By: Susan Kelly, Jun 13, 2013
  Question

My elderly mother has just been diagnosed with diabetes, and the doctor has warned us if she doesn’t take care of her feet, she may have to have one or both amputated. What can we do to prevent this from happening?

Proper food care is essential to help manage diabetes.

One of the areas of diabetic management that has often been overlooked is care of the feet. The goal of good foot care is to promote independence and mobility by preventing infection, gangrene and amputation.

Living with diabetes adds an additional burden to your already overworked feet. The following statistics are startling but they provide clear evidence of the battle waged when managing diabetes throughout a lifetime:

  • 15 per cent of people with diabetes will develop foot ulcers
  • More than 70 per cent of lower limb amputations are related to diabetes
  • 85 per cent of lower limb amputations are preceded by a non-healing ulcer
  • 85 per cent of amputations can be prevented

These facts become even more alarming when we realize that one quarter of all diabetics are not diagnosed. Knowing the facts provides a clear picture of the road ahead. Taking serious steps to prevent foot problems from the start – and manage existing foot issues – will help minimize devastating long-term complications.

Here is a ‘happy feet checklist’ of dos and don’ts for foot care:

DO:

  • Check your feet every day for cuts, cracks, bruises, blisters, sores, infections or unusual markings.
  • Use a mirror to see the bottoms of your feet if you can’t lift them up.
  • Check the colour of your legs and feet.
  • If there is swelling, warmth or redness, or if you have pain, see your doctor or foot specialist right away.
  • Clean a cut or scratch with a mild soap and water and cover it with a dry dressing, every day.
  • Trim your toenails straight across so that they are even with the tips of your toes. Cut toenails when they are soft after a bath or a shower. Use nail clippers (instead of manicure scissors) which have a smaller, straighter cutting bald and a longer handle.
  • Wash and dry your feet every day, especially between your toes.
  • Apply a good skin lotion every day on your heels and soles. Wipe off excess lotion and allow your feet to dry before putting on socks.
  • Change your socks every day. Cotton or wool seamless socks allow your feet to breathe. Wear light coloured socks to detect drainage. (i.e. bleeding from a blister).
  • Always wear a good supportive shoe that has a wide toe box, with ½ inch between the tip of the toe and the end of the shoe; a sturdy sole and uppers made of natural materials, such as leather.
  • Buy shoes in the late afternoon when your feet are slightly swollen.
  • Exercise regularly.

DON’T

  • Don’t cut your own corns or calluses. Instead, smooth with a pumice stone.
  • Don’t treat your ingrown toenails with a razor or scissors. See your doctor, foot specialist or foot care nurse.
  • Don’t use over-the-counter medications to treat corns and warts.
  • Don’t apply heat to your feet with a hot water bottle or electric blanket. You could burn your feet without realizing it.
  • Don’t soak your feet for extended periods of time – no more than five minutes.
  • Don’t take very hot baths or soaks in hot tubs to avoid excess skin dryness.
  • Don’t use lotion between your toes.
  • Don’t walk barefoot inside or outside. Athlete’s foot or other fungal infections are often picked up by walking barefoot in public places. Wear flip-flops by the poolside and on the beach to avoid cuts.
  • Don’t wear shoes that have heels higher than 4 cm (or 1.5 inches).
  • Don’t wear tight socks, garters, knee-highs. If it leaves a mark on your leg then it is too tight.
  • Don’t wit for long periods of time. If on a plane, get up and move or do exercises about every 1.5 hours.
  • Don’t wear over-the-counter insoles – they can cause blisters.
  • Don’t cross your legs.
  • Don’t smoke.

Susan Kelly is the Director of Health & Wellness for We Care Health Services, Inc. Sue brings a wealth of experience from her 30+ years of community nursing. Sue’s home is shared between Gravenhurst and Toronto, Ont. She can be reached at sue_kelly@wecare.ca.  To learn more, visit www.wecare.ca.