I am a health care professional working in the diabetes education field. Foot care is one area that I spend a significant amount of time on when I talk to my clients with diabetes. Sometime this advice comes too late and I have seen far too many people in my practice develop diabetic foot ulcers.

Foot ulcers occur in approximately 15% of people living with diabetes. Diabetic foot ulcer related amputations account for 50 - 60% of all non-traumatic lower-limb amputation. This article is one of a series of articles educating people living with diabetes.

So you are a diabetic and you have developed a foot ulcer. What is going to happen? What will your health care professional do to help you?

The goal of treatment is to prevent worsening of the ulcer and eliminate the potential for amputation. The plan is usually to treat the ulcer in its early stages, allow prompt healing of the ulcer and to prevent it from recurring in the future once it has healed. This is why it is so important to inform your health care provider right away if you notice any wound on your foot.

Upon initial examination, your health care professional will be determining the cause of your ulcer. Is it neuropathic, ischemic or a combination? Based on his or her assessment, the treatment plan to tackle the ulcer will be determined. Oftentimes, your physician will suggest having appropriate shoe modifications made to take the weight away from the area that has the ulcer. Some devices that are often used to keep pressure off the ulcer include total contact casts, removable cast walkers, or “half shoes. If your ulcer is draining it may have a dressing on to absorb the drainage.

It is important to keep the wound edges of your ulcer dry. If the edges remain moist over an extended period of time, it can cause further ulceration of the skin around the edges. Your ulcer will become larger. You may be placed on antibiotics if the wound is infected. The dressing change schedule is varied depending on the type of ulcer, the amount of drainage and the type of dressing being used.

If you develop a foot ulcer, it will be more important than ever to make sure your blood sugar levels remain in an acceptable range. Diabetics whose blood sugar levels remain high have a tendency to have foot ulcers that heal very slowly.

It is frightening to any person with diabetes when they develop a foot ulcer. They have heard of stories of other people who have ended up with amputations when the ulcer became badly infected. If you are worried, ask your health care provider about what you can do to help in healing your ulcer. If you need to, ask your health care provider about support systems out in the community that will help you to handle the fear if you are finding it hard to cope.

I hope that this article has been informative and has provided you with the information you were looking for. If you want more information, please call your health care provider.

Knowledge Is The Key

When you were first diagnosed with diabetes, were you given instruction on how to take care of your feet on a daily basis? Chances are that you were given limited information in this very important area. The most common reason is because you and your health care professional were mainly focused on getting your blood sugar down to an acceptable range. I am a health care professional working in the diabetes education field and foot care is one area that I really stress when I talk to my clients with diabetes.

Why?

Because I have seen the damaging effects of poor foot care. These damaging effects include chronic foot ulcers that can lead to disability and in some cases, amputation.

My goal is to educate as many people as I can about how to care for your feet. The more you know about foot care, the less chance you will have in developing foot ulcers now and in the future.

Let’s start with daily care.

One of the things that are important in diabetes foot care is that you have to do it on a daily basis. Whether it is when you first get up in the morning to take a bath or shower or whether it is in the evening. The important thing is that you need to do this EVERY DAY. Very much the same way that you are checking your blood sugar every day. It needs to become part of your daily routine.

Your Daily Foot Care Routine.

1. Wash your feet in warm (never hot) water, using a mild non-perfumed soap If you have diminished sensation in your hands and feet, you can use your elbow to test the temperature of the water or you can go out and get a bath thermometer. Never soak your feet, as this can dry your skin making it prone to crack.

2. While your feet are still wet, use a pumice stone to keep calluses under control making sure you don’t rub too hard.

3. Dry your feet carefully, especially between your toes. Some people whose feet perspire find comfort in applying a little powder in between the toes.

4. Thoroughly check your feet and between your toes on a daily basis to make sure there are no cuts, cracks, ingrown toenails, blisters, etc. If you are unable to easily inspect your feet, use a hand held mirror to see the bottom of your feet. If you are still having difficulty, ask someone else to check them for you.

