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Diabetic Foot Care

GENERAL INFORMATION:

What is diabetic foot care?

• Diabetes (di-uh-be-tees) is a disease that changes the way your body uses the sugar found in food. Without the right treatment, the sugar level in your blood may go very high or very low. This can cause many problems with your health. Diabetes causes problems with blood circulation and makes you more likely to get infections (in-fek-shuns). Diabetes can also cause nerve problems so you may not have good feeling in your legs and feet.
  
  
• Diabetes may also make your feet very dry, and change their shape. Over half of all diabetics have foot problems. These problems may be sores called ulcers (ull-sirs) that may not heal fully. It is very important that you take special care of your feet if you are diabetic. If you do not get treatment for foot problems right away, you may need to have surgery.

What causes diabetic foot problems? Problems with being diabetic (di-a-bet-ick) often lead to problems with your feet. These problems include:

• Blood vessel changes, causing decreased blood flow to your feet.
  
  
• Nerve problems causing a decreased sense of feeling of pain and pressure in your feet.
  
  
• Increased dryness and cracks in your skin.
  
  
• Decreased ability to fight infection.
  
  
• Poor wound healing.

What are the signs and symptoms of foot problems?

• Feet that are cold and blue or black in color.
  
  
• Feet that are warm and red in color.
  
  
• Foot swelling.
  
  
• Weak pulses (heartbeats) in your feet.
  
  
• Not feeling pain although there is a cut or sore on your foot.
  
  
• Pain in your feet when you are resting or active.
  
  
• Shiny smooth skin of the feet and lower legs.

What can I do to avoid having problems with my feet?

• Daily Foot Care: Check and wash your feet carefully every day.
  
  
• Appointments: Keep all appointments with your caregiver.
  
  
• Blood Sugar Control: Have good control of your blood pressure and blood sugar. Take your medicines as ordered, and ask your caregiver about diet changes. Follow an exercise program that is set up by your caregiver. Exercise helps increase blood flow to your feet.
  
  
• Footwear: Do not wear shoes that are too small, or socks that do not fit right inside your shoes. Remove your shoes and socks when you see your caregivers. This will remind them to check your feet.
  
  
• Nail Care: Before cutting your toenails, soak your feet in warm soapy water for 10 minutes to soften the toenails. Trim your toenails straight across to prevent ingrown toenails, or just file them down. Do not cut into the corners or close to the skin. You should not dig under or around the nail.
  
  
• Safety: Do not use a razor, knife, or corn medicine to remove corns, calluses or warts. Talk to your caregiver if you have corns, calluses or warts. They can decide the best treatment for them. Wear shoes or sandals if you are in a public changing area or shower, and never walk barefoot.
  
  
• Smoking: If you smoke, you should quit. Join a stop smoking program to help you quit.

What tests may be used to check my feet for problems?

• Monofilament (mon-o-fill-a-mint) Test: This test checks your ability to feel things touching your feet, like a feather or a pin.
  
  
• Thermal Sensation Testing: This test checks your ability to feel heat on your feet.
  
  
• Arterial doppler: An arterial doppler test is done to check blood flow through an artery. A small metal disc with gel on it is placed on your skin over the artery. You can hear a "whooshing" sound when the blood is flowing through the artery. An "X" may be marked on your skin where caregivers feel or hear the blood flowing best. Caregivers may need to check blood flow more than once.

What may caregivers do to treat ulcers or other problems with my feet? Your treatment depends on how well your are able to control your diabetes. It also depends on whether you have ulcers or other wounds on your feet, and how big they are. If you have an infection in your feet, that may also change your treatment.

• Amputation: Removal of all or part of a limb if the limb has died. You may have this because of an infection, or because the area cannot be fixed with surgery.
  
  
• Debridement (de-breed-mint): Removing dead skin from a wound.
  
  
• Electrical stimulation: A machine that increases the activity of the muscles and nerves in an area.
  
  
• Living skin: This is artificial (r-ti-fish-ull) skin that is put over areas where skin is dead or removed.
  
  
• Medicines:
  
  
  • Anti-microbial therapy: This medicine destroys or prevents growth of germs that cause infection.
    
    
  • Aspirin: This is medicine that may be given to help thin the blood to keep blood clots from forming.
    
    
  • Growth factors: This is medicine that is applied onto the skin to help heal diabetic foot ulcers.
  
  
• Revascularization (re-vas-q-ler-i-za-shun): This is surgery to make or repair blood vessels to get blood circulation back into an area.

Medical Alert Bracelet or Necklace: Make sure you wear a medical alert bracelet or necklace that says you have diabetes. You may get one from your local drugstore or contact the MedicAlert Foundation listed below:

• MedicAlert Foundation
  2323 Colorado Avenue
  Turlock, CA 95382
  Phone: 1-888-633-4298
  Web Address: http://www.medicalert.org
  

Support:

• Diabetes is a life-changing disease for you and your family. Accepting that you have diabetes is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person with diabetes.
  
  
• Ask your caregiver if there are any foot clinics for diabetics in your area. These clinics teach you how to care for your feet. You may contact one of the following organizations for more information:

• American Diabetes Association
  1701 North Beauregard Street
  Alexandria, VA 22311
  Phone: 1-800-342-2383
  Web Address: http://www.diabetes.org
  

• National Diabetes Information Clearinghouse
  1 Information Way
  Bethesda, MD 20892-3560
  Phone: 1-800-860-8747
  Web Address: www.diabetes.niddk.nih.gov/
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how to treat it. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

References and sources