HEALTH PLUS MED­ICAL COR­RE­SPON­DENT

Un­con­trolled Di­a­betes is dan­ger­ous to your feet, even a small cut can pro­duce se­ri­ous con­se­quences.There is a lot to man­age if you have di­a­betes: check­ing your blood sug­ar, mak­ing healthy food, find­ing time to be ac­tive, tak­ing med­i­cines, go­ing to doc­tor ap­point­ments. With all that, your feet might be the last thing on your mind. All di­a­bet­ics are at risk of in­creased in­fec­tion in the pe­riph­eries and se­ri­ous com­pli­ca­tions, such as am­pu­ta­tion.

How Can Di­a­betes Af­fect My Feet?

Di­a­betes can cause the ma­jor prob­lems that can af­fect your feet:

Di­a­bet­ic neu­ropa­thy

Un­con­trolled di­a­betes can dam­age your nerves. If you have dam­aged nerves in your legs and feet, you might not feel heat, cold, or pain there. This lack of feel­ing is called “sen­so­ry di­a­bet­ic neu­ropa­thy.” If you do not feel a cut or sore on your foot be­cause of neu­ropa­thy, the cut could get worse and be­come in­fect­ed. The mus­cles of your foot may not work prop­er­ly be­cause nerves to the mus­cles are dam­aged. This could cause your foot to not align prop­er­ly and cre­ate too much pres­sure on one part of your foot.

Pe­riph­er­al vas­cu­lar

dis­ease

Di­a­betes al­so af­fects the flow of blood. With­out good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called “pe­riph­er­al vas­cu­lar dis­ease.” If you have an in­fec­tion that will not heal be­cause of poor blood flow, you are at risk for de­vel­op­ing ul­cers or gan­grene (the death of tis­sue due to a lack of blood). Most times, the treat­ment for a gan­grenous toe or ul­cer­at­ed le­sion is am­pu­ta­tion.

Red Flags to note

Any of these prob­lems are warn­ing signs that must be heed­ed and treat­ed:

- Changes in skin colour or skin tem­per­a­ture

- Swelling in the foot or an­kle

- Pain in the legs

- Open sores on the feet that are slow to heal or are drain­ing

- In­grown toe­nails or toe­nails in­fect­ed with fun­gus

- Corns or cal­lus­es

- Dry cracks in the skin, es­pe­cial­ly around the heel

- Foot odour that is un­usu­al or won’t go away

How can I avoid de­vel­op­ing Di­a­bet­ic Foot Syn­drome?

In­spect your feet dai­ly. Check for cuts, blis­ters, red­ness, swelling or nail prob­lems. Use a mag­ni­fy­ing hand mir­ror to look at the bot­tom of your feet. Call your doc­tor if you no­tice any­thing. Get pe­ri­od­ic ex­ams. See­ing your foot and an­kle sur­geon on a reg­u­lar ba­sis can help pre­vent the foot com­pli­ca­tions of di­a­betes.

Nev­er walk bare­foot. Not even at home! Al­ways wear shoes or slip­pers. You could step on some­thing and get a scratch or cut.

Bathe feet in luke­warm, nev­er hot, wa­ter. Keep your feet clean by wash­ing them dai­ly. Use on­ly luke­warm wa­ter, the tem­per­a­ture you would use on a new­born ba­by. Nev­er use a heat­ing pad or a hot wa­ter bot­tle on your feet.

Be gen­tle when bathing your feet. Wash them us­ing a soft wash­cloth or sponge. Dry by blot­ting or pat­ting and care­ful­ly dry be­tween the toes.

Mois­turise your feet but not be­tween your toes. Use a mois­turis­er dai­ly to keep dry skin from itch­ing or crack­ing. But do not mois­turise be­tween the toes, that could en­cour­age a fun­gal in­fec­tion.

Cut nails care­ful­ly. Cut them straight across and file the edges. Do not cut nails too short, as this could lead to in­grown toe­nails. If you have con­cerns about your nails, con­sult your doc­tor.

Wear clean, dry socks. Change them dai­ly. Con­sid­er socks made specif­i­cal­ly for pa­tients liv­ing with di­a­betes. These socks have ex­tra cush­ion­ing, do not have elas­tic tops, are high­er than the an­kle and are made from fi­bres that wick mois­ture away from the skin. If your feet get cold at night, wear socks.

Shake out your shoes and feel the in­side be­fore wear­ing. Re­mem­ber, your feet may not be able to feel a peb­ble or oth­er for­eign ob­ject, so al­ways in­spect your shoes be­fore putting them on.

Con­sid­er us­ing an an­tiper­spi­rant on the soles of your feet. This is help­ful if you have ex­ces­sive sweat­ing of the feet. Nev­er treat corns or cal­lus­es your­self. No ‘bath­room surgery’ or med­icat­ed pads. Vis­it your doc­tor for ap­pro­pri­ate treat­ment.

Each one of these steps will help in pre­vent­ing di­a­bet­ic foot com­pli­ca­tions. First and fore­most how­ev­er, is keep­ing your blood glu­cose lev­els un­der con­trol.