Department of Podiatry patientinformation
Hearing about your experience of our services is very important as it means we can pass compliments to our staff and make improvements where necessary. Tell us what you think at feedback@rothgen.nhs.uk If you require this document in another language, large print, braille or audio version, please contact Patient Information on 01709 424281 or email patientinformation@rothgen.nhs.uk
People with diabetes need to take good care of their feet. This is because high blood sugar levels can damage the nerves and blood vessels, leading to poor circulation, loss of sensation to the feet and the inability to feel pain. This can put you at risk of developing foot problems. If you have diabetes ensure that you have your feet checked at least once per year. This foot check needs to be performed by a health care professional with the appropriate training. At your foot check, the health care professional should inform you of your individual risk of developing diabetic foot problems. Your feet should be classified as Low, Moderate or High risk of developing a foot problem. Diabetic foot problems include infection, ulceration, gangrene, amputation and Charcot foot (a condition that causes severe foot deformity). It is important that you look after your diabetes to reduce the risk of complications. This includes being physically active (unless advised otherwise by a health care professional), eating a healthy balanced diet, and taking good control of your blood glucose, cholesterol and blood pressure. 3
Diabetes and the foot Diabetes can affect the nerves and circulation to your feet. You may not notice this happening. Neuropathy is a form of nerve damage caused by diabetes. It can lead to the inability to feel pain, but can also cause unusual sensations in the feet such as tingling, numbness, burning or pins and needles. If your pain sensation is affected by diabetes you may not notice trauma or damage to the feet resulting in blisters and wounds. Poor circulation or reduced blood supply to the feet can result in cuts and wounds taking longer to heal. People with diabetes may develop foot deformity. This includes prominent joints and clawed toes. This can lead to increased pressures at these sites resulting in calluses, corns, or wounds. It is important that your footwear fits well to prevent rubbing and pressure. Smoking If you smoke we strongly advise that you stop. Smoking can increase your risk of cardiovascular disease and affect the circulation in your feet resulting in poor wound healing. If you need help to stop smoking, support services are available. 4
How to look after your feet Foot hygiene Foot hygiene is extremely important for people with diabetes. You should wash your feet daily with mild soap and warm water. A thermometer can be used to check water temperature, this is particularly important if you have developed nerve damage as a result of your diabetes. Do not soak your feet for too long as this can cause skin damage. Ensure that you dry your feet thoroughly, especially between your toes. Toenails Patients with no nerve damage and a good blood supply to their feet may trim their own nails if able to see and reach. Alternatively you can file your nails 2-3 times per week. Follow the natural shape of your nail. This should be done before bathing. Use a nail file to gently smooth the nail edges ensuring there are no sharp corners or spikes. Do not cut your nails too short or down the edges as you may catch the skin or cause an ingrowing toe nail. You can even use a soft nail brush to clean under your nails if required. If you have nerve damage or poor blood supply to your feet, you should seek advice from a podiatrist, before trimming your own toe nails. Moisturiser If your skin is dry, apply a good quality moisturiser daily. Do not apply between your toes as this can cause the skin to become moist and irritated and increase the risk of fungal infections. 5
Footwear It is important that your footwear is the correct size and fit. Well-fitting shoes are an essential part of diabetic foot care. Your shoes need to be supportive, with good gripping outer soles and soft cushioning insoles and seamless where possible. The toe box should be deep enough and wide enough to safely accommodate your toes and any deformity without rubbing. Laces or straps are recommended to hold the foot inside the shoe preventing movement and friction. Leave 1 cm of room, (or one finger width) from the end of your longest toe to the end of the shoe. To start with when using new shoes only use for short periods at first, around 20 minutes, so that you can check for any irritation or rubbing. New shoes that do not fit well are often associated with diabetic foot problems. If they do not fit, stop wearing them. Footwear that is badly fitting is a common cause of blisters, trauma and damage to feet. Your healthcare professional may need to give you advice about your shoes. Avoid barefoot walking Never walk barefoot, even when at home. We advise that you use a supportive, well-fitting slipper or a house shoe (a pair of shoes that you just use in the house) for use in the home. This is to help avoid trauma and protect your feet. Never walk outside barefoot or in socks alone. 4
