DIABETES AND FOOTCARE

Transcription

1 DIABETES AND FOOTCARE Self-Care and Treatment for Healthy Feet

2 Don t Take Your Feet for Granted Every day, you depend on your feet to keep you moving. But when you have diabetes, your feet need special care. Even a small foot problem can become very serious. So don t take your feet for granted. By working with your diabetes healthcare team, you can learn how to protect your feet and keep them healthy. Foot Problems Can Be Serious Diabetes can damage nerves in your feet and cause neuropathy. This condition makes it hard for you to feel injuries or sore spots. Diabetes can also change blood flow, making it harder for small problems, like a blister, to heal properly. In fact, minor injuries can quickly become serious infections that send you to the hospital. So take a look at your feet. Are they healthy? Signs of foot problems can include: Red spots, blisters, corns, or calluses Drainage on your sock Dry, cracked, or scaly skin Thick, yellow, or ingrown toenails Slow-healing sores A tingling, cold, or burning sensation Numbness Red streaks or changes in skin color Use a mirror to inspect the bottoms of your feet. 2

3 Take Lifelong Care of Your Feet Taking care of your feet is a lifelong task. It also requires cooperation between you and your diabetes healthcare team. For best results, make foot care part of your daily routine. Three things will help the most: Manage your diabetes. Foot problems are less likely to develop if you keep your blood sugar in your target range. So check blood sugar regularly. Eat healthy foods. And take diabetes medicines as prescribed. Inspect your feet every day. This helps spot potential problems before they get worse. You can also do basic skin care to help keep your feet healthy. Have regular checkups with your healthcare team. These help make sure your diabetes is under control and that your feet are healthy. Be sure your healthcare provider checks your feet at least once a year. If you have any foot problems, have your feet checked at every provider visit. Your Team Is There to Help Your diabetes healthcare team can teach you how to inspect your feet and look for problems. They can also provide treatment and follow-up care. Members of your healthcare team may include: A primary healthcare provider, such as your doctor, who guides your overall care. A podiatrist, a specially trained foot doctor who can treat diabetic foot problems. Your diabetes healthcare team will help you keep your feet healthy. A diabetes educator or nurse, who can teach you about managing your diabetes. A dietitian, who can advise you on a healthy diet. 3

4 A Healthy Foot With each step, a healthy foot withstands the pressure of two to three times a person s body weight. Bones and joints help spread this weight evenly throughout the foot. Blood vessels bring oxygen-rich blood to keep the foot healthy. And nerves help alert you to any foot problems or injuries. Blood vessels carry oxygen and nutrients to the foot. This helps heal injuries. When Skin Is Healthy Healthy skin is your foot s first line of defense against infection. Beneath the skin are tissues such as fat, nerves, and blood vessels. These tissues cushion your foot from the pressure of your body s weight. All of the parts in your foot work together to keep it healthy. Bone Nerve Blood vessel Fat Skin Nerves let you feel pain, vibration, pressure, heat, and cold. Joints are where bones come together. They help absorb pressure and allow the parts of the foot to move. Bones give the foot structure. They also help spread the pressure of body weight over the foot. 4

5 Common Foot Problems Most foot problems are caused by rubbing or pressure in areas where skin lies close to bone. Although these problems can happen to anyone, having diabetes makes them much more serious. Even a tiny break in the skin can develop into a severe infection. Diabetes can lead to nerve damage (neuropathy) in the feet. With neuropathy, you may not be able to feel foot problems. In some cases, bones and joints can break without your knowing it. A corn or callus is caused by too much rubbing in the same spot. Over time, an infection may develop. Bunions result when the big toe is pushed inward, making the joint stick out. The bunion can get sore, infected, or even lead to arthritis. When Skin Is Infected Broken-down skin can be caused by rubbing, too much pressure, or injuries. If bacteria are present, a break in the skin may get infected. Having high blood sugar can make it harder to heal and may allow the infection to spread. Ingrown toenails develop when the nail grows into the skin. This can let bacteria enter and lead to infection. A hammer toe is bent downward like a claw. This can lead to a corn or blister where the joint sticks up. Blister A blister or callus may start as a red or warm hot spot in the skin. This can allow bacteria to enter. Infection An infection may reach all the way through the skin and underlying tissues. It can even spread to bones and joints. 5

6 Inspecting Your Feet Diabetes can affect nerves in your feet, making it hard for you to feel injuries. So inspect your feet every day. This helps you find small skin irritations before they become serious infections. If you have trouble checking your feet, ask a family member or friend to help. And see your healthcare provider right away if you have any of the problems listed on these pages. Call your healthcare provider right away if you have: Redness with streaks, or color changes in your feet. A blister or sore on your foot. Severe or increasing foot pain. A burning sensation that gets worse. Increased swelling in your feet. Drainage on your sock. How to Check Your Feet Below are tips that will help you look for foot problems. Try to check your feet at the same time each day, such as when you get out of bed in the morning. Check the top of each foot. The tops of toes, back of the heel, and outer edge of the foot can get a lot of rubbing from poor-fitting shoes. Check the bottom of each foot. Daily wear and tear often leads to problems at pressure spots (see the top of page 7). If needed, a mirror can help you see the bottoms of your feet. Check the toes and nails. Fungal infections often occur between toes. Toenail problems can also be a sign of fungal infections or lead to breaks in the skin. Check your shoes, too. Loose objects inside a shoe can injure the foot. Each time you put shoes on, use your hand to feel inside for things like pebbles, loose stitching, or rough areas that could irritate your skin. 6

