caused by footwear, or knocks and bumps which may break the skin. As the pain is not felt, no steps are taken to protect the area, and the tissue damage become worse, potentially leading to infection.
So you see, the combination of Diabetic Peripheral Neuropathy and Peripheral Vascular Disease makes it important to take good care of your feet, to reduce the risk of developing a foot ulcer.
Other Contributing Risk Factors
There are other factors that may increase the risk of foot ulcers for diabetic patients. If someone has previously had an ulcer, there is an elevated chance of developing another, and naturally if a patient is prone to skin damage from minor cuts, corns or calluses then the likehood of an ulcer developing goes up. There is also a correlation between other complications of diabetes, such as eye or kidney problems, and the risk of ulcers. Men appear to be at greater risk than women.
The Good News
It’s not all doom and gloom. There are steps you can take to reduce the possibility of a foot ulcer developing.
- Attend regular check up appointments. Make sure your feet are examined at least annually, with attention paid to the sensation and circulation in your feet.
- Where possible, keep diabetes under control. This also applies to complications of diabetes, such as high blood pressure or cholesterol.
- If you smoke, stop.
- Pay attention to your feet – wash and dry them thoroughly, and check them daily for any changes, such as cuts or bruises. If in doubt about anything, see your doctor or chiropodist. If you have difficulty checking your own feet, ask someone to do it for you.
- Cut nails with care. Trim them straight across, echoing the shape of the toe. Don’t cut down the sides. If you can’t trim your own nails, get someone else to do it for you rather than risk damaging the skin.
- Don’t try to treat corns or calluses yourself. You may end up damaging the skin without realising, especially if you suffer from sensation loss. If you have dry skin on your feet, apply moisturising lotion (but do not rub moisturiser between the toes as this can cause skin to be excessively moist, and can cause infections).
- Do not walk without shoes or slippers, even at home.
- Wear well fitting shoes, and always wear socks with them to reduce the chance of them rubbing and leading to blisters.
- Try to avoid extremes of temperature and don’t sit with your feet too close to a fire, or hot water bottle.
If you look after your feet well, you have the best chance of avoiding complications, but if you do develop sores on your feet it is vital to be treated by a doctor. This is likely to involve having the wound dressed and padded, which will need to be changed regularly by a nurse. Occasionally a small operation is necessary to drain the ulcer of pus if a severe infection develops. You may also need antibiotics.
What can you do every day?
The easiest way to take care of your feet is by building a simple three step routine into your day, so remember:
- Check your feet thoroughly for marks, bruises or cuts
- Wash your feet well in warm soapy water and dry thoroughly
- Moisturise your feet with a lotion designed for dry skin, paying attention to any dry areas but avoiding between the toes.
Now, take the first step toward healthy feet.