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Diabetes and Julie’s Feet

Anytime is a good time to remind those with Diabetes about the importance of foot care. Diabetes can be dangerous to your feet— even a small cut can cause serious problems.  Julie (names have been changed to protect the . . . health information – google HIPPA) came into my office yesterday having walked around Disney World the prior week.  She expressed that she had pain and blisters.  The following are some of the things we discussed.

Inspect Your Feet Daily—Check for blisters, redness, cuts, swelling or nail problems. If you have trouble seeing the bottom of your feet, use a hand mirror or ask a family member to inspect them for you. If you notice anything abnormal, call our office to have it checked out.  I asked Julie when she noticed the swelling and blisters.  She indicated that she had waited an entire week to come in because, “I though they were going to get better”.  Some of these blistered/ulcerated areas were very red and required that she be put on an oral antibiotic.

Wash Your Feet in Lukewarm Water—Wash your feet daily with a soft washcloth or sponge in lukewarm water, not hot water. Be sure to dry by patting or blotting and carefully dry between your toes.

Moisturize Daily—With the cooler temperatures of fall and winter, it is even more important to moisturize your feet daily to prevent your skin from itching and cracking. Because we live in Colorado this is absolutely vital.  Don’t use moisturizer between the toes, however, where it can lead to skin breakdown and infection.

Cut Nails Carefully—Cut nails straight across and don’t cut them too short. Nails cut too short can lead to ingrown toe nails.  During the course of my examination I noted that Julie had excellent pulses in her feet and enough sensation that she could pick up on any painful stimulus such as the blisters that had formed.  I determined, though, that because of the swelling and current blisters we would need to visit more than once a year (her prior visit frequency) until things had resolved.

Never Treat Corns or Calluses on Your Own—If you have corns, calluses or severely dry skin on your feet, make an appointment with our office and we can help.  Julie had returned home earlier in the week with multiple blisters on the toes and one behind her heel.  She delayed coming into the office and by that time had a full blown infection.  Corns and calluses can increase in thickness and actually act like a rock in the shoe.  As they get thicker and thicker they can form wounds especially if you have decreased sensation.  Any opening in the skin can lead to infection and must be treated immediately.

Wear Clean, Dry Socks—Change your socks daily. Avoid tight elastic bands and thick or bulky socks that can fit poorly and irritate the skin.  Besides the pain, Julie knew she was in trouble because of the drainage she noted on her white socks.  With her swelling, Julie may benefit from something called a compression stocking.

Schedule Regular Foot Exams—Regular foot exams help to prevent foot complications of diabetes before they start.  One of the tragedies in Julie’s story is that she had stopped communicating with her Podiatrist because she “felt that (she) was doing alright”.  Julie also had not measured her feet in some time.  She did not know that she was actually a half size larger than the size shoe she had been wearing.  Julie has hammertoes also which contribute to her difficulty in finding appropriate shoe gear.  Your podiatrist can consult with you about what features in your shoe gear are required.

Family and loved ones with diabetes should be seen by a podiatrist at least on a yearly basis.  By incorporating the above tips into their life we won’t have to put out a fire in my office.  In diabetes and foot care – an ounce of prevention is worth a pound of cure.