FOOTCARE

FOOTCARE:
NO FEAT TOO HARD

Tye LeeTze, a podiatrist from The Podiatry Centre, lays down the bare facts on how diabetes can hurt the feet and highlights I 0 simple steps to protect your feet.

Diabetes is possibly the most damaging disease to one's feet. A person with diabetes is more susceptible to foot lesions because of high blood glucose. High blood glucose can cause two problems that can hurt your feet.

Nerve Damage: One problem is damage to nerves in your legs and feet. With damaged nerves, you might not feel pain, heat, or cold in your legs and feet. A sore or cut on your foot may get worse because you do not know it is there. This lack of feeling is caused by nerve damage, which is also called diabetic neuropathy (ne-ROP-uh-thee).

Poor Blood Flow: The second problem happens when not enough blood flows to your legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral (puh-RlF-uh-rul) vascular disease. Smoking when you have diabetes worsens blood flow problems.

Take off your shoes and socks so your doctor will check your feet

These two problems can work together to cause a foot problem. For example, you get a blister from shoes that do not fit. You do not feel the pain from the blister because you have nerve damage in your foot. Next, the blister gets infected. Poor blood flow to your legs and feet can slow down healing. If the infection spreads,this may lead to gangrene (GANG-green), If a person has gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

To keep gangrene from spreading, a doctor may have to do surgery to cut off a toe, foot, or part of a leg. Cutting off a body part is called an amputation (amp-yoo-TAY-shun).

10 Steps to Preventive Care

Wash your feet every day. Make sure the water is not too hot by testing the temperature with your elbow. Do not soak your feet. Dry your feet well, especially between your toes by pat drying, not rubbing.

Look at your feet every day to check for cuts, sores, blisters, redness, calluses, or other problems. Checking every day is even more important if you have nerve damage or poor blood flow. If you cannot bend over or pull your feet up to check them, use a mirror. If you cannot see well, ask someone else to check your feet.

A mono filament is used to check for neuropathy or lack of sensation

Make it a daily routine, like brushing your teeth. We all know what happens if you do not brush your teeth twice a day.

Problems will certainly arise, so check your feet everyday.

If your skin is dry, apply lotion on your feet after you wash and dry them. Do not put lotion or powder between your toes.

Do not cut or use commercial corn plasters for corns and calluses. Seek your podiatrist's help.

Cut your toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board.

Never walk barefoot even in your own home.
Always wear shoes to protect your feet from injuries.
Always wear socks or stockings to avoid blisters. Do not wear socks or knee-high stockings that are too tight below your knee.
Wear shoes that fit well. Shop for shoes at the end of the day when your feet are bigger. Break into shoes slowly. Wear them one to two hours each day for the first one to two weeks.
Before putting your shoes on, feel the insides to make sure they have no sharp edges or objects that might injure your feet.

TAKE OFF your shoes and socks so your doctor will check your feet.

Tell, Ask, Seek, Knock (TASK)

• Tell your doctor right away about any foot problems.

• Ask your doctor to look at your feet at each diabetes checkup. To make sure your doctor checks your feet, take off your shoes and socks before your doctor comes into the room.

• Ask your doctor to check how well the nerves in your feet sense feeling.

• Ask your doctor to check how well blood is flowing to your legs and feet.

• Ask your doctor to show you the best way to trim your toenails. Ask what lotion or cream to use on your legs and feet.

• If you cannot cut your toenails or you have a foot problem, seek a foot doctor. A doctor who cares for feet is called a podiatrist (puh-DY-uh-trist). Your doctor can send you one or can send you to one.

• Knock on your podiatrist's door. Have a foot check-up every six months.

Common Foot Problems That Affect People With Diabetes

Anyone can have corns, blisters, and athlete's foot. If you have diabetes and your blood glucose stays high, these foot problems can lead to infections.

Corns and calluses are thick layers of skin caused by too much rubbing or pressure on the same spot. Corns and calluses can become infected if not treated properly.

Blisters can form if shoes always rub the same spot. Wearing shoes that do not fit or wearing shoes without socks can cause blisters. Blisters can become infected.

Ingrown toenails happen when an edge of the nail grows into the skin. The skin can get red and infected. Ingrown toenails can happen if you cut the corners of your toenails when you trim them. If toenail edges are sharp, smooth them with an emery board. You can also get an ingrown toenail if your shoes are too tight.

Dry and cracked skin can happen because the nerves in your legs and feet do not get the message to keep your skin soft and moist.

Athlete's foot (Singapore foot) is a fungus that causes redness and cracking of the skin. It is itchy. The cracks between the toes can be an entry point for infection.

All of these foot problems can be taken care of. Tell your doctor or podiatrist about any foot problem as soon as you see it. Do not `wait a few days to see what happens'. Those few days may present a huge difference between a good and dreadful outcome. The sooner the treatment begins, the better.

FOOTNOTE

Up to 70% of all leg amputations happen to people with diabetes

In developed countries, up to five per cent of people with diabetes have a foot problem.
Foot problems are the most common cause of admission to hospital for people with diabetes.
Most amputations begin with a foot ulcer.