DIABETIC FOOT CARE

Associated foot problems can occur when you have diabetes, it is important to ensure that you take proper care of your legs and feet.

In some diabetics this can lead to:

• Nerve damage in the feet and legs that may result in a loss of sensation, pins and needle or possible numbness and burning sensations. This is called neuropathy.
• If the blood supply to the feet and legs are reduced this will result in cold, painful feet.

Due to this injuries to the feet may go unnoticed, have slower healing time, and can become infected.

An annual review by your GP or at the Diabetic clinic is important so that any problems can be treated early on.

To prevent problems it is important to take care of your feet. The following information may help.

1. Wash your feet daily with a mild soap and luke warm water.
2. Dry feet thoroughly taking particular attention between toes, use a soft towel or tissue.
3. If your feet are moist and have sweaty skin apply surgical spirit between the toes with cotton wool.
4. If you have dry skin use moisturising cream but avoid between the toes.
5. When cutting the toenails, follow the curve but avoid digging in the corners and do not cut them too short.
6. Use nail clippers and then use a file to avoid sharp edges.
7. If you have thickened nails, problem nails or poor eyesight, consult a chiropodist/podiatrist.
8. Corns and callus should be dealt with by a chiropodist/podiatrist. Do not attempt to use razor blades, corn plasters etc. You can use a pumice stone to smooth hard skin and corns.
9. Choose shoes that have laces as they will hold your foot in place. Shoes are better with round toes and allow plenty of room for your toes.
10. Have feet measured when buying new shoes. It is better for you to gradually wear new shoes so that blisters and rub can be prevented.
11. It is important to always wear shoes and slippers especially indoors to protect your feet.
12. Wear socks or stockings that fit correctly and ensure that they are in good condition. Socks and tights should be changed daily.
13. Check your feet every day paying attention to the underneath of the feet and between the toes, you can use a mirror if needed.
14. What should you look for:
    • Cuts, scratches and blisters
    • Any change in colour (red, black, blue, white)
    • Any changes of temperature
    • Any discharge from a break or crack in the skin
    • Any painful areas and any unusual swelling
15. Check shoes inside and out before putting them on for any sharp edges, cracks or pebbles, as these may irritate the skin. If you have loss of sensation you may not feel this until it causes a problem.

FOOT CARE FOR THE ELDERLY

As an elderly patient, it is important that you pay special attention to your feet with regard to foot hygiene, the cutting of nails, the type of sock stockings/hosiery worn, type of shoe and other matters concerning the feet.
 

GENERAL CARE OF THE TOENAILS

Your nails should be attended to on a regular basis using a pair of ordinary nail clippers. The nails of the elderly are usually quite thick in many cases and therefore it would be best to do nail cutting after bath time as the nail would be much easier to cut. Nails should be cut making sure that you follow the length and shape of the toe so as to minimise damage to the nail during the regrowth stage. NEVER probe the nail groove or any part of the nail. Should you be experiencing any difficulty with your nails or should you suffer any pain or discomfort, consult your Practitioner for help and advice.
 

CORNS AND CALLUSES

It is important for the elderly patient to know that any corn or callus should be treated by a qualified Practitioner and that removal of these disorders should not be attempted by the patient. Equally NEVER use any corn cures as the medicaments in the preparations could have a serious effect on you.
 

HYGIENE

Your feet should be washed daily in tepid water using mild toilet soap. After washing, the feet should be carefully rinsed in plain water and properly dried, paying special attention to between the toes.
If you have sweaty feet normally, then clean the feet, dry them and apply talcum powder. If you suffer from dry feet, then use of a cream will help to maintain the feet. It is important that you change to a clean pair of socks/stockings every day.
 

HEAT AND COLD

Due to age the elderly in many cases have problems with circulation and because of this you should avoid very hot baths, electric blankets should be turned off at bedtime and you should not sit too close to fireplaces or heaters.
 

FOOTWEAR

Shoes must be chose carefully. It is best to have lace–up and soft-upper shoes so that your feet will be held firmly during walking. To be sure that shoes are suited to your feet, test walk on a solid area of the store NOT ON THE CARPETED FLOOR.
It is best to have your feet measured when buying shoes. Feet must be measured standing, as this is when the true size is known.
 

FIRST-AID

If any minor injuries should happen to you (e.g. cuts, bruises) clean the area and apply a mild antiseptic cream (e.g. savlon). DO NOT apply adhesive strappings directly to the area or wrap the strapping around toes, as this will restrict circulation.
Blisters on the feet should be left alone and should not be punctured (pricked) to release the fluid but should be left to dry up on their own. Should they open of their own accord and discharge their contents dress with an antiseptic dressing.
It will be necessary to visit your Practitioner or G.P. if the injury is not responding to the treatment.
 

UNHEALTHY FEET

If you notice discharge coming from a break in the skin, from a nail or corn it is important that you visit your Practitioner.
If there is pain, itching, swelling or colour in the changes in the feet or legs, visit the Practitioner.