Foot care and its importance in diabetes

Diabetes is a lifelong disease that brings with it some problems and responsibilities. Diabetic foot is one of the most serious and severe complications of diabetes. Approximately 50% of people with diabetes are at risk of developing diabetic foot throughout their lifetime. For this reason, foot problems in diabetes are very important both medically, socially and economically.

If your blood sugar is very high and irregular, you will start to have problems with your feet. The reason for this is the blood circulation disorder in the veins. As a result of this circulatory disorder, destruction begins in the vessels. Dysfunctions occur in organs that cannot reach enough blood.

At the same time, when blood sugar is high, damage to the nerves in the feet occurs. When the nerves are damaged, loss of sensation in the feet and fingertips may occur. Because; pressure, pain, cuts, burns and injuries may not be felt. Foot ulcers occur after cuts, burns and wounds. In addition, some microbes (bacteria and fungi) multiply more easily in a sugary environment. Bacterial and fungal infections disrupt the integrity of the skin and again lead to wound formation. These wounds become inflamed very quickly and cause serious problems. Left untreated, gangrene and even cutting of the damaged area may be possible.

With nerve damage, foot muscles become weak. This causes damage to the skin, soft tissue, bones and joints. When these damages begin, it is necessary to avoid activities that may cause more damage to your feet, such as running, football, stepping, etc.

At the same time, when blood sugar is high, damage to the nerves in the feet occurs. When the nerves are damaged, loss of sensation in the feet and fingertips may occur. Because; pressure, pain, cuts, burns and injuries may not be felt. Foot ulcers occur after cuts, burns and wounds. In addition, some microbes (bacteria and fungi) multiply more easily in a sugary environment. Bacterial and fungal infections disrupt the integrity of the skin and again lead to wound formation. These wounds become inflamed very quickly and cause serious problems. Left untreated, gangrene and even cutting of the damaged area may be possible.

With nerve damage, foot muscles become weak. This causes damage to the skin, soft tissue, bones and joints. When these damages begin, it is necessary to avoid activities that may cause more damage to your feet, such as running, football, stepping, etc.

FOOT COMPLICATIONS

Frequency of Examination

HOW FREQUENTLY FEET SHOULD BE EXAMINED BY THE DOCTOR?

• 3 years after the diagnosis of type 1 diabetes and every year thereafter
• When the diagnosis of type 2 diabetes is diagnosed and every year thereafter
• When there is any complaint, the examination should be done.

WHAT DOES THE DOCTOR SEE IN THE FOOT EXAMINATION?

• Circulatory collapse
• Nerve damage
• Skin changes
• Shape changes
• Wounds
• Nails

MATTERS TO BE CONSIDERED FOOT CARE

• Quit smoking.
• Do not step on the ground with bare feet at home or on the beach, always wear slippers on your feet.
• Wash your feet daily in warm water (not exceeding 37 degrees) with a non-irritating soap. After washing, dry thoroughly with a soft towel, especially between your toes. This drying will prevent fungal infection, especially between the fingers.
• You can apply moisturizing cream to your feet against drying and cracking. But never apply the cream between the toes.

• Change your socks every day. Prefer cotton socks that do not tighten the foot
• Be careful not to tighten the elastic parts of the feet. Do not wear repaired or sewn socks. These can cause skin damage and irritation.
• Never use cutting tools for calluses and hardened skin on your feet.
• Cut your toenails when they are soft after a bath, do not cut them too short and do not cut the corners deep. File it later with a nail file.
• Do not warm your feet in any heater (stove, heater, electric heater, etc.) or using a hot water bag. In this type of heating, serious burns may occur on your feet without realizing it.
• Wear your socks when your feet feel cold.
• Before entering the bathroom, make sure to have a member of the family check the temperature of the water. Do not step into the bathroom without measuring the temperature. Because you may not be able to feel the heat of the water due to damage to the foot nerves.
• Check your feet every day (maybe before going to bed at night). You can look at the parts you can’t see with the help of a mirror. In this way, you can notice the cuts, scratches, swelling, dryness of the skin, redness and blisters on your feet early and take their precautions.
• Never cut dead tissue and blisters around nails.
• Do not use commercially available cosmetic products for your feet hardness, calluses and nail problems without consulting your doctor.
• Do not sit cross-legged or cross-legged, as this will cause circulatory disorders.
• Check the feeling by touching the bottom, top, heel and toes of your feet every day.
• Get regular and good foot care habits.

Shoe Selection

USE OF SHOES AND SELECTION OF SHOES FOR A DIABETES

Points to be considered in the use of shoes by a diabetic person and shoe selection should be as follows:
• Wear comfortable, soft shoes that fit well. If necessary, have special shoes made for your feet.
• Do not wear your shoes without socks. Prefer seamless, non-tight, flexible socks that absorb sweat, keep warm when necessary, cool when necessary.
• Do not use open-toed slippers and flip-flops. (Glass, nails, stones, etc. things may prick your feet)
• Before wearing your shoes, check the inside of your shoes by shaking them for areas that may cause blisters and friction on the feet. (for stones etc.) )
• Wipe the inside of your shoes with a wet soapy cloth once a week.
• If the insole is worn, replace it. (Can be changed every 6 months)
• Have your shoes painted frequently to protect the outer surface.
• Do not wear sandals, high heels and pointed-toed shoes. These types of shoes put your feet under excessive pressure and lead to crushing of the skin in these areas.
• Your feet cannot maintain their size in the morning, they swell. For this reason, go to buy shoes in the afternoon. When you buy new shoes, try to wear them for a maximum of 1-2 hours during the day, so that your feet get used to the shoes.
• Shoes should be changed during the day if possible to relieve pressure areas.
• When you are going to exercise, wear running and walking shoes.
• If you have deformities or scars on your feet, you may want to consider custom-made shoes.

HOW IS THE TREATMENT FOR PROBLEMS IN THE FEET?

There are treatment approaches suitable for the type, depth and size of foot wound and infection. The necessary treatment plan for your problem is prepared by specialists (Endocrinologist, Dermatologist, Plastic surgeon, Cardiovascular surgeon, Orthopedist, Infectious diseases specialist).

The first and most important treatment is to maintain tight blood glucose control. In order to ensure this continuity, first of all, the diet program must be reorganized and the treatment you have received for diabetes must be reviewed.

For this reason, go to your doctor’s controls regularly. Do not neglect your necessary care by giving importance to your foot health.

Wishing you a healthy life….

ATTENTION…!

• Absolutely do not smoke. Smoking damages the vascular and nervous system a lot.
• Living with diabetes; In addition to being able to apply diet, exercise and the treatment that your doctor has recommended to you, it is of great importance for you to follow yourself and take care of yourself and to continue your life in a healthy way.
• Fingers or feet are amputated in approximately 5% of male and female diabetic patients. This poor outcome can often be prevented by good blood sugar control and daily foot care.
• When you observe a problem in your foot, consult your doctor as the first thing.

DIABETIC FOOT IS A PREVENTABLE DISEASE.