Diabetes and foot care

Most people understand that diabetes has something to do with the blood sugar in the body and that this causes problems, but many people don’t understand exactly what some of these problems can be.

When I worked on a medical unit, I frequently had patients who were newly diagnosed with diabetes. This meant that a lot of patient teaching was needed about the disease, lifestyle changes, and how to prevent complications. Of all the patient teaching I ever did, nothing brought about more disbelief and questioning than foot care. So much so that frequently, the part about foot care would to in one ear and out the other. The article 63 percent of diabetics risk serious foot problems by wearing the wrong-sized shoes tells me that I wasn’t that far off with thinking that way.

Why is foot care so important for people with diabetes?

Your body is only meant to have a certain amount of blood glucose (sugar). Too low causes problems as does too high. The higher sugar eventually causes damage to the blood vessels and nerves throughout the body. Because your feet are the furthest away from the heart, they are most easily affected by poor circulation.

If your nerves are affected, you can have a constant type of nerve pain or you can start losing feeling in certain parts of the body, like your feet. If your circulation and nerves are working properly and you get a blister or cut, you feel it and usually can try to take measures to keep this from worsening, as well as trying to heal the wound. But, if your circulation is compromised, you may not feel the wound starting. Once the wound has started, because the circulation is poor, it is harder for it to heal and can easily become infected. It then becomes a vicious cycle.

People with diabetes who develop wounds in their feet can end up having to have their foot amputated if the wounds can’t be controlled. Of course, this results in more health issues. Great care needs to be taken to be sure the wound heals properly and doesn’t cause other problems. Ambulation (moving about) becomes affected as a wheelchair may now be needed. This results in social isolation and there are other physical issues that result from being in a wheelchair.

So, how does someone with diabetes protect the feet? Here are some simple rules:
- make sure your shoes fit properly and do not cause wounds
- wear socks with your shoes
- avoid high heels that can put too much pressure on the bottom of the feet
- shop for shoes at the end of the day when your feet are usually a bit swollen
- don’t walk around barefoot
- wear socks inside out to prevent the seam from rubbing against the toes
- check your feet every day while cleaning them
- don’t rub your feet clean – pat gently
- ensure your feet are completely dry before putting on socks
- if you want to apply a cream to cracked heels, be sure it is absorbed well
- do not self treat any corns, warts, or calluses; see your doctor or foot care nurse
- when cutting nails, be sure to cut straight across, not curved down at the sides
- keep your feet protected in the winter, keeping them warm
- notify your doctor or foot care nurse of any blisters, cuts, wounds, or other problems with the skin on your feet or toes

This is a situation where prevention is truly the most important weapon. Take care of those feet because you don’t know how much you depend on them until you can’t use them!


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Perhaps a visit to a podiatrist may be the ticket

Have sore feet? Ever do anything about it? Most people don’t, although I can’t prove that. I just gather that most people don’t seek help from the number who complain about sore feet – including me.

I was on my feet pretty well all day Saturday because of an event I was at, promoting my book, and then yesterday for a good few hours again as I chopped, sliced, and diced 10 pounds of carrots. When I worked as a nurse, I was on my feet all day/evening/night long at work and I believe that I started the path to ruining my feet by wearing the cheap shoes I did while I worked.

In my youth, I figured, what’s the difference? A shoe’s a shoe, right? I learned the hard way, no, that’s not right. And if you are a nurse, or anyone who is on their feet all day long, a good shoe is so very important.

So, now that I’ve learned that, what is the best thing for us with the aching feet. A visit to a podiatrist might be a good idea. Most people don’t know that a podiatrist has to go through a 4-year program, much like general physicians. They study the same anatomy and biology as general physicians, although the podiatry students focus on the foot and ankle. There are eight accredited school in the United States that provide this education. Canadians who want to study podiatry have to go to the US as there are no podiatric schools in Canada right now.

Once the 4-year training is complete, a podiatry residency follows, much like the medical residencies. In podiatry, the residents participate in a year of training in clinics and hospital settings. Podiatrists can specialize in orthopedics (bone), medicine (foot care) and/or surgery. Those who specialize in surgery are allowed to perform complicated foot and ankle surgery.

According to the Calgary Foot Clinic, there are no certification bodies in Canada, but there is certification in the U.S.

So, maybe I should follow my own advice and see a podiatrist. It sure beats complaining about my sore feet.

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