DIABETIC FOOT CARE – PATIENT INSTRUCTION LEAFLET

Most foot problems that people with diabetes face, arise from two serious complications of the disease: nerve damage and poor blood circulation. The lack of sensation and poor blood flow can allow a small blister to progress to a serious infection in a matter of days.Chronic nerve damage (neuropathy) can cause dry and cracked skin, which provides an opportunity for bacteria to enter and cause infection. The consequences can range from hospitalization to amputation of a toe or foot.

General Care

Never walk barefoot, indoor or outdoor.
Wash your feet every day with mild soap and warm water. Test the water temperature with your elbow first.
Do not soak your feet.
When drying them, pat each foot with a towel rather than rubbing vigorously. Be careful drying between your toes.
Trim your toe nails straight across. Avoid cutting the corners. Good nail care is important in preventing infections.
Apply thin coat of lotion to keep the skin of your feet soft and moist. This prevents dry skin cracks and decreases the risk of infection. Do not put lotion between the toes.
Always keep your feet warm. Wear loose socks to bed if needed.
Avoid sitting in same position for long stretch.
Don’t try to remove corns or calluses.
Do not use antiseptic solutions, drugstore medications, heating pads, or sharp instruments on your feet. Do not put your feet near radiators or in front of the fireplace.
Do NOT smoke.
Get periodic foot exams from a physician to prevent complications. They can reduce risk of amputation by 45% to 85%.

A Step Each Day Can Help Keep Problems At Bay

Keep the blood flowing to your feet. Wiggle your toes and move your ankles for five minutes, two to three times a day.
Shake out your shoes and feel for objects inside before wearing. You may not feel a small foreign object when your shoe is on your foot.
Regular Low Impact Exercises such as walking, or swimming.
Maintain healthy blood sugar levels. Out-of-control blood sugar levels can lead to faster nerve cell damage.
Inform your doctor immediately if you suspect swelling, change in shape, color or temperature, pain, burning sensation, loss of sensation or presence of any wound, blister or change in nail color.

Inspection

Inspect your feet every day.
Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts, and nail problems.
Get help of someone, or use a mirror if you are unable to do it. You may not feel that damage has occurred to the skin.
Look at and feel each foot for swelling.
Examine the bottom of your feet and toes. Check the six major locations on the bottom of each foot:
1)The tip of the big toe.
2)The heel.
3)The base of the little toes.
4)The outside edge of the foot.
5)The base of the middle toes.
6)Across the ball of the foot

Shoe Wear

Choose and wear your shoes carefully. A poor fitting shoe can cause an ulcer and lead to an infection.
Buy new shoes in the evening when your feet are larger. Buy shoes that are comfortable.
Check how your shoe fits in width, length, back, bottom of heel, and sole. Have your feet measured every time you buy new shoes. Your foot will change shape over the years and you may not be the same shoe size you were 5 years ago.
Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes.
Wear new shoes for only 2 hours or less at a time. Gradually increase your wearing time. Always inspect foot after use for signs of redness or injury.
Do not wear the same pair every day. Let it dry.
Do not lace your shoes too tightly or loosely.
Always wear clean pair of socks or stockings with shoe.
Avoid long walks without taking a break, removing your shoes and socks and checking for signs of pressure (redness) or ulcers.
If you are suffering from ulcers, Charcot’s joints or have foot abnormalities, your doctor will prescribe you modifications or special type of footwear.
Keep shoe and insoles in good repair.
Do not wear tight socks or socks constricting at the top.
Do not wear sandals with thongs between the toe.