March 12, 2010
Diabetics, Put Your Best Foot Forward
By Dr. Peter Rissing, Medical Director
Walton Wound Care and Infusion Center
Augusta, GA—For diabetics, caring for your feet may be almost as important as watching what you eat.
When you have diabetes, you are at higher risk for developing chronic wounds and infections in your feet due to two related conditions: neuropathy and narrowing of the arteries. Diabetic neuropathy is damage to the nerves of your feet that reduces your sensation of pain; narrowing of the arteries reduces blood flow, making it harder for cuts and sores to heal. When these two conditions are combined, even a minor abrasion or blister can easily develop into a bigger problem: a chronic wound or infection that can take months to heal, and—as a last resort—require amputation.
Diabetics can help prevent foot problems by staying vigilant and committing to taking the following precautions:
• Inspect feet daily. Check for blisters, cuts, cracks or sores, both on the bottom of the feet and around toes. If you can’t see the bottom of your feet, ask a family member to help, or use a mirror.
• Pamper your feet. Wash feet daily with warm water, and use lotion to help prevent dryness, cracking and chafing. Don’t soak your feet. Trim toenails carefully (be cautious of clipping too closely, especially at the sides of the toenails where skin can then overlap the nail, leading to an “ingrown” nail), and never file or use clippers on calluses, warts, bunions or other problems. Instead, ask your medical provider for treatments for these common foot problems.
• Wear the right equipment. Shoes should fit well; tight or ill-fitting shoes can cause blisters. Wear clean, dry socks that wick away moisture, and make sure socks aren’t too tight-fitting or too bulky. And never go barefoot, even indoors.
• If you smoke or use other forms of tobacco, stop. Nicotine use narrows the arteries, further reducing blood flow to the feet. A single cigarette causes arterial contraction that can last for 12 hours.
• Get regular checkups. Visit your medical professional regularly for checkups.
• Get treatment for diabetic foot lesions early. Most of these infections can be treated and resolved if therapy begins early. So if you see a worrisome spot, don’t wait. Check with your doctor and if treatment is needed, make sure to complete all necessary visits until the wound is healed. Amputations are only needed in a small number of patients who get early treatment.
• Manage your diabetes. Keeping blood sugar under control will help reduce your risk of developing foot complications.
What If Amputation is Necessary?
If a foot problem becomes a deep-seated wound and infection that requires amputation, patients will benefit from care at an inpatient rehabilitation facility after surgery. There, specialists can teach techniques to help an individual live successfully with an amputation, as well as fit a patient with a prosthesis or other equipment. After discharge, lifelong care is important to ensure the continued health of the limb. Continued physical therapy can help patients regain maximum use of their leg in conjunction with a prosthesis.
Dr. Peter Rissing is a fellowship-trained infectious disease physician and medical director of the Walton Wound Care and Infusion Center.
Media Contact: Danielle Wong Moores, Public Relations Specialist, 706-434-0150
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