ready reckoner- foot care for diabetic

Diabetes mellitus is a metabolic disorder of the pancreatic cells. This is a combination of hereditary factors and lifestyle disturbance.

The general symptoms being Polydipsia(extreme thirst), polyuria (lot of urination) polyphagia increasing need to munch or eat, there are chances of loss of peripheral vision, breathe smells of acetone, weight loss, hyperventilation when it comes to breathing, nausea, vomiting , abdominal pain, glycosuria (sugar in the urine)

What happens here the hormone insulin which regulates the uptake of  glucose by the cells reduces in levels, which means the glucose required for cells is reduced.

Diabetic neuropathy is one of the complication diabetes, there is abnormally decreased sensation starting from the feet, and then moves on to the other nerves, it referred to as stocking and glove pattern. If this combines with the damaged blood vessels then we could land with a diabetic foot.  This manifests as skin infection, ulcers and may move on gangrene when we are left with no option but to go in for a surgery. In fact diabetic gangrene amputation accounts for the largest non traumatic cause for amputation.

Some common diabetic foot problems

  • Corns
  •  callus
  • Ingrown toes
  • Planter warts
  • Blisters
  • Bunion
  • Hammertoes
  • Dry cracked skin
  • Athletes feet

This condition can be avoided by taking proper care of the feet.

  1. The feet have to be checked every day including between the toes.
  2. even if you feel the slightest decrease in sensation to your feet talk to your diabetologist
  3. Cracks, corns, callus of the feet should be brought to the attention of the doctor and not neglected or self medicated.
  4. a moisturising cream can be used  on the legs but please avoid using it between the toes it can cause fungal infection
  5. clip your nails following the curve of the nail than straight across, if need be take someone’s help
  6. wash and dry your feet particularly between the toes regularly do it as an evening ritual this will help to gauze the sensation too
  7. never walk barefoot , wear a foot wear even at home
  8. wear comfortable socks when wearing shoes

buying comfortable shoes

  • Buy a pair that will accommodate abnormalities like bunions or collapsed tarsal plates.
  • have broad fronts that allow movement and breathing of toes
  • pick low heels to prevent embarrassing the toes
  • Have good lace guard or Velcro so that the inner surface does not bruise the skin.

Diabetic foot ulcers are caused by narrowing of the blood vessels and decreased sensation due to peripheral neuropathy, the wound tends to get aggressively infected and necrotic due to the presence of higher blood sugar

For whatever reasons if the foot ulcer does develop then the following care should be taken.

  • Ulcer should be covered with a dressing
  • A nurse of a podiatrist should handle the re-dressing till healing is complete
  • Depending on the size of the ulcer it might require padding to take the pressure off.
  • Special footwear maybe required to keep the pressure minimum
  • Antibiotics may be required to keep the infection in control.
  • If there is cellulites then the puss may have to be drained.
  • In very severe cases widening of the arteries may be needed.

in all the foot care is essential in a diabetic to prevent amputation of the feet due to development of a diabetic ulcer which in turn is a result of thickened arteries and peripheral neuropathy or loss of sensation in the feet.

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