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Diabetic Foot

Diabetes affects approximately 16 million Americans and is classified into two different types: Type 1 and Type two. Type 1 is usually associated with juvenile diabetes and is often linked to heredity. Type 2, commonly referred to as adult-onset diabetes, is characterized by elevated blood sugars, often in people who are overweight or have not attended to their diet properly. Diabetics must pay particular attention to their feet as they are at risk for developing complications that can lead to foot and lower leg amputation and even death.

SYMPTOMS

  • Neuropathy (nerve damage) – tingling, pain, numbness
  • Degenerative structure and shape of foot
  • Ulcers
  • Infection from untreated blisters

Complications Related to Diabetes 

There are numerous complications associated with diabetes. Diabetes disrupts the vascular system, affecting many areas of the body, such as the eyes, kidneys, legs, and feet. This can lead to peripheral neuropathy (nerve damage) in the feet. In fact, diabetes is the most common cause of peripheral neuropathy. Neuropathy can lead to a dangerous foot condition called Charcot Foot, a degenerative process where the structure and shape of the foot collapse due to undetected injury creating a deformity. Charcot Foot can lead to ulcers in the feet that are difficult to heal, often resulting in amputation and even death. High blood sugar damages the vascular system and nerve fibers, especially in the feet and legs affecting both sensory nerves and the proprioceptors (the nerves that tell your body where it is in relation to space, e.g. where your foot is relative to the floor, the stairs, etc.). This nerve damage results in sensations that range from tingling, to pain or numbness. For some people, the symptoms can be mild, while for others they can be severe, disabling and even fatal. Because diabetic neuropathy affects the nerves of the feet, even small injuries such as a blister or rubbing inside a shoe can go undetected. Because shoes are a warm, moist environment, bacteria grows quickly. This can lead to infection, which can be difficult to treat as the blood supply to neuropathic feet is compromised due to vascular damage. Infections that won’t heal can quickly turn into diabetic ulcers (injury into the deeper layers of tissue) which dramatically increase the risk of amputation of the affected area.

CAUSES

  • Elevated blood sugar
  • Damage to the vascular system
  • Damage to nerve fibers
  • Obesity/overweight

TREATMENT

  • Inspect your feet daily, including between the toes.
  • Wash your feet daily.  Dry carefully, especially between the toes.
  • Avoid extreme temperatures.
  • Inspect the insides of your shoes.
  • Wear properly fitted shoes and socks at all times – never go barefoot.
  • Protect your feet from hot and cold.
  • Always wear seamless socks with your shoes.
  • Cut your nails straight across, using an emery board to file corners.
  • Wiggle your toes and move your ankles up and down for 5 minutes 2 or 3 times a day to increase blood flow to your feet.
  • Ask your doctor to plan an exercise program that is right for you.
  • Call your doctor immediately if you have a cut, sore, blister or bruise that does not heal after one day.
  • Get regular foot examinations

Solutions to Diabetic Foot Issues 

If you have diabetes, it is vitally important that you examine your feet regularly, even if you do not have peripheral neuropathy. It is not uncommon for diabetics to not realize that they have neuropathy as it can present with a gradual numbing of the foot. Any small injury, left undetected, can lead to complications that can result in amputation. Pressure and friction are the enemies of diabetic feet. Shoes should be fitted by a shoe fitting expert (pedorthist) who can assure that the shoes will properly fit and support the feet reducing the risk of injury from shoes that are too tight or are likely to rub or cause injury. Excessive pressure causes calluses and corns, which can easily lead to an injury which can be hard to heal in a diabetic foot. The best way to reduce pressure points and improve foot function is through the use of arch supports. If you have Charcot Foot, at a minimum, you require custom arch supports (orthotics) and properly fitted shoes. You may require custom shoes. Only get your footwear from a certified pedorthist (C.Ped.) or orthotist/prosthetist (CPO) to ensure you protect and care for your very special, at-risk feet. Call The Orthocare Placeto make an appointment with one of our Certified Pedorthists.

THE ORTHOCARE PLACE PRODUCTS

  • Supportive athletic, casual or dress shoes
  • Wellness shoes to help you walk properly and correct your balance
  • Off-the-shelf arch supports
  • Custom-fitted, custom-crafted arch supports

Visit a The Orthocare Place fit expert today for a free digital foot assessment, consultation and treatment recommendations for effective non-invasive solutions

 

DO:

  •  Inspect your feet daily, including between the toes.
  • Wash your feet daily. Dry carefully, especially between the toes.
  • Avoid extreme temperatures. Test water with your elbow or a thermometer before bathing.
  • Inspect the insides of your shoes before putting them on to detect foreign objects, nail points, torn lining and rough areas.
  • Wear shoes and socks at all times.
  • Protect your feet from hot and cold. Wear socks if feet are cold at night. In cold weather, check feet often to keep feet warm and avoid frostbite. Keep feet away from radiators, open fires, and out of hot tubs. Use sunscreen on feet to avoid sunburn.
  • Buy shoes and other footwear from a trained pedorthist (shoe fitting specialist) such as the staff at The Orthocare Place to ensure proper fit.
  • Always wear seamless socks with your shoes to help avoid blisters and sores developing.
  • Cut your nails straight across, using an emery board to file corners, if nails are easily trimmed. If not, have your podiatrist or other medical professional trim your nails.
  • Wiggle your toes and move your ankles up and down for 5 minutes 2 or 3 times a day to increase blood flow to your feet.
  • Ask your doctor to plan an exercise program that is right for you.
  • Call your doctor immediately if you have a cut, sore, blister or bruise that does not heal after one day.
  • See your doctor regularly and be sure to have your feet examined at each visit for sense of feeling, pulses and general foot health.

DON’T:

  • Do not smoke. Smoking reduces blood flow to your feet. Do not apply hot water or heating pads.
  • Do not walk on hot surfaces, such as sandy beaches or on the cement around a swimming pool.
  • Do not walk barefooted, even indoors.
  • Do not use chemical agents to remove corns, calluses or warts. Do not use strong antiseptic solutions on your feet. Do not use adhesive tape on your feet.
  • Do not soak your feet. Do not use hot tubs.
  • Do not cut your own nails if they are thick or yellow. Have a doctor trim them.
  • Do not wear restrictive footwear that can cut off circulation such a tight socks, elastic, rubber bands or garters.
  • Do not wear mended socks or socks with seams. Do not use oil on cream between your toes.
  • Do not cut corns or calluses, see your doctor.
  • Do not cross your legs for long periods of time. This cuts off circulation to your feet

MEDICARE’S PREVENTION PROGRAM FOR DIABETICS 

If you are a diabetic and have Part B Medicare coverage, you may be eligible for Medicare’s Therapeutic Shoe Bill, which was designed to help prevent amputation due to the complications from diabetes. Eligible participants can receive diabetic appropriate shoes and inserts at greatly reduced or no cost. Participating The Orthocare Place stores can provide you with all you need to benefit from this important program and the required forms that must be filled out by your medical doctor. Check with your local The Orthocare Place store to find out if they participate in this program, and if they do these forms can be downloaded from their store’s website.