How to take good care of the diabetic foot?

First of all, it is necessary to pay attention to the good regulation of diabetes, because as we mentioned, complications on the feet belong to the chronic complications of diabetes, especially with unregulated diabetes.

We have to pay attention to proper foot care, which means washing your feet daily with lukewarm water and soap, then carefully drying them and finally applying cream. When cutting your nails, be extremely careful and if you can, it is recommended to use a rasp. Choose socks made of natural materials, make sure they do not constrict the lower leg. When putting on shoes, be sure to check the inside.

Ideal care includes:

• Regular self-examinations and foot examinations, and medical examination in case of any doubt.

• Determining the existence of a risk for the development of foot problems.

• Education on self-control of people with diabetes.

• Use of appropriate footwear, which must be comfortable for walking.

• Quick treatment of all foot problems, so that serious complications do not occur.

• If you smoke, stop because smoking further worsens circulation.

• If you notice a wound on your feet, contact your doctor immediately, because timely and proper treatment provides the best result.

Recognizing the warning signs is crucial in preventive treatment.

• The appearance of pressure (calluses) on the feet

• Swelling of the foot or joint

• Very cold legs or feet

• Changes in the color of the feet

• Pain in the legs while resting or walking

• Open wounds, regardless of how small they are

• Wounds that do not heal

• Ingrown nails

• Lack of hair on the feet

What should you pay special attention to?

Thin skin on the feet or bluish color of the skin with a weakened or non-palpable pulse of the arteries of the feet with difficulty in walking (patients have to stop due to pain in the lower legs while walking) indicates a possible weaker circulation.

Nerve damage can cause some “strange sensations” in the legs – pain (especially at rest), cramps (also especially at rest, especially at night), burning, burning, tingling, numbness in the legs, fatigue, feeling that the legs are “wooden”.

It is especially dangerous if the foot becomes completely insensitive to both touch (pressure) and pain (it can occur gradually, without any previous symptoms) because then the patient does not feel that, for example, he has inadequate footwear, a stone in his shoe, or that he is carelessly while walking barefoot he tripped on something and that the foreign body might still be in his foot.

Patients with diabetes often feel cold in their feet. Due to the aforementioned disorders, it is extremely dangerous to use hot water heaters with boiling water, electric heaters, radiators, hot tiles or, for example, putting your feet in a hot oven. Burns of varying degrees can occur due to the disturbed sensation of hot and cold and the disappearance of pain, which in the most severe cases may require amputation of the affected part of the leg. To warm the feet, it is recommended to use warm woolen socks (again, make sure they are not too tight so as not to hinder circulation).

Why worry about your feet, especially if you have diabetes?

• Patients with diabetes have a 25 times greater risk of losing a leg (amputation).

• Worldwide, up to 70% of all leg amputations occur in people with diabetes.

• Every 30 seconds somewhere in the world, a leg is amputated due to diabetes.

• It is estimated that up to 85% of all amputations due to diabetes can be prevented.

• Foot ulcers precede up to 85% of diabetes-related lower extremity amputations, and many can be prevented with proper health care and education about self-examination.

• In developed countries, one out of 6 people with diabetes has an ulcer during their lifetime, and foot problems account for up to 15% of the health budget.

Appropriate footwear

Appropriate footwear should be worn for each activity.

During sports activities, sports sneakers support the feet and allow air to flow.

The following guidelines are for people with diabetes to adjust their footwear according to their current health condition.

• It is necessary to inspect the shoes before putting them on, so that there are no unknown objects in them.

• Protecting feet from heat/cold by wearing footwear suitable for the season. Wear shoes even on hot pavement or on the beach. In winter, it is not recommended to put hot water bottles, hot water bottles or heated pads on your feet. If your feet are cold, wear socks even during the night.

• Diabetics often have impaired sensation to the extent that they do not feel if their socks are wrinkled, so it is necessary to wear socks of the appropriate size for the foot and made of natural materials. Tight socks reduce circulation and can irritate the skin.

How to help yourself?

One of the very important activities that will help you is not to wear tight shoes that squeeze your toes. They can contribute to problems with wet feet, fungal infections, ingrown toenails and skin problems such as corns and calluses. Improper footwear can cause foot deformities and wounds. A lot of foot problems can be avoided if you protect your feet with appropriate footwear that fits you immediately and does not need to be stepped on. Wear appropriate footwear for each activity. Formal shoes should be worn only occasionally, and for a short time. Careful trimming of toenails is part of foot care. If you cut your nails properly, they will not grow back or become infected.

Feet should be washed in the same way as hands. Bathing or showering is preferable, but do not soak your feet. Soaking damages the natural moisture of the skin and causes it to crack. Keep your skin soft and supple with moisturizing creams. Wear appropriate shoes to prevent pressure and the formation of hard, thickened skin. Never walk barefoot. Sprinkle sweaty feet with absorbent foot powder.

Whether you have diabetes or not, physical activity is good for you. It strengthens muscles, heart, bones, improves circulation, helps regulate body weight and blood glucose. Just half an hour of daily physical activity will improve your health. In type 1 diabetes, the activity helps the effectiveness of injected insulin, and in type 2, it reduces insulin resistance.

Diabetes does not limit the choice of physical activity. It is best to start gradually, with reduced intensity, but over time, according to possibilities, the level of activity can certainly be increased. Walking, housework, yard maintenance or swimming are activities that are adaptable and suitable for everyone and have a positive effect on you and your body.

However, it is important to monitor the blood glucose level if you exercise for more than an hour. If you have an elevated blood glucose level during exercise and it does not decrease, but increases, you probably do not have enough insulin to enable the muscles to consume glucose. If you have type 1 diabetes and your blood glucose level is greater than 15 millimoles per liter, do not exercise until the level has decreased.

S.J.
11.10.2022.