December 14, 2017
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Diabetes in Real Life

Daily foot care can prevent later problems

 
What should a person with diabetes be doing on a daily basis to ensure good foot health?

Neuropathy, vasculopathy and a faulty immune system affect the feet of patients with diabetes and can lead to needless and preventable foot pathology. People with diabetes on a daily basis should be visually and manually inspecting both their feet and their shoes. The foot inspection is to identify a crack in the skin or a locally red swollen or warm area. The shoe inspection is to identify any defect in the shoe itself and any foreign objects in the shoes.

People with diabetes who notice dry skin on their feet or legs due to autonomic neuropathy should apply a urea-based moisturizing lotion. They also need to wear appropriate socks and shoes for their activities. They should practice preventive foot care to avoid developing foot ulcers from the combination of sensory neuropathy and mechanical, chemical or thermal trauma. Foot ulcers can lead to infection, hospitalization and the most dreaded complication of the diabetic foot, amputation. People with diabetes have a list of recommended tasks they are to perform daily to manage their foot health. They should be aware of any changes to their foot health, and if they find a problem, they should seek professional attention promptly.

Every person with diabetes should have a yearly comprehensive diabetic foot exam by their foot specialist that includes a monofilament test.

What are the most common foot problems?

A quick list of the most common foot problems includes those of the nails; keratosis, or corns and calluses; bone and joint deformities; and nerve and heel pain. No matter what the foot problem, visiting a podiatrist for a comprehensive diabetic foot exam, X-rays and laboratory tests is the first step to resolution.

The most common foot problem involves the toenails, which can be thick or discolored, ingrown or deformed. Trimming toenails can be difficult and often not realistically possible for people with diabetes, who should seek professional care for nail trimming and medical treatment of mold yeast or fungal nail infections. I have witnessed patients with diabetes who unknowingly have cut the end of their toes off while trimming their nails. How does this happen? The reasons include poor vision, poor lighting, poor eye-motor coordination, and inappropriate and nonsterile instruments. A person with diabetes who has nail problems and poor vision should have professional foot care by a chiropodist.

 

Endocrine Today, November 2017

In this issue, Susan Weiner, MS, RDN, CDE, CDN, talks with podiatrist Mark Hinkes, DPM, about foot problems that commonly affect people with diabetes.

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