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Diabetes mellitus (DM) represents several diseases in which high blood glucose levels over time can result in damage to the nerves, kidneys, eyes, and blood vessels. Diabetes can also decrease the body's ability to fight infection. In people with diabetes, foot problems commonly develop.
• Normal sweat secretion and oil production that lubricates the skin of the foot is often impaired in those individuals living with diabetes. Dry feet are often a problem for people living with diabetes due to the high blood sugar. Unfortunately, even skin that is simply dry and flaky can eventually progress to cracks, cuts and fissures. It is for this reason regular moisturising of feet and legs are recommended.
• People with diabetes must be fully aware as to how to prevent foot problems before they occur, to recognise problems early, and to seek the right treatment when problems or foot complications occur. People with diabetes should learn how to examine their own feet and how to recognise the early signs and symptoms of diabetic foot problems.
• Damage to blood vessels and impairment of the immune system as a result of diabetes often makes the healing of wounds more difficult. Bacterial infection of the skin and connective tissues can then occur. Because of the poor blood flow, medication is not able to get to the site of the infection easily.
• Although treatment for diabetic foot problems has improved, prevention - including good control of blood sugar level - remains the best way to prevent such diabetic complications.
• People with diabetes should seek assistance from their healthcare provider.
Self-Care at Home
When it comes to proper diabetic foot care, the following guidelines should be followed:
• Diabetes control: Following a reasonable diet, adjusting your lifestyle and taking your medications, checking your blood sugar regularly, and ensuring you have regular check-ups with your healthcare provider is essential in managing your diabetes condition. Consistent long-term blood sugar control to near normal levels can greatly lower the risk of damage to your nerves, kidneys, eyes, and blood vessels.
• Smoking: If you smoke any form of tobacco, quitting can be one of the best things you can do to prevent health complications or problems with your feet. Smoking accelerates damage to blood vessels, especially small blood vessels which leads to poor circulation - and is a major risk factor for foot infections.
• Exercise: Regular exercise will improve circulation to your legs and feet, and will also help to stabilize your blood sugar levels. Consult your healthcare provider prior to beginning any exercise programme.
• Foot examination: Examine your feet daily and also after any trauma, no matter how minor, to your feet. Report any abnormalities to your doctor or healthcare provider. Use a water-based moisturiser every day (but not between your toes). Eliminate obstacles: Move or remove any items you are likely to trip over or bump your feet, or stub your toe on. Light pathways used at night - indoors and outdoors.
• Toenail trimming: Always cut your toe nails with a safety clipper, never scissors. Cut them straight across and leaving plenty of room out from the nail-bed. If you have difficulty with your vision or using your hands, ask a podiatrist to do it for you or train a family member how to do it safely.
• Footwear: Wear cotton or wool socks. Avoid elastic socks and hosiery because these can impair circulation. Wear sturdy, comfortable shoes whenever feasible to protect your feet. To be sure your shoes fit properly, see a podiatrist for fitting recommendations or shop at shoe stores specialising in fitting people with diabetes. If you have flat feet, bunions, or hammertoes, you may need prescription shoes or shoe inserts.
