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1 Diabetic Foot Care Cover:Layout 1 18/12/08 14:35 Page 1 info@northerntrust.hscni.net This document is available, on request, in accessible formats, including Braille, CD, audio cassette and minority languages. NT/WCS/12/08/ k CCD

2 Diabetic Foot Care Cover:Layout 1 18/12/08 14:35 Page 2 Foot Care for people with diabetes

3 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 1 Foot Care for people with diabetes 1

4 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 2 2

5 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 3 Contents As a Diabetic 4 Hygiene 5 Nail Care 6 Corns and Callouses 7 Skin 8 Heat and Cold 9 Shoes and Hosiery 10 First Aid 12 Going on Holiday 13 Also Remember 14 Further Information 16 3

6 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 4 As a Diabetic You may have been told that it is especially important to take good care of your feet. There are several reasons for this. Diabetes may hinder the blood supply to your feet or it may affect the nerve supply. If there is poor blood supply, any cuts or open wounds on the foot may be more difficult than usual to heal. If the nerve supply is affected, pain or pins and needles may occur. This might make it more difficult to recognise heat or cold or the sensation of touch on the skin. If loss of feeling occurs you may not notice small cuts or damaged skin. In fact, you may not feel pain at all. Most people with diabetes, however, are unlikely to have serious problems with their feet and it should be remembered that prevention is better than cure. 4

7 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 5 Hygiene Wash your feet daily in warm water (42 C or 110 F) using a bath thermometer to check the temperature before immersing your feet. Use a mild toilet soap. Do not soak your feet - unless advised to do so by your doctor or podiatrist. Pat dry with a soft towel taking care to dry between your toes. 5

8 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 6 Nail Care Cut when soft - after bathing. Cut the edge following the shape of the end of the toe. Do not cut down the sides. Do not cut your nails too short. Use a good quality nail file or an emery board to smooth the edge of the nail, working in the line of growth. Never use a sharp instrument to clean down the sides. If you find your nails difficult to cut, if they are troublesome, or if you cannot see clearly to cut them, consult your podiatrist. 6

9 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 7 Corns and Callouses Leave these to your podiatrist. Do not cut your corns and callouses yourself or let a well meaning friend or relative do them for you. Do not use corn paints or plasters - these often contain acids which can be dangerous. If you require foot appliances or special footwear, consult your podiatrist as these can be made for you by your podiatrist or obtained through the hospital department. 7

10 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 8 Skin Your skin may be very dry. If so, use an emollient cream such as E45 after daily bathing. If your skin is very sweaty, dab with a little surgical spirit. After daily bathing, examine your feet carefully watching for: any change in colour of any part of the foot or leg; discharge from a break in the skin, a corn or from under a toe nail; and troublesome itching, pain, throbbing or swelling. If you notice any of these you should seek advice immediately from either your podiatrist or doctor. 8

11 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 9 Heat and Cold Check the temperature of bath water using a bath thermometer - it must not exceed 42 C or 110 F. Do not sit too close to fires or heaters. Remove hot water bottles before getting into bed. Switch off electric under-blankets before getting into bed. Bed socks, if worn, should be woollen and must be loose fitting. Avoid getting cold from wet feet - dry them carefully and change socks or stockings and footwear. Keep feet warm especially in winter - wear woollen socks. Never use hot poultices or fomentations. 9

12 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 10 Shoes and Hosiery Make sure socks and stockings are not too tight - these can have the same effect as tight shoes. Change socks or stockings daily. Do not wear garters. Wear wool or cotton instead of nylon. If socks or stockings have seams around the toes, wear them inside out so the seam is not next to the skin. Have your feet measured when buying shoes - they should be correct in length, width and depth. A suitable shoe is one which is held securely onto your foot with a lace, a bar or a buckle. Never buy shoes which you feel must be broken in. 10

13 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 11 Ideally your shoes should: be made of soft leather; have no fancy stitching around the toe area; have a heel of no more than 1 1 /2 inches; have the heel attached firmly to the sole of the shoe; and have a broad heel - not a stiletto type. Never wear someone else s shoes. Court and casual shoes should only be worn for short periods of time. Slippers are only suitable if worn for short periods of time. Always check inside your shoes for foreign objects or roughness before putting them on. Change shoes regularly - airing in an open space after use. For summer, open sandals with adjustable straps are more suitable than mules. REMEMBER The price of the shoe does not matter, the maker of the shoe does not matter; but the shape and fitting of the shoe is important. 11

14 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 12 First Aid Minor cuts should be gently cleansed with warm water, dressed with a mild antiseptic cream and covered with a sterile gauze dressing. Cover a blister with a sterile gauze dressing and leave to dry up on its own. If it breaks, apply an antiseptic dressing and keep covered until it has healed. Never burst a blister. Never place adhesive strapping directly over a wound. If minor injuries do not respond to your own treatment within a few days - it is advisable to see either your podiatrist or doctor. 12

15 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 13 Going on Holiday Long journeys on trains, buses and planes can make your feet swell. Walk up and down the aisle every half hour as the exercise will help keep the swelling down. Also take a pair of adjustable sandals for the journey. Do not walk barefoot. Wear plastic sandals on the beach and in the sea. Avoid sunburn to your feet and legs. Use a high protection sun screen or keep them covered. Take some small sterile dressings, antiseptic cream and non-allergic plasters such as Micropore, with you. Remember to carry out the daily examination of your feet. 13

16 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 14 Also Remember Do not walk around with bare feet, even in the house, or go outside in soft soled shoes or slippers - nails or splinters may go through such footwear. Be vigilant - even a mild infection may upset your diabetes. Podiatry treatment is available free of charge for diabetics of any age group from the National Health Service. Podiatrists working for the National Health Service are registered with the Health Professions Council. If you attend a podiatrist privately, make sure that they are registered with this national body. 14

17 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 15 It is recommended that all newly diagnosed diabetics attend the podiatrist for initial assessment and advice. Routine follow-up or treatment, if required, will be arranged at your hospital diabetic clinic or local health centre. The podiatrist is, after all, especially trained to deal with your foot problems and will provide you with the appropriate help, advice and treatment. 15

18 Diabetic Foot Care text:layout 1 19/12/08 13:14 Page 16 Further Information Nearest clinic: Phone: Your podiatrist is: and is available at this clinic on: Day: Time: 16