Auteur: Podiatre Montreal
According to the American Diabetes Association, approximately 15.7 million people (5.9 per cent of the U.S. population) have diabetes. Damage to the nervous system (also called neuropathy) affects about 60 to 70 per cent of people with diabetes and is a major complication that can cause loss of feeling in the feet or hands of people with diabetes.
Foot problems are a high risk for people with diabetes. Diabetics must constantly monitor their feet or face serious consequences, such as amputation.
On the foot of a diabetic patient, an injury as small as a blister caused by wearing shoes that are too tight can cause enormous damage. Diabetes decreases blood circulation, so the wounds are slow to heal and there is a high risk of infection. As a diabetic, your infection spreads quickly. If you have diabetes, you should check your feet every day. Look for stings, bruises, pressure areas, redness, heat, blisters, ulcers, scratches, cuts and nail problems. Ask someone to help you, or use a mirror.
Here are some basic tips to take care of your feet:
- Always keep your feet warm.
- Don’t get your feet wet from snow or rain.
- Do not put your feet on a radiator or in front of the fireplace.
- Don’t smoke or sit cross-legged. This reduces the blood flow to your feet.
- Do not soak your feet.
- Do not use antiseptic solutions, medicines, heating pads or sharp instruments on your feet.
- Trim your right toenails. Avoid cutting corners. Use a nail file or emery file. If you find an ingrown toenail, please contact our office.
- Use a quality lotion to keep the skin on your feet soft and moist, but do not put lotion between your toes.
- Wash your feet daily with mild soap and warm water.
- Wear wide socks at bedtime
- In winter, wear warm socks and shoes.
- When drying your feet, pat each foot with a towel and be careful between the toes.
- Buy shoes that are comfortable. Check how your foot feels in the shoe in terms of width, length, bottom of the heel. Avoid models that point toes and high heels. Try to get shoes made with genuine leather material. Wear new shoes only for two hours or less. Don’t wear the same pair of shoes every day. Inspect the inside of each shoe before putting it on. Do not tie your shoes too tightly or too loosely.
- Choose your socks and stockings carefully. Wear clean and dry socks every day. Avoid socks with holes. Lightweight cotton socks are more absorbent in summer. Some socks will not squeeze your toes. Avoid elastic socks.
When your feet are numb, they may become deformed. This can lead to ulcers. Open sores can become infected. Another type of deformity is Charcot bone disease (pronounced “Sharko”). This is one of the most serious foot problems you can face. It deforms the shape of your foot when the bones are broken, yet you continue to walk because you do not feel pain. Diabetic foot ulcers and the early stages of Charcot fractures can be treated with a mold.
Your leg takes the shape of the mold. It helps heal your ulcer by distributing the weight and relieving pressure. If you have Charcot’s disease, the mould controls the movements of the foot and supports its contours if you do not exert any pressure on it. To use a total contact molding, you need good blood circulation in the foot. The mold should be changed every week or two until your foot heals. A custom-made boot is another method of treatment for Charcot’s disease. It supports the foot until all the swelling goes down, which can take up to a year. You should avoid putting your weight on Charcot’s foot. Surgery is considered if your deformity is too severe for a staple or shoe.2021