Introduction
About 15.7 million people in the United States are diagnosed with diabetes mellitus. Thats roughly 6% of the population of the United States. Diabetes is a multi-organ disease that can affect the circulation and the nerves of the body. These circulatory changes can cause blindness (retinopathy), kidney disease (nephropathy) and nerve damage (neuropathy) just to name a few.
In the feet, when diabetes affects the circulation (angiopathy) and nerves (neuropathy), this can lead to trouble. If the foot becomes neuroapthic, pressure sensation is diminished which can lead to skin breakdown or ulcers. If circulation is impaired, this can lead to a non-healing ulceration which may cause deeper infection. If the deeper infection is not corrected, amputation can result.
Fortunately, most diabetics can prevent ulcers by following some simple steps in their daily routine. Diabetics should be under the close eye of their primary physician or endocrinologist and have a full understanding of the effects of their disease. Regulation of your blood sugar can prevent angiopathies and neuropathies from progressing. Also, diabetics should establish a relationship with a podiatrist. This is the first step in the prevention of foot complications.
The AOFAS suggests some basic advice for taking care of your feet:
1. Wash your feet every day with mild soap and warm water. Test the water temperature with your hand first. Don’t soak your feet. When drying them, pat each foot with a towel and be careful between your toes.
2. Use quality lotion to keep the skin of your feet soft and moist — but don’t put any lotion between your toes.
3. Trim your toe nails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, see your doctor. If you nails are thick and unmanagable, see your podiatrist.
4. Don’t use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet. Don’t put your feet on radiators or in front of the fireplace.
5. Always keep your feet warm. Wear loose socks to bed. Don’t get your feet wet in snow or rain. Wear warm socks and shoes in winter.
6. Don’t smoke or sit cross-legged. Both decrease blood supply to your feet.
Here’s some basic advice about shoes and socks:
1. Never walk barefoot or in sandals or thongs.
2. Choose and wear your shoes carefully. Buy new shoes late in the day when your feet are larger. Buy shoes that are comfortable without a “breaking in” period. Check how your shoe fits in width, length, back, bottom of heel and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don’t wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don’t lace your shoes too tightly or loosely.
3. Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.
Children and Diabetes
Although less than 1 % of all patients diagnosed with diabetes are children, this can still be a troublesome disease in children. There have been many advances in research that promises hope for a cure in the future for diabetic children.
As in adults, children can be especially vulnerable to diabetic changes that can cause foot problems as they mature. The most important aspect of diabetes in the child is its early diagnosis. Your child may be lethargic, out of energy and subject to mood swings. Many of the same signs in adults are seen in children who have diabetes. Such as frequent nocturnal urination, excessive thirst and lethargy. If you have a strong family history of diabetes and you suspect these symptoms in your child, see your pediatrician right away.
Foot Ulcers
If you have been diagnosed with diabetes mellitus, it is important that you prevent complications causing local foot infection. Diabetes can affect the blood circulation and most importantly, the nerves in your feet. This can lead to loss of proprioception or the simple feeling in your feet. If a minor cut or blister forms, many times without proper sensation, these areas can cause infections and foot ulcers.
Very often, foot ulcers begin by simple areas of irritation or blisters, that can continue to break down deeper into the skin. Once the ulcer begins, it can easily get infected. It is important that you see you doctor immediately when an ulcer begins. Many times, we can stop the progression of the ulceration with simple, accommodative treatments.
|Adult Foot Deformities|Biomechanics|Children’s Feet|Diabetic Foot Care|Foot Surgery|Nails|Skin|Sport Injuries|Trauma|
