Diabetic Foot Care
Introduction
Diabetes Mellitus can cause foot problems by causing damage to the nerves and restricting the blood supply to the feet.
This means that:
- Healing may be much slower than normal
- Infection can occur easily and not treated promptly, can spread very quickly
- Feet may be numb and foot problems or injuries to feet may go unnoticed
- Remember that even if foot problems are painless they can still be serious
Daily Foot care
- You should wash your feet daily in warm soapy water
- Test the water temperature with an elbow to avoid scalding accidents
- It is important to dry your feet well particularly between your toes
- Use oil or lotion to keep your skin soft
- Examine your feet daily, check them for signs of discharge, inflammation, cracks blister
- A mirror can be useful in examining your feet, if this is difficult, seek help from someone else
- Wearing socks can help to prevent injury. Make sure they are not too tight and wash them daily
- Always protect your feet, by wearing suitable footwear inside and outside your home to avoid injuring your feet
- Cut toe nails straight across and file any sharp edges
- Keep any wounds covered with clean dressing
- Have your feet checked periodically by a healthcare professionals
Foot wear
- Wear shoes that fit properly and provide adequate support
- Avoid pressure on your feet and rarely provide adequate support
- When buying shoes, always ask for your feet to be measured
- Keep feet warm and dry in cold weather
- Buy new shoes late in the day. This is because feet become swollen towards the end of the day and you can be more sure that your shoes are not too tight and feet well
Things to Avoid
- Avoid extreme temperatures
- Do not burst blisters but seek help from your podiatrist
- Do not warm feet on radiators or with hot water bottles
- Never pick or try to clean the sides of the nail with sharp instruments
- Do not wear tight socks
- Never try to treat your own feet with corn medicines or razor blades. Always seek help from a professional if you have a problem
- Do not smoke , it damages the supply of blood to the feet
Foot complication associated with Diabetes
Neuropathy:
One of the early changes can be loss of sensation in your feet, often starting at the toes. This is known as peripheral neuropathy. This can be gradual and first can go unnoticed. That why it is important that you receive an annual diabetic foot assessment by a diabetes specialist.
Painful Neuropathy:
Very occasionally pain or a burning sensation may accompany loss of feeling
Foot deformity:
Due to nerve and circulation problems, the shape of your toes and feet may change, causing clawing of toes, excess pressure under the sole of your feet.
Ischeamic Foot: (Poor Blood Supply)
When the blood supply to the foot is poor, the situation becomes even worse. Healthy feet require oxygen and essential nutrients that are delivered by the blood. In people with diabetes, the supply is sometimes inadequate, and this slows wound healing. When the blood is severely reduced, the foot is at high risk of tissue damage and parts of the foot may become threatened. The tissue may decay, leading to part of the foot dying and turning black. This is called gangrene.
Ulceration:
Injuries are common in people with nerve damage because they have reduced pain to warn them of problems. Many ulcers are caused by pieces of grit, rough seams, and sharp objects. That why we advise people not to walk barefoot, because people step on sharp objects and increase the risk of severe injury.
Contact Details:
- Thandy Mali Diabetes Clinical Lead
- Linda Ernest Diabetes Specialist Podiatry
The Westminster Diabetes Centre
4b Maida Vale
London
W9 1SP
Tel: 020 7316 1200
Fax: 020 7316 1299
E-mail:Thandy.Mali@nhs.net
MAIN PODIATRY OFFICE:
Podiatry Services Westminster PCT
Health @ The Stowe
260 Harrow Road
London W2 5ES
Patient Enquiries Line 020 7316 6808
Fax 020 7316 6809
E-mail: PodiatryEnquiries@Westminster-pct.nhs.uk