5. Always clean cuts or scratches with mild soap and water, and cover with a dry dressing suitable for sensitive skin.

6. Trim your toenails straight across and file any sharp edges. Don’t cut the nails too short.

7. Apply lotion to your heels and soles, preferably lotion that does not have perfume in it. Wipe off any excess lotion that is not absorbed. Don’t put lotion between your toes, as the excessive moisture can promote infection.

8. Wear fresh clean socks and well-fitting shoes every day

I cannot stress it enough; your daily foot care routine along with managing your blood sugar will significantly make a difference between having a good quality of life vs. living with disability. Here are some other guidelines to ensure that your feet remain healthy. I call this my Do’s and Don’ts list.

Foot Care Do’s And Don’ts

Do wear well-fitting shoes. The shoes should be supportive, have low heels (less than 5 cm high) and should not rub or pinch your feet. It is a good idea to shop at a reputable store with knowledgeable staff that can professionally fit your shoes.

Do wear loose socks at night if your feet get cold.

Do elevate your feet when you are sitting.

Do wiggle your toes and move your ankles around for a few minutes several times a day.

Do exercise regularly to improve foot and leg circulation.

Do inspect your feet daily and in particular check for skin temperature differences between your feet.

Don’t wear high heels, pointed-toe shoes, sandals (open toe or open heel) or worn-out shoes.

Don’t wear anything tight around your legs, such as tight socks or knee-highs.

Don’t go barefoot, even indoors. Even if this means buying a pair of shoes for indoors and another pair for outdoors.

Don’t put hot water bottles or heating pads on your feet.

Don’t cross your legs for long periods of time.

Don’t smoke.

Don’t have pedicures by non-healthcare professionals.

I hope that this article has been informative and has provided you with good guidelines to take care of your feet. If you take these guidelines and use them on a daily basis, my goal will have been accomplished and you will have been given the opportunity to live your life to the fullest.

I’m sure that you are here to read this as you have had an alarming call from your body in the form of signs of diabetes. You must have been told that it was predictable as you have a genetic connection to diabetes by means of your parents. Is this statement enough to make you happier? Should you now grab your syringe and have an insulin injection and the rest of task would be handled by insulin itself?

No! I think you are not right; as here is the news that will turn your joy to thrill.

The simple addition of these foods that lower blood sugar level into your meal plan can make you a healthier and normal person. I can bet that you’ll end saying

Where is the sugar???

Grains: Generally grains are said to be best for diabetics. I love to eat oats. Better idea is to go in the super market. You’ll find various bins of different types of granola. Read the labels carefully and check the sugar content. There will be some as low as 4 gm. I’m sure the temptation is to grab the one with 20 gm; as you are suffering from sugar craving because of diabetes. This is the point where your concern for your adrenal glands and blood sugar level must kick in. This concern will definitely help you to pick the one with maximum 8 gm sugar.

Design the breakfast in such a way that it contains foods that lower blood sugar level. Better give your blood a rest from biscuits, pancakes, doughnuts, white bread and some other sugar laden foods.

Here is a nice idea for breakfast

Take 2 handfuls of granola and add it to the half cup of low fat yogurt and ? cup of skimmed milk. You can choose coconut and almond granola; as this mix is loaded with good fat content of almonds and fortified with fiber content of coconut.

Sweet Potato: It is not easy to believe that foods which start with the word sweet bring an impression of joy along with the health benefits. These foods also help to adjust the intensity of sweet tooth. Sweet potato helps to stabilize the blood sugar level. It also enables to respond the hormone that stabilizes the movement of glucose from bloodstream into cells. Beta carotene content of sweet potato has the potential to reverse this insulin resistance of the body. It also contains a good amount of vitamin B6 which then help to keep the diabetics away from diabetic complications.

Just bake the sweet potato in microwave. Add it to salads, make a soup of sweet potato or just stir diced sweet potato into cooked brown rice. Your creativity will certainly take you away from French fries

Snack on nuts: It is better if you roast raw nuts. Roast for 10 minutes in the oven at 425 degrees. Never trust tinned nuts; as you should not trust the source of the oil that has been used. As diabetic you must be thoughtful about the fats that you pour into your body.