diabetesand footcare

1. DiabetesDiabetes
andand
FootCareFootCare

2. What is Diabetes?
 Diabetes is a condition in which there is too much sugar
(glucose) in the blood. Although sugar is needed to provide
energy for the body, when in excess, it causes problem.
 Persons with diabetes have excess sugar because they lack
or have deficient supply of insulin.

3. Diabetes
“Mild Disease”
Serious consequences

4. Diabetes Mellitus
A Serious Disease
Leading cause of new
cases of blindness
25 times more prone to
eye problems
6 times higher risk for
Paralysis (stroke)
5 times more prone to
Kidney failure
20 times more prone to
lower limb amputation
Nerve damage causes
loss of sensation
2-3 times higher risk for
heart attack

5. Diabetes and Feet
Why people with diabetes require good care of their feet?
There are several reasons
Loss of sensation with increased risk of injury
Poor circulation causing delayed healing
Higher likelihood of developing infections that go unnoticed and
spread widely leading to gangrene
 Diabetes foot ulcers are the most common cause for
prolonged hospitalizations
 Diabetes is the most important cause of non traumatic foot
amputations

6.  Learn to take good care of your feet
 Practice what you learn every day
 Foot problems must be detected and treated properly
 Take help of a Foot Care specialist or your Diabetes Care
Team
Prevention Is Better Than Cure

7. Daily Foot Care
 You can prevent major foot problems, if you
Learn to recognize signs of early foot problems
Inspect your feet daily
Keep your feet clean and dry
Trim your toenails carefully
Protect you feet with appropriate footwear
Have your doctor or nurse examine your feet regularly
(especially if you have any loss of sensation in your feet or
toes or have a poor eyesight)

8. Recognize the Symptoms of
Foot Problems
 Pay attention to peculiar sensations such as
Tingling, like a feeling of “ants crawling” or “pins and needles”
Numbness and heaviness “feeling of walking on cotton”, or feeling of
“wearing tight socks” even when the feet are bare
Reduced ability to sense heat and cold
Stabbing or burning pain
A persistent “restlessness” in the feet and legs
(These are tell tale signs of impending serious foot problems)

9. Inspect Your Feet Daily
 Examine feet in good light after bath
Check for in-grown nails, corns and calluses, swelling of the leg and feet,
dry skin or areas that are irritated.
Check to see that the nails are well trimmed.
Use a mirror to see the bottom of the feet.
Look and feel carefully for possible injuries, for breaks in the skin, cuts,
scratches, bruises, blisters, sores, and discolouration especially
between the toes.
Using Mirror

10.  Learn to recognize the early signs of Infection
Unusual warmth over the injured area
Redness
Swelling
Pain (if you still have good sensation)
Drainage of pus from an opening in the skin
(If you find any of these immediately take Doctor’s advice or ask your
Diabetes Care team)
Fungal infection between the toesBlister on the foot
Inspect Your Feet Daily

11. Keep your feet clean and dry
 Wash feet daily as you wash your hands, using soap and
lukewarm water
 Dry feet carefully with a soft towel after bathing, especially
between the toes where moisture can lead to a fungal
infection
 Apply a moisturising cream to keep skin over the feet
smooth and soft

12. Take Care of Your Toenails
 Helps avoid ingrown toenails, which lead to infection
 Trim and cut toenails with a nail cutter after a bath, when
soft and pliable
 Cut your toenails straight across the top and not too far
back on the sides
 Do not use a sharp instrument to clean under the nail, or in
the grooves
 If your toe nails are too thick to cut, you can have them cut
by the foot specialist in your Diabetes Care team

13. Protect Your Feet With
Appropriate Footwear
Many foot problems can be avoided if you are careful to
protect your feet at all times
 Don’t walk barefoot even at home especially when there
is loss of sensation
 Choose proper footwear of the correct shape and size
Always shop for shoes in the evening when the feet are the largest
Check the size of the shoes wearing the thickest socks
Choose cotton or woolen socks
Socks should be free of wrinkles and holes, elastic should not be
tight

14. Proper Footwear
 Shoe should be comfortable and should fit well
 Never wear Shoes which are too short or too narrow
 Rounded toes give more space to the feet
 Always choose flat shoes with thick, sturdy soles to protect the
feet from sharp objects

