Advice for Diabetics
The advice given here applies to diabetics and anyone who has compromised circulation, immunity or neuropathy.
Why do diabetics have to take care of their feet?
Diabetes can be present without any obvious foot complaints however, diabetics should be aware of the possible slow onset of the following:
1. Poor blood supply.
Diabetics are 20 times more likely to suffer from poor circulation than non-diabetics. This reduced blood supply leads to slow healing of damage to the skin and other tissues.
2. Lack of sensation (neuropathy).
This may be a mild tingling in the toes or a feeling of numbness. Severe neuropathy results in a complete loss of pain and temperature sensations. The result being that injury goes unnoticed.
3. Increased risk of infection.
High sugar levels in the blood and a diminished blood supply means that some diabetics are more susceptible to infection, which also delays healing.
4. Poor eyesight.
Due to poor circulation poor eyesight can result in diabetics not being able to see their feet.
Prevention is better than cure!
The risk of getting any of the problems listed above can be reduced by a good healthy diet, exercise and giving up smoking. It is important for all diabetics to control their diabetes, keeping the blood glucose levels stable.
Taking careDon’ts
- Never use sharp instruments.
- Never use medicated products to remove hard skin and corns.
- Do not soak feet.
- Never use ingrowing toenail liquid.
- Never cut down the sides of your toenails.
- Avoid going barefoot
- Avoid tight shoes and socks
- Do not use talc
- Avoid extremes of temperature.
Do’s
- Make an appointment to see a State Registered Podiatrist. Diabetics are generally entitled to see a Podiatrist on the NHS for annual foot checks, however more specialised Podiatry is only available in some NHS trusts.
- Get into the habit of checking your feet on a daily basis. If you are unable to see the soles of your feet get a mirror to help you. If you notice any changes in the skin such as colour, leaking and swelling or you are experiencing pain then see a podiatrist or doctor.
- Check inside shoes and socks for anything that might rub or cut your feet. It’s amazing how drawing pins gravitate towards the shoes of diabetics.
- Check bath water temperature.
- Wash your feet daily in warm soapy water. Remember to dry thoroughly especially between the toes.
- Change socks or tights daily. Do not wear any that are tight or have a thick seam.
- Apply moisturising cream to dry skin, and rub a pumice gently over hard skin.
- Cut toe nails following the line of the toe rounding off the corners with a file. Do not cut them too short or down the sides.
- For sweaty feet use surgical spirit. Apply with cotton wool especially between the toes. This will prevent athletes foot.
- Keep feet at a constant temperature. Wear good fitting shoes and thick socks in the winter.
- When buying shoes have your feet measured. Buy shoes in the afternoon, as your feet can swell during the day.
- Shoes should have some support in them e.g. some fastening, a lace or a buckle.
- Leather uppers are best as they allow the feet to breath and the shoes will conform to the foot.
- New shoes should be broken in and feet should be inspected for signs of rubbing.
Always consult either a State Registered Podiatrist or Doctor, if concerned.
How can Podiatric Biomechanics Help?
A Podiatric Biomechanics Specialist can help to determine which areas of the feet are being subjected to too much pressure and friction due to poor foot function. Some 80% of us have some degree of biomechanical dysfunction, diabetics have to take extra care that poor foot function doesn’t lead to hard skin and ulceration. The use of physical therapies such as stretching, exercise and orthoses can help to improve foot function and redistribute pressure from at risk pressure spots. Orthoses are tailor made shoe inserts that are either functional in that they help the foot support itself or accommodative in that they support the foot. For functional foot orthoses I generally use RX Laboratories ( www.RXLabs.com) who manufacture the orthoses according to my prescription made biomechanical data and a plaster cast of the feet.