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Sunday, April 27, 2008

Diabetic Footcare Handout

I will be posting healthcare educational handouts for NPs to give to their patients from time to time. Feel free to distribute them to others!
Diabetic Foot Care Information
People with diabetes experience higher than normal blood glucose
levels, which can affect the heart, eyes, kidneys and feet. This
handout focuses on why it is especially important that you take
proper care of your feet if you have diabetes.
Two Reasons for Foot Problems
One factor contributing to foot problems in diabetes is nerve
damage, which causes a lack of sensation in your feet. As a result,
you might not feel pain, heat or cold. A minor cut on your foot could
get infected, and you might not even notice.
Another problem you might have is decreased circulation, which
means that less blood flows to your feet, making it harder for
wounds to heal.
Common Foot Problems
If you have diabetes, you’re at greater risk for foot problems that
can lead to infection:
• corns and calluses caused by rubbing or pressure on the same
spot, forming thick layers of skin
• blisters caused by shoes that do not fit properly or by wearing
shoes without socks
• ingrown toenails, which are toenail edges that have grown into
the skin
• dry and cracked skin, caused when nerves in the legs and feet
do not receive the message to keep the feet soft and moist; germs
can then enter through the cracks
• athlete’s foot (caused by a fungus), leading to red, cracked and
itchy skin and thick, yellow and hard-to-cut toenails.
How to Care for Your Feet
Wash your feet every day using warm water and a mild soap.
Use your elbow or a thermometer to check the temperature of the
water — lack of sensation in your feet may prevent you from feeling
when water is too hot. Pat your feet dry with a soft towel.
If the skin on your feet is dry and cracked, use a moisturizing
cream. Check with your nurse practitioner about which kind to use.
Never put the cream between your toes, since this could create an
atmosphere for infection.
Inspect your feet every day for problems. You might need to use
a mirror or enlist the help of someone you trust. Do not try to treat
any foot problems with home remedies.
You may file corns or calluses lightly with a pumice stone or
emery board if your NP says it’s OK. Also, cut your toenails when
needed after you wash your feet, since the toenails will be soft at
that time. Trim straight across, and do not cut them too short. If
your toenails are thick or too hard to cut, your NP can help you.
Wear shoes all the time to avoid irritations that could worsen or
become infected. Do not leave your feet exposed by going barefoot
or wearing sandals. Even at home, you should at least wear hardsoled
slippers. Wear surf shoes at the beach, and remember to
apply sunscreen to the tops of your feet when you are outside to
avoid burns.
Finally, if you smoke, stop immediately. Smoking damages blood
vessels, decreasing circulation to the feet.
The Right Shoes and Socks
Poorly fitting shoes can cause injury or irritation. Buy shoes that
fit correctly — you should be able to wiggle your toes in them.
Avoid plastic shoes since they don’t stretch and your feet cannot
breathe. Instead, choose leather or canvas shoes to support your
feet and let air in and out.
Break in your new shoes gradually. In addition, inspect each shoe
every day before you insert your foot. Make sure there are no torn
linings or foreign objects, such as a tack or a pebble.
Always wear cotton or wool socks with your shoes to avoid blisters.
Socks should fit loosely and leave no marks on your skin.
Stockings can also be worn. Make sure they are not too tight — they
shouldn’t leave marks on your skin, either. In some cases, you may
need inserts or even custom shoes to help with your foot problems.
Avoid the Worst-Case Scenario
Schedule a visit with your NP if you are having a problem with
your feet that won’t go away. If you avoid treating the problems,
your feet could become infected, and poor blood flow could slow
the healing process. Make sure you get your feet treated so that you
can avoid severe complications such as amputation.
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