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Diabetes is a disease that affects many different parts of the body, including the feet. The podiatric physician, as an integral part of the diabetic treatment team, has documented success in the prevention of amputations, one of the most serious conditions
of diabetes. The key to amputation prevention in diabetic patients is early recognition and treatment of foot problems and regular foot screenings, at least annually, from a podiatric physician. In addition to these check ups, there are warning signs that you should be aware of so that they may be identified and called to the attention of the family physician or podiatrist. These warning signs include:
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Skin color changes
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Elevation in skin temperature
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Swelling of the foot or ankle
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Pain in the legs
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Open sores on the feet that are slow to heal
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Ingrown and fungal toenails
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Bleeding corns and calluses
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Dry cracks in the skin, especially around the heel
 Foot Ulcers
Ulcer formation is a common occurrence with the diabetic foot, and should be carefully treated and monitored by a podiatrist to avoid amputations. Poorly fitted shoes, friction rubbing, or pressure from a stocking seam, can create a foot wound that may not be felt by someone whose level of skin sensation is diminished, such
as a diabetic patient. If left untreated, such foot ulcers can quickly become infected and lead to more serious complications. Your podiatric physician knows how to treat and prevent these wounds and can be an important factor in keeping your feet healthy and strong. New products are available for the podiatric physician to use in the treatment of foot ulcers or wounds to achieve healing.
Diabetic Foot Care
Tips for Healthy Feet:
Wash feet daily; using mild soap and lukewarm water, wash your feet in the mornings or before bed each evening. Dry carefully with a soft towel, especially between the toes, and dust your feet with talcum powder to wick away moisture. If the skin is dry, use a good moisturizing cream daily, but avoid getting it between the toes.
Inspect feet and toes daily; check your feet every day for cuts, bruises, sores or other changes that may be less obvious. If age or other factors hamper self-inspection, ask someone to help you or use a mirror to see your feet.
Lose weight or maintain a weight appropriate for your age and height; people with diabetes are commonly overweight, which nearly doubles the risk of complications.
Wear thick, soft socks; socks made of an acrylic blend are well suited, but avoid mended socks or those with seams, which could rub to cause blisters or other skin injuries.
Give up smoking; tobacco can contribute to circulatory problems, which can be especially troublesome in patients with diabetes.
Cut toenails straight across; never cut toenails into the corners, or taper, which could trigger an ingrown toenail. Use an emery board to gently file away sharp corners or snags.
Exercise regularly; as a means to keep weight down and improve circulation, walking is one of the best all-around exercises for the diabetic patient. Walking is also an excellent conditioner for your feet. Be sure to wear appropriate athletic shoes when exercising. Ask your podiatric physician what’s best for you.
See your podiatric physician; regular checkups by your podiatric physician, at least annually, are the best way to ensure that your feet remain healthy.
Be properly measured and fitted every time you buy new shoes; shoes are of supreme importance to diabetic patients because poorly fitted shoes are involved in as many as half of the problems that lead to amputations. Because foot size and shape may change over time, have feet measured by an experienced shoe fitter whenever buying a new pair of shoes.
New shoes should be comfortable at the time they’re purchased and should not require a "break-in" period, though it’s a good idea to wear them for short periods of time at first. Shoes should have leather or canvas uppers, fit both the length and width of the foot, leave room for toes to wiggle freely, and be cushioned and sturdy.
Avoid Unhealthy Feet:
DON'T . . . Go barefoot. not even in your own home. Barefoot walking outside is particularly dangerous because of the possibility of cuts, falls, and other foot injuries on unfamiliar terrain. When at home, wear slippers. Never go barefoot.
DON'T . . . Wear high heels, sandals, and shoes with pointed toes. These types of footwear can put undue pressure on parts of the foot and contribute to bone and joint disorders, as well as diabetic ulcers. In addition, open toed shoes and sandals with straps between the first two toes should also be avoided.
DON'T . . . Drink in excess. Alcohol can contribute to neuropathy (nerve damage) which is one of the consequences of diabetes. Drinking can speed up the damage associated with the disease, deaden more nerves, and increase the possibility of overlooking a seemingly minor cut or injury.
DON'T . . . Wear anything that is too tight around the legs. Panty hose, panty girdles, thigh-highs or knee-highs, and men's dress socks (if the elastic is too tight) can constrict circulation to your legs and feet.
DON'T . . . Never try to remove calluses, corns or warts by yourself. Commercial, over-the-counter preparations that remove warts or corns should be avoided because they can burn the skin and cause irreplaceable damage to the foot of a diabetic sufferer. Never try to cut calluses with a razor blade or any other instrument because the risk of cutting yourself is too high, and such wounds can often lead to more serious ulcers and lacerations. See your podiatric physician for assistance in these cases.
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