THE IMPORTANCE OF FOOT-CARE IN DIABETES

By: Sara John, C.Ped (C)., C.Ped Tech (C)

Foot problems are one of the leading causes of hospitalization of people with diabetes. Out of a good number of people living with diabetes, a per cent get affected with infections and ulcerations, and will be at risk of losing a lower limb or foot through amputation.

Regular foot inspection and care along with appropriately fitted footwear can prevent foot complications. Inspect it personally or get it inspected by a family member for any redness, swelling, bumps, blister or broken skin.

Ingrown toe nails can lead to infection. To prevent it, cut the toenails square, leaving a bit of nail over the toe. Dryness, peeling and cracks in the heels have to be attended to as they are another route for bacteria to enter and cause infection.

Inspect shoes daily to make sure that there are no stones or foreign objects embedded which can cause irritation to the skin. Examine the top, heel and toe of the shoes for any seams, damage or wearing out. Damage to the shoe changes the fit and can lead to a bad sore which can easily develop into a sore or blister.

Neuropathy, which is the loss of sensation in the foot, is the key reason why persons with diabetes develop foot wounds.  If someone cannot feel an injury to the foot, they keep walking on the damaged tissues, creating a break in the skin, thus leading to the start and spread of infection. Decreased circulation known as peripheral vascular disease can lead to delayed wound healing which further worsens the situation. Lack of sensation and pain results in non -detection of blisters or infection ultimately resulting in ulcers.

Talk to your doctor and visit a Canadian Certified Pedorthist for pedorthic evaluation and management including orthopaedic footwear, shoe selection guidance and orthotics. Pedorthists are one of the few healthcare professionals educated and trained to assess, modify, design and fit footwear and foot orthotics. They are trained to troubleshoot shoe fitting issues for diabetic patients and help reduce risk of amputation.

Foot care and shoe-fitting tips for people with diabetes:

1. Inspect your foot daily for any redness, blister, broken skin, bleeding, bumps or callus. If you notice any of this, visit your physician.
2. Inspect your shoes daily to make sure that there are no stones or foreign objects are embedded which can cause irritation to the skin.
3. Keep your feet clean and dry. Wash with soap and water, but do not soak them.
4. Attend to peeling and cracks in the heels to avoid infection.
5. Cut your toe nails square leaving a bit of nail over the skin to avoid ingrown toe nails.
6. Have your feet protected at all times to avoid injury– use indoor and outdoor footwear.
7. Wear seamless moisture-wicking socks. Seams can cause irritation of skin leading to redness, blisters and ulcer.
8. Footwear should have soft uppers with minimal seams, cushioned but firm soles, strong heel, rockered sole and removable liners. Have shoes fitted by a trained specialist such as Canadian Certified Pedorthist.
9. Custom made orthotics can be fabricated to offload the risk areas of the foot.