7 What to Look For Pay attention to any changes in your feet. These include changes in skin or toenail color, swelling, or areas that appear red, dry, or cracked. Also be aware of changes in sensation, such as burning, tingling, or a feeling of pins and needles. Other warning signs of foot problems include numb spots, or a foot that feels hot or cold. Pressure spots on the bottom of the foot absorb pounding pressure from the body s weight. These are common areas where problems develop. Hot Spots Look for red hot spots in areas that get a lot of rubbing, like the tops and bottoms of toes, the outer edge of the foot, and the ball of the foot. Over time, hot spots may turn into blisters, corns, calluses, or sores. Sores, Ulcers, and Wounds Look for sores in places like the bottom of the big toe or the ball of the foot. Sores can have white, yellow, or clear drainage. See your podiatrist immediately if you have a sore. Athlete s Foot Look for redness, scaling, or cracks around and between toes. This can be a sign of a fungal infection that causes itching and breaks in the skin. Toenail Problems Look for toenails growing into the skin and causing redness or pain. Thick, yellow, or discolored nails can signal a fungal infection. Cracks in the Skin Look for cracks on the heel and top and bottom of the foot. These are often caused by dry or irritated skin. Color Changes Look for any color changes in the foot. Redness with streaks can signal a severe infection, which needs immediate medical attention. 7

8 Evaluating Your Feet An evaluation helps your healthcare provider check the condition of your feet. The evaluation includes a review of your diabetes history and overall health. It may also include a foot exam, X-rays, or other tests. These can help show problems beneath the skin that you can t see or feel. Medical History You will be asked about your overall health and any history of foot problems. You ll also discuss your diabetes history, such as whether your blood sugar level has changed over time. Be sure to mention any prescription or over-the-counter medicines, supplements, vitamins, or herbal remedies you take. Foot Exam A foot exam checks the condition of different parts of your foot. First, your skin and nails are examined for any signs of infection. Blood flow is checked by feeling for the pulses in each foot. You may also have tests to study the nerves in the foot. These include using a small filament (plastic wire) to see how sensitive your feet are. You may be asked to walk a short distance to check for bone, joint, and muscle problems. 8

9 The Doppler test uses painless sound waves to measure the blood flow in your feet and lower legs. Diagnostic Tests If needed, your healthcare provider may suggest certain tests to learn more about your feet. These include: Doppler tests to measure blood flow in the feet and lower leg. X-rays, which can show bone or joint problems. Imaging tests, such as an MRI (magnetic resonance imaging), bone scan, and CT (computed tomography) scan. These can help show bone infections. Other tests, such as vascular tests, which study the blood flow in your feet and legs. You may also have nerve studies to learn how sensitive your feet are. Creating a Foot Care Program Based on the evaluation, your healthcare provider will create a foot care program for you. Your program may be as simple as starting a daily selfcare routine and changing the types of shoes you wear. It may also involve treating minor foot problems, such as a corn or blister. In some cases, surgery may be needed to treat an infection. 9

10 Preventing Problems When you have diabetes, it s easier to prevent problems than to treat them later on. So see your healthcare team for regular checkups and foot care. Your healthcare team can also help you learn more about caring for your feet at home. In some cases, this may include wearing special footwear to protect your feet. Have Regular Checkups Foot problems can develop quickly. So be sure to follow your healthcare team s schedule for regular checkups. During office visits, take off your shoes and socks as soon as you get into the exam room. Ask your provider to examine your feet for problems. This will make it easier to find and treat small skin irritations before they get worse. Regular checkups can also help keep track of the blood flow and feeling in your feet. If you have neuropathy, you may need to have checkups more often. Learn About Self-Care The more you know about diabetes and your feet, the easier it will be to prevent problems. Members of your healthcare team can help you learn how to inspect your feet and look for warning signs (see pages 6 and 7). They can also give you other foot care tips. During office visits, be sure to ask any questions you may have. Talk with your healthcare provider about inspecting your feet for problems. 10

11 Take Care of Your Feet Regular foot care helps keep minor nail and skin problems from becoming more serious. (See page 15 for foot care tips.) Some things you can do on your own. Others, like trimming corns or calluses, should be done by a healthcare provider. See your provider if you have a cut, blister, ulcer, or athlete s foot. Ask your provider whether you should cut your own toenails. In certain cases (especially if you have neuropathy), your provider may recommend seeing a podiatrist for nail trimming. Wear Proper Footwear Have your toenails trimmed by a podiatrist if you have neuropathy, poor circulation, or poor vision. Wearing proper footwear is very important. If areas of your feet have been damaged by too much pressure, your healthcare provider may suggest changing your footwear. In some cases, avoiding high heels or tight shoes may be all that s needed. In others, special shoes or custom inserts may be recommended. These help protect your feet and keep existing irritations from getting worse. 11

