Treament
Because diabetes is a systematic disease affecting many different
parts of the body, ideal case management requires a team approach.
The podiatric physician, as an integral part of the treatment
team, has documented success in tje prevention of amputation prevention
diabetic patients is early recognition and regular foot screening
at least annually from a podiatric physician.
Along with medication and diet to keep glucose levels stable,
there are many things to look out for in order to prevent extra
problems. Here are a few guidelines to follow along with your
doctors' plans for treatment:
Wound Healing
Ulceration is a common occurrence with the diabetic foot, and
should be carefully treated and monitored by a podiatrist to avoid
amputations. Poorly fitted shoes, or something
as trivial as a stocking seam, can create a wound that may not
be felt by someone whose skin sensation is diminished. Left unattended,
such ulcers can quickly become infected
and lead to more serious consequences. Your podiatric physician
knows how to treat and prevent these wounds and can be an important
factor in keeping your feet healthy and strong.
Wash feet daily
Using mild soap and lukewarm water, wash
your feet in the mornings or before bed each evening. Dry
carefully with a soft towel, especially between the toes, and
dust your feet with talcum powder to wick away moisture. If the
skin is dry, use a good moisturizing cream
daily, but avoid getting it between the toes.
Inspect feet and toes daily
Check your feet every day for cuts, bruises, sores or changes
to the toenails, such as thickening or discoloration. If age or
other factors hamper self-inspection, ask someone to help you,
or use a mirror.
Lose weight
People with diabetes are commonly overweight, which nearly doubles
the risk of complications. Wear thick, soft socks. Socks made
of an acrylic blend are well suited, but avoid mended socks or
those with seams, which could rub to cause blisters or other skin
injuries.
Stop smoking
Tobacco can contribute to circulatory problems, which can be especially
troublesome in patients with diabetes.
Cut toenails straight across
Never cut into the corners, or taper, which could trigger an ingrown
toenail. Use an emery board to gently file away sharp corners
or snags. If your nails are hard to trim, ask
your podiatrist for assistance.
Exercise
As a means to keep weight down and improve circulation, walking
is one of the best all-around exercises for the diabetic patient.
Walking is also an excellent conditioner for your feet. Be sure
to wear appropriate athletic shoes when
exercising. Ask your podiatric physician what's best for you.
See your podiatric physician
Regular checkups by your podiatric physician - at least annually
are the best way to ensure that your feet remain healthy.
Be properly measured and fitted every time
you buy new shoes
Shoes are of supreme importance to diabetes sufferers because
poorly fitted shoes are involved in as many as half of the problems
that lead to amputations. Because foot size and shape may change
over time, everyone should have their feet measured by an experienced
shoe fitter whenever they buy a new pair of shoes. New shoes should
be comfortable at the time they're purchased and should not require
a "break-in" period, though it's a good idea to wear
them for short periods of time at first. Shoes should have leather
or canvas uppers, fit both the length and width of the foot, leave
room for toes to wiggle freely, and be cushioned and sturdy.
Don't go barefoot
Not even in your own home. Barefoot walking outside is particularly
dangerous because of the possibility of cuts, falls, and infection.
When at home, wear slippers. Never go barefoot.
Don't wear high heels, sandals, and shoes
with pointed toes
These types of footwear can put undue
pressure on parts of the foot and contribute to bone and joint
disorders, as well as diabetic ulcers. In addition, open toed
shoes and sandals with straps between the fIrst two toes should
also be avoided.
Don't drink in excess
Alcohol can contribute to neuropathy
which is one of the consequences of diabetes. Drinking can speed
up the damage associated with the disease, deaden more nerves,
and increase the possibility of overlooking a seemingly minor
cut or injury.
Don't wear anything that is too tight
around the legs
Panty hose, panty girdles, thigh-highs or knee-highs can constrict
circulation to your legs and feet. So can
men's dress socks if the elastic is too tight.
Never try to remove calluses, corns or
warts by yourself
Commercial, over-the-counter preparations that remove warts or
corns should be avoided because they can
burn the skin and cause irreplaceable damage to the foot of a
diabetic sufferer. Never try to cut calluses with a razor blade
or any other instrument because the risk of cutting yourself is
too high, and such wounds can often lead to more serious ulcers
and lacerations. See your podiatric physician
for assistance in these cases.
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