FOR FEET’S SAKE – The Diabetic Foot
Pete de la Pena, MD
As a contributor to a new section in “Hormone Hotspots“, I am indulged to write about a topic I fancy most—the diabetic foot.
Diabetic foot describes the foot of a diabetic patient that has risk for ulceration, infection and/or destruction of deep tissues associated with neurologic abnormalities, peripheral vascular disease and/or metabolic complications of diabetes in the lower limb.
More than 120 million people in the world have diabetes mellitus. This figure is predicted to reach 333 million by 2025. Many of them have diabetic foot ulcers, which may eventually lead to an amputation.
• Every 30 seconds a lower limb is lost to diabetes
• 40 -70 % of all extremity amputations are related to diabetes
• 85% of diabetes -related amputations are preceded by foot ulcers
Even then, there is hope! It is possible to reduce amputation rates by up to 85%.
Although the pathways to ulceration and amputation do not differ throughout the world, the prevalence of ulcers and amputations varies markedly between different countries. The differences probably reflect variations in population characteristics and wound management strategies across different regions. Prompt action must be taken to address this menace. This will require:
• Multidisciplinary treatment of foot ulcers
• Appropriate organization
• Close monitoring
• Education of people with diabetes and health care professional.
The time to act is now – better foot care through education and prevention! After all small steps when added together make one giant leap.
Simple tips to prevent foot ulcers. You must do the ff:
1. Examine your feet for blisters, cuts, color changes, swelling and open sores. (Use a mirror to see the soles of your feet.) 2. Always protect your feet. Wear suitable footwear inside and outside your home to avoid injuring your feet.
3. Check inside your shoes for stones, sharp Objects and rough patches before putting your shoes on.
4. Buy new shoes late in the day. This is because feet become more swollen towards the end of the day and you can be sure that your shoes are not too tight and fit well.
5. Wearing padded socks can help prevent injury. Make sure they are neither too tight nor loose. Make sure they have no holes.
6. Always wash your feet with soap and water. Take care to wash between your toes. Dry your feet carefully, especially between the toes. Use oil or lotion to keep your skin soft.
7. Cut toe nails straight across and file any sharp edges.
8. Have your feet checked periodically by a healthcare professional.
9. Keep any wounds covered with clean dressings.
You must avoid the following:
1. Avoid pointy -toe shoes, high heels, stilettos and strapless and backless shoes.
2. Don’t wear tight /Ioose socks.
3. When washing your feet be careful that the water is not hot, so as not to burn them.
4. Don’t use a heater or hot water bottle to warm your feet. Temperature of the water should be less than 37 C.
5. Avoid walking barefoot whenever possible. If this cannot be avoided because of cultural or religious reasons, you must be extremely careful and avoid the risk of burns from hot surfaces in hot climates.
6. Never try to treat your own feet with corn medicines or use razor blades to remove rough skin or calluses. Always seek professional help for this.
7. Avoid becoming overweight.
8. Don’t smoke – smoking damages the supply blood to the feet.
9. Don’t wear jewellery on your feet.
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Brought to you by the Philippine College of Endocrinology Diabetes and Metabolism (PCEDM)