12 Treating Infections Diabetes can sometimes make it harder for the body to heal properly. This is why even minor foot problems (such as a small blister or an ingrown nail) can become infected. Left untreated, infections can spread and damage nearby tissues. They can even become lifethreatening. Your healthcare provider or a podiatrist can help clear up infections and restore your health. Minor Infections If you have a minor infection, you ll be started on a treatment program. The goal is to heal the infected area while keeping the infection from getting worse. Your healthcare provider will examine and clean the infected area. You may also be given antibiotics to fight the infection. Take all the medicines you are prescribed, even if the sore begins to look better. If you don t, the infection may spread. In certain cases, you may be told to keep your feet elevated or to limit walking. Follow-Up Visits Even with antibiotics and other treatments, a foot infection may take a long time to heal. For best results, be sure to keep all your follow-up appointments. These help ensure complete treatment. They also allow your healthcare provider to make sure you re healing properly. 12

13 Severe Infections In some cases, an infection can spread through the foot and up the leg. To treat a severe infection, you may be hospitalized and given intravenous (IV) antibiotics. You may also be referred to healthcare providers who specialize in treating infections. If the infection is a serious risk to your health, surgery may be recommended. Surgical Treatment The goal of surgery is to remove the infection and protect your foot or leg. Surgery may be done in a hospital or wound care facility. The length of your stay depends on the surgery and how well you re healing. During recovery, you will likely need to limit activity for a while. You may also have visits from a home healthcare nurse. Be sure to see your doctor for follow-up appointments. Wound Care Your healthcare team may refer you to a wound care facility. These are medical facilities that specialize in treating ulcers and infections that are hard to heal. While you re there, you may work with several kinds of doctors. You may also be given antibiotics or other medicines that help fight infection. Part of your treatment also includes learning to care for the wound at home. 13

14 Keeping Your Feet Healthy Managing diabetes and caring for your feet are lifelong tasks that go hand in hand. Do your part by controlling your blood sugar and making time to care for your feet each day. It will also help if you get regular exercise and wear shoes and socks that fit well. Get Regular Exercise Regular exercise improves blood flow in your feet. It also increases foot strength and flexibility. Gentle exercises, like walking or riding a stationary bicycle, are best. You can also do special foot exercises. Just be sure to talk with your healthcare provider before starting any exercise program. Also mention if any exercise causes pain, redness, or other signs of foot problems. Instep fits the foot. Toe box allows all toes to wiggle. Clean socks cushion the feet. Avoid socks with large seams or heavy stitching. Heel fits without slipping. Purchase shoes that feel comfortable as soon as you put them on. Increase the amount of time you wear them an hour each day. This can help your feet get used to the new shoes. Ask your podiatrist what kind of shoes to wear during exercise. Arch provides support and conforms to the foot. Make Sure Shoes and Socks Fit Any pair of shoes new or old should feel comfortable as soon as you put them on. Buy shoes at the end of the day, when your feet are larger. Make sure the shoes provide support without feeling too loose. Be sure socks fit, too. To protect your feet, avoid shoes that are open-toed or open-heeled. If you have questions about what kinds of shoes and socks are best, talk to your healthcare team. 14

15 Foot Care Tips These self-care tips can help you prevent foot problems: Manage your diabetes. Keep your blood sugar in your target range. Take diabetes medicines as prescribed. Eat healthy foods. And see your healthcare provider for regular checkups. Inspect your feet daily for hot spots, blisters, cracks, or dry skin. Avoid walking barefoot, even indoors. Always wear shoes and socks when you re out of bed. Don t use corn or wart removers. These products often contain salicylic acid, which can damage skin. Wash feet with warm water and mild soap every day. Don t soak your feet. And dry your feet well, especially between the toes. Ask your healthcare provider about cutting your toenails or having pedicures. And never trim corns and calluses yourself. Stop smoking. Smoking restricts blood flow and can make it harder for wounds to heal. Avoid tight stockings, socks, tights, or pantyhose. These can cut off blood flow to your feet. Also, avoid crossing your legs for long periods. Don t use heating pads on your feet. If you have neuropathy, you could get a burn and not feel it. Use moisturizing cream or lotion to moisten dry areas, such as cracked heels. But don t use it between your toes. 15

16 Take It in Stride It takes time and effort to prevent foot problems. So commit yourself to the care of your feet. Start by managing your diabetes. Inspect your feet every day. And be sure to see your healthcare team for regular care. That way, you can keep enjoying things that matter most in life even if it s just a walk around the block. Resources To learn more, contact: American Podiatric Medical Association American Diabetes Association Medicare Diabetes Services (type diabetes into the search bar) Also available in Spanish TAKE OUR PATIENT SURVEY. Help us help other patients. Please visit to provide your feedback on this booklet. This booklet is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem The StayWell Company, LLC All rights reserved. Made in the USA