15. Proper Footwear
 Leather shoes let the foot breathe freely
 Do not wear chappals without back support especially when
there is loss of sensation
 When buying a pair of shoe, take in to account any bunions or
other irregularities. These will require wider and deeper shoe to
avoid pressure points

16. Proper Footwear
Ill-fitting shoes
 Take a paper cut of the foot shape
 Place the paper inside the shoe
 Paper must fit without folds

17. Pressure Sores or Ulcers
 It starts with a callus, which is a sign of continuous
pressure or friction on a particular part of feet
 It is always advisable to treat the callus before an ulcer
occurs. See your Doctor or Diabetes Care Team
immediately
 If not treated properly, such ulcers can lead to serious foot
problems like gangrene
 Gangrene often leads to the removal of a toe or foot
(Amputation)

18. Red marks on the foot Inflammed toe
Black discoloration
Early sign of gangrene
Ulcer
Cramped toes
Callus
Blister
Ingrown toenails
Feet At High Risk

19. Cuts and Injuries
 Keep the affected area or injury clean and apply a sterile
bandage
 If you have decreased sensation in your feet, you have to be
more careful to avoid injuries such as minor accidents, burns
etc
 In absence of pain (alarm system), these minor injuries may
become serious and can lead to amputation or removal of
that part of the foot

20. Blisters and Cracks
 Never squeeze or puncture a blister
 Proper dressing and careful inspection is most important
 If the blisters appears to contain blood or becomes
inflamed see your doctor or Diabetes care team
 Cracks are difficult to heal and infections occur easily
 Daily use of foot cream to soften the skin as well as a
shock absorbing insole is recommended

21.  Often caused by improper nail trimming or poorly fitted
shoes
 The problem can be solved by correcting the footwear. Ask
you Diabetes Care Team for assistance
 As with all foot problems, prevention is the best cure for
ingrown nails
Ingrown Nails

22. Corns and Calluses
 Usually Corns and calluses result from poorly fitted
footwear that puts pressure on a certain area of the foot
 A deep ulcer or crack can result if the callus is left
untreated
 Do not apply corn caps or self treat
 Consult your doctor or Diabetes Care Team for further
treatment of corns and calluses

23. Callused skin
Bunion
Corn
Foot At High Risk

24. Nerve Problems Lead to Foot
Deformity
 Nerve damage in your feet may lead to loss of sensations
and muscle weakness
 It affects the way you walk, and increases pressure on
certain parts of the feet leading to fractures and bony
deformities that occur without any apparent accident or
reason
 It decreases your ability to sweat and impairs blood flow to
your feet

25. Who Is at Risk of Foot Ulcers?
 Some People with Diabetes have a greater risk of developing
foot ulcers than others
 The factors which may play a role are:
Long standing poorly controlled diabetes
Loss of sensation in the feet
Poor blood circulation
Bunions or other foot deformities
Impaired Vision
Smokers

26. Poor Vision
 Poor vision puts your feet at risk, because you may not be
able to see the minor sores and other foot problems at the
bottom of the feet
 Ask your diabetes care team for complete inspection of the
feet
Smoking
 Do not smoke as nicotine causes blood vessels to shrink and
slows down the blood flow to the foot
 Impaired blood circulation can increase the foot problems

27. Examination of Your Feet
 Insist that your doctor examines your feet from time to time
to
Assess the general condition of your skin and nails
Check for signs of poor circulation
- Cold extremities, absent or weak pulsations
Check for signs of decreased sensation
Look for the deformities such as bunions
Note any pressure points that lead to calluses
Check for signs of infection, injury and ulcers
Watch the way you walk and note any changes

28.  Insist that your doctor examines your feet from time to time
to
Test for the loss of protective sensation
Check your ability to feel vibration
Test light touch with a monofilament
Check for impaired blood circulation
Check for foot pulses
Test toe blood pressure
Perform an angiogram of arteries if needed
Examination of Your Feet

29. Blood Sugar Control
 Poor blood sugar control is a risk factor for the
development of foot ulcers
 Good control can prevent the development and progression
of nerve problems (loss of sensations)
 Good control ensures continued good blood supply
 Good control prevents minor injuries getting infected
 The better your blood sugar control, the better your body
can take care for itself. Take Insulin, if advised

30. Conclusion
Achieve good blood sugar control - save your feet.
Take Insulin, if advised.