more of these procedures, and diabetes is the leading cause of Often, diabetes-related foot problems start with a foot ulcer. …
Patient Information
Keeping Feet Healthy When You Have Diabetes
Lower-extremity amputations are an unfortunate complication of diabetes In 1996, 86,000 Americans with diabetes underwent one or more of these procedures, and diabetes is the leading cause of amputations in the lower half of the body With proper care, almost half of these amputations are preventable Often, diabetes-related foot problems start with a foot ulcer Because of diabetes-related peripheral neuropathy, structural foot deformity and peripheral arterial occlusive disease, diabetics are prone to foot ulcers About 15 of people with diabetes will get a foot ulcer, and between 12 and 24 of them will require an amputation, according to the American Diabetes Association But by some estimates, early detection and appropriate treatment of these ulcers may prevent up to 85 of amputations Despite these statistics, studies show that diabetes patients rarely receive foot examinations on a regular basis Lack of foot examinations costs patients personally and financially 4 Keep your skin soft and smooth Rubbing a thin coat of skin lotion over the tops and bottoms of the feet–but not between the toes–is important 5 Gently
smooth corns and calluses A pumice stone can be used, but over-the-counter products or sharp objects can cause harm 6 Trim toenails each week, or when needed Cut toenails straight across and file at the edges with an emery board or nail file If you have peripheral neuropathy, vascular disease or eye disease, you should not attempt to cut your own toenails, because this can lead to serious self-injury 7 Wear shoes and socks at all times Diabetes patients with atrisk feet should never walk barefoot Shoes should fit properly and protect the feet Feel the inside of your shoes before putting them on to make sure the lining is smooth and there are no objects inside 8 Protect your feet from hot and cold Wear shoes at the beach or on hot pavement, wear socks at night if your feet are cold, do not test bath water with your feet and do not use hot water bottles or heating pads on your feet 9 Improve your circulation Keep blood flowing to your feet by putting up your feet when sitting, and wiggling your toes and moving your ankles up and down for 5 minutes two or three times a day 10 Plan a physical activity program For people with diabetes, regular exercise can lower blood glucose, improve
insulin sensitivity, raise HDL cholesterol, improve blood flow and heart muscle strength, enhance fibrinolysis, control weight, increase muscle mass and provide an overall sense of well-being These benefits can delay the onset of neuropathy and atherosclerosis
Adapted from Feet Can Last a Lifetime: A Health Care Providers Guide to Preventing Diabetes Foot Problems, part of a joint national diabetes education program of the National Institutes of Health and the Centers for Disease Control and Prevention
Keep Your Feet Healthy
Here are 10 ways to keep your feet healthy: 1 Take care of your diabetes Work with your nurse practitioner to keep your blood sugar within a good range A landmark 1993 study, the Diabetes Control and Complications Trial, showed that keeping blood glucose as close to normal as possible significantly slows the onset and progression of nerve and vascular complications These complications are what lead to lowerextremity amputations Control over blood glucose also slows the progression of eye and kidney diseases caused by diabetes 2 Check your feet every day If your feet are identified as at risk, make sure to check them twice a day Look for cuts, blisters, red
spots and swelling If you have trouble seeing your feet, using a mirror or asking a caregiver or family member will be of great help 3 Wash your feet every day in warm–not hot–water Dry your feet thoroughly and do not neglect the area between the toes
Additional Notes:
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Your nurse practitioner has given you this patient education handout to further explain or remind you about principles related to your medical condition This handout is a general guide only If you have specific questions, be sure to discuss them with your nurse practitioner
wwwadvanceforNPcