Diabetic Foot Care

According to the International Diabetes Federation, every 10 seconds, 2 people are diagnosed with diabetes somewhere in the world.  The Federation goes on to state that with the current trend, more people will have diabetes in 2025 than the current population of the US, Canada and Australia combined.

Definitions to Know

Type 1 diabetes:  accounts for 5%-10% of diabetes and usually occurs in childhood or adolescence.  Treatment is by insulin, meal planning and monitoring of blood glucose.

Type 2 diabetes:  accounts for 80% – 90% of all diabetes and usually develops after age 30, although now it is seen in childhood. Treatment is by weight loss, exercise, oral hypoglycemic medications and may require insulin.  Blood glucose monitoring is also necessary.

Microangiopathy/Macroangiopathy:  Damage to small and large blood vessels.  Resulting circulatory deficits will affect the heart, eyes, kidneys and lower limbs.

Neuropathy:  Damage to the nerves of the feet and lower limbs.  Indications of neuropathy include tingling, burning, or numbness.  There is also a loss of sensation to the feet making it difficult to feel pain.

How the feet are affected

Skin:  Circulatory changes often result in dry, fragile skin that is easily irritated.  Athlete’s foot, a.k.a. tinea pedis, is common in diabetes because poor circulation in the feet causes impaired ability to fight fungal infection.  Corns and callouses must be carefully reduced because they can cause additional pressure to underlying tissues.

Nails:  Impaired circulation also causes changes to the nail.  Diabetic clients are concerned with thickened, fungal, brittle nails.

Sensation:  Neuropathy (see above) which is caused by microangiopathy and macroangiopathy (see above) results in a decreased ability to feel sensations such as pain, heat, cold.  This is a concern because the diabetic client may not be aware of cuts or other open areas on the bottom of their feet.  These areas can become infected and lead to gangrene if they are not treated in time.  An inability to feel heat may cause burns to the feet.  Similarly, the inability to feel cold may result in frostbite.

Simple Tips for Maintaining Foot Health

  • Control blood glucose optimally 4 – 7 mmol/L by following a proper diet, medication and regular, gentle exercise.
  • If you’re a smoker, take measures to stop smoking.
  • Inspect your feet twice a day for blisters, redness, cuts, cracks between the toes.  If needed, have someone else check your feet.  Use a hand-held mirror to check the bottom of the feet.
  • If you notice any changes in the condition of your feet, see your doctor.
  • Avoid medicated corn and callous pads because the medication can cause a chemical burn.
  • Avoid direct heat from hot water bottles and heating pads.
  • Avoid walking barefoot, even in the house.
  • Always wear breathable, absorbent socks inside properly fitted shoes.
  • Try some of the varied styles of diabetic socks that are available.
  • If clipping your own toenails, clip straight across to prevent ingrown toenails.
  • Wash feet daily using warm, not hot, water.  Test the water temperature using your inner forearm.
  • Limit foot soaks to 10 minutes, 3 times per week to avoid over – drying the skin.
  • Dry feet thoroughly, especially between toes.  Bacteria breed in warm, moist spaces between the toes.
  • Moisturize the feet daily using a rich emollient moisturizer.  Be careful to avoid moisturizer between the toes.
  • Maintain regular foot care home visits by a qualified foot care nurse.

At McDermott Footcare, diabetic clients are managed carefully.   The first assessment includes a Diabetic Foot Screening using the Medical Monofilament Sensory Testing Screening Tool.  During subsequent visits, any changes to the condition of the feet are noted and a proper course of action is implemented, including a medical referral if needed.

As per all services delivered by McDermott Footcare, toenails are clipped and filed, corns and callouses are reduced, and skin care is given.  Footwear is inspected and clients are given instructions for purchasing proper footwear and diabetic socks.  As well, recommendations are given for moisturizer and easy to follow treatments for uncomplicated athlete’s foot.

Foot health is an important part of diabetic management.  Knowledgeable self-care, proper medical treatment and regular nursing foot care visits will keep your feet healthy.

Copyright Terry McDermott. May not be reproduced in whole or in part without permission of author

5 thoughts on “Diabetic Foot Care

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