Socks Always wear socks or stockings with your footwear. Ensure these are clean and changed daily. Socks need to be well fitting and ideally made from cotton or wool. Avoid thick seams, which may cause rubbing or irritation, and tight elastic which may cause indentations in your skin or reduce your circulation. Things to avoid 1. Never use over the counter corn plasters or paints, these may contain strong acids. 2. Do not pick or pull dry skin. 3. Do not burst blisters. 4. Do not use sharp instruments to self-treat hard or dry skin. 5. To prevent damage to your feet do not put your feet close to fires or heaters. 6. Turn off electric blankets before getting in bed. 7. Never use hot water bottles to warm the feet as they could burn your skin. Daily foot and footwear checks You should check your feet every day. Check the top, bottom, sides, heel and between your toes daily for redness, swelling, warmth, wounds, blisters or fungal infections. If you cannot see your own feet ask a friend or family member to help. Mirrors can be helpful to aid your daily foot check. 5
You should check inside your shoes or socks before using them. Things to look for include damage, holes, and foreign objects, such as stones or creased insoles. These could all injure your feet. If damaged replace accordingly or do not use. Minor cuts and blisters Any minor cuts or blisters should be cleaned with a sterile solution (saline or water) and covered with a sterile dressing. Blisters should NOT be burst. If they burst, cleanse and cover with a sterile dressing. If treated incorrectly minor wounds can lead to serious complications. If minor wounds and blisters do not respond to simple care or deteriorate or become infected seek medical advice from your GP, Nurse or Podiatrist. When to seek help Consult your Podiatrist, Doctor, or Nurse immediately if you develop any changes in colour to your feet (red/ blue/purple/white/black), if you develop any sudden change in foot shape, or develop unusual pain, throbbing or swelling. If you develop any discharge (pus or bleeding) from a sore, break in the skin, corn, callus or toe nail, seek help. Signs of local infection include redness, swelling, heat, pus, pain or malodour. If suspected seek help immediately from your Podiatrist, Nurse, GP or nearest walk-in-centre. You may require a course of antibiotics. 4
Infections may even become severe and even limb and/ or life-threatening if not treated. Sepsis and severe infections require urgent emergency treatment, usually in hospital. Symptoms can be vague and not explicit, therefore, seek medical advice immediately if you have any concerns. Signs and symptoms may include, fever, or feeling cold, shivering, feeling clammy, mottled or pale skin, fatigue, muscle aches or abdominal pain, nausea or vomiting repeatedly, loss of appetite, diarrhoea, confusion, feeling light headed or faint, seizures, or reduction in urination. If you do have a severe infection you may also have flu-like symptoms. Early treatment is extremely important, call 999 or attend your nearest A&E, if you are concerned of severe infection, sepsis, limb and/or life-threatening infection. Always remember: Preventative foot care combined with good glycaemic control is the best protection against foot problems. 5
How to contact us The Appointments Office at Rotherham Community Health Centre deals with all general enquiries regarding our services. Please find their contact details below Department of Podiatry Rotherham Community Health Centre Greasbrough Road Rotherham S60 1RY Telephone 01709 423200 Appointments Office Telephone 01709 423200 Email podiatryappointments @rothgen.nhs.uk Diabetes Podiatry Service Diabetes Education & Resource Centre Rotherham General Hospital Moorgate Road Rotherham S60 2UD Telephone: 01709 42 7910 Fax: 01709 42 7911 Useful contact numbers NHS Direct Telephone 0845 4647 NHS 111 Produced by The Department of Podiatry August 2012. Revised January 2018, Revision due August 2020. Version: 2.0 The Rotherham NHS Foundation Trust 2018. All rights reserved. 6 Health Information Telephone 01709 427190 Stop Smoking Service Telephone 01709 422444 Patient Services Telephone 01709 424461 Urgent & Emergency Care Centre Telephone: 01709 424455 For GP out of hours, contact your surgery Useful websites www.diabetes.org.uk www.direct.gov.uk www.therotherhamft.nhs.uk NHS Choices: www.nhs.uk We value your comments If you have any comments or concerns about the care we have provided please let us know, or alternatively you can write to: Patient Services The Rotherham NHS Foundation Trust Rotherham Hospital Moorgate Road Oakwood Rotherham S60 2UD Telephone 01709 424461 Email complaints@rothgen.nhs.uk
How to find us Hospital site plan Woodlands P Two Way traffic One Way traffic Public Parking Busy Bees Nursery Oakwood Hall P PAY AND DISPLAY Oldfield Centre OAKWOOD HALL DRIVE Moorgate Wing Greenoaks Day Surgery Centre Maternity Entrance Urgent & Emergency Care Centre Rotherham Hospital Main Entrance IT Centre P PAY AND DISPLAY P PAY AND DISPLAY P Oakwood Community PAY AND Unit DISPLAY One Way Bus stop BAKER STREET MOORGATE One way Bus stop ROAD A618 Bus stop Security Centre TO WOODSIDE Rotherham main routes To Leeds Parkgate To Doncaster 35 Thorpe Hesley B6089 A633 Kimberworth Park A630 A629 East Dene Kimberworth M1 Place TOWN Clifton A6123 Kimberworth CENTRE A630 A6109 Herringthorpe Rotherham North 34 Hospital A631 South To Sheffield 34 Woodside A631 Brinsworth A630 To Sheffield A630 33 Treeton Moorgate A618 A631 Whiston A618 M1 Wickersley Bramley M1 32 A631 To A1, M62 & Hull M18 1 To Nottingham and the South 7
Sustainable Forests / Low chlorine JS 58 12/17 V2 Jones and Brooks Rotherham Hospital Moorgate Road Oakwood Rotherham S60 2UD Telephone 01709 820000 www.therotherhamft.nhs.uk