- Diabetic foot refers to pathology that results specifically from diabetes. Because of the nerve dysfunction that is related to diabetes (diabetic neuropathy), patients have a decreased ability to feel pain.
- For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications, including foot and skin problems, as well as heart disease, stroke, kidney disease, eye damage, and other problems.
DIABETIC FOOT CARE
WHAT IS DIABETIC FOOT?
WHAT ARE THE SYMPTOMS OF DIABETIC FOOT?
Symptoms vary widely from individual to individual and include the following:
- Pain or a tingling sensation in the feet at night.
- Skin temperature changes.
- Deadness or shivering sensation.
- Blisters or other wounds without pain.
- Red streaks.
- Wounds with or without seepage.
- Loss of feeling.
- Staining on socks.
- Skin staining.
- Deformed foot appearance.
- The fungus causes itching, redness, and cracking.
- Germs can enter through the cracks in your skin.
- Medicines that kill the fungus are used to treat athletes’ feet. These medicines may be pills and/or creams applied directly to the problem area.
FUNGAL INFECTION OF NAILS
- Nails that are infected with a fungus may become discolored (yellowish-brown or opaque), thick and brittle, and may separate from the bed of the nail.
- Fungal nail infections are difficult to treat.
- Topical medications are available, but they only help a small number of fungal nail problems.
- Treatment also may include periodic removal of the damaged nail tissue.
A callus is a build-up of hard skin, usually on the underside of the foot and heel.
- Uneven distribution of weight.
- Improperly fitting shoes.
- Skin abnormality.
- Proper care is necessary if you have a callus.
- After your bath or shower, use a pumice stone to gently remove the build-up of tissue.
- Use cushioned pads and insoles.
- Medications also may be prescribed to soften calluses. DO NOT try to cut the callus or remove it with a sharp object.
- Corn is a build-up of hard skin near a bony area of a toe or between toes.
- Corns may be the result of pressure from shoes that rub against the toes or cause friction between the toes.
- Proper care is necessary if you have corn. After your bath or shower, use a pumice stone to gently remove the build-up of tissue. Do not try to cut the corn or remove it with a sharp object.
- Blisters can form when your shoes keep rubbing the same spot on your foot.
- Wearing shoes that do not fit properly or wearing shoes without socks can cause blisters, which can become infected.
- When treating blisters, it’s important not to “pop” them.
- The skin covering the blister helps protect it from infection.
- A bunion forms when your big toe angles in toward the second toe. Often, the spot where your big toe joins the rest of the foot becomes red and callused. This area also may begin to stick out and become hard. Bunions can form on one or both feet.
- Often they are caused by wearing high-heeled shoes with narrow toes. These shoes put pressure on the big toe, pushing it toward the second toe. The use of felt or foam padding on the foot may help protect the bunion from irritation.
- A device also may be used to separate the big and second toes. If the bunion causes severe pain and/or deformity, surgery to realign the toes may be necessary.
- Dry skin can result if the nerves in your legs and feet do not get the message from your brain (because of diabetic neuropathy) to sweat, which keeps your skin soft and moist.
- Dry skin can crack, which can allow germs to enter.
- Use moisturizing soaps and lotions to help keep your skin moist and soft.
- A foot ulcer is a break in the skin or a deep sore, which can become infected.
- Foot ulcers can result from minor scrapes, cuts that heal slowly, or the rubbing of shoes that do not fit well.
- Early intervention is important in treating foot ulcers. Antibiotics wound dressing and assessment of blood supply to the foot is standard protocol for treatment.
- A hammertoe is a toe that is bent because of a weakened muscle.
- They also may be caused by wearing shoes that do not fit properly (are too short).
- Hammertoes can cause problems with walking and can lead to other foot problems, such as blisters, calluses, and sores.
- Splinting and corrective footwear can help in treating hammertoes. In severe cases, surgery to straighten the toe may be necessary.
- Ingrown toenails occur when the edges of the nail grow into the skin. Ingrown nails cause pressure and pain along the nail edges, cut into the skin, causing redness, swelling, pain, drainage, and infection.
- The most common cause of ingrown toenails is pressure from shoes. Other causes of ingrown toenails include improperly trimmed nails, crowding of the toes, and repeated trauma to the feet from activities such as running, walking, or doing aerobics.
- Keeping your toenails properly trimmed is the best way to prevent ingrown toenails. Severe problems with ingrown nails may be corrected with surgery to remove part of the toenail and growth plate.
- Plantar warts look like calluses on the ball of the foot or on the heel.
- They may appear to have small pinholes or tiny black spots in the center.
- They are usually painful and may develop singly or in clusters.
- Plantar warts are caused by a virus that infects the outer layer of skin on the soles of the feet.
TREATMENT OPTIONS FOR DIABETIC FOOT
- Control infection.
- Removal of dead tissue.
- Regular dressing.
- Assess blood supply.
- Proper footwear to remove the pressure off the wound.
CAN THESE FOOT PROBLEMS BE PREVENTED?
Proper foot care can help prevent these common foot problems and/or treat them before they cause serious complications. Here are some tips for good foot care:
- Control your diabetes
- Wash your feet in warm water every day, using a mild soap. Do not soak your feet. Dry your feet well, especially between the toes.
- Check your feet every day for sores, blisters, redness, calluses, or any of the other problems listed above.
- If the skin on your feet is dry, keep it moist by applying lotion after you wash and dry your feet. Do not put lotion between your toes.
- Gently smooth corns and calluses with an emery board or pumice stone. Do this after your bath or shower, when your skin is soft. Move the emery board in only one direction.
- Check your toenails once a week. Trim your toenails with a nail clipper straight across. Do not round off the corners of toenails or cut down on the sides of the nails. After clipping, smooth the toenails with an emery board.
- Always wear closed-toed shoes or slippers. Do not wear sandals. Do not walk barefoot, even around the house.
- Always wear socks or stockings. Wear socks or stockings that fit your feet well and have soft elastic.
- Wear shoes that fit well. Buy shoes made of canvas or leather, and break them in slowly.
- Protect your feet from heat and cold. Wear shoes at the beach or on hot pavement. Wear socks at night if your feet get cold.
- Maintain good blood flow to your feet. Put your feet up when sitting, wiggle your toes and move your ankles several times a day.
- Stop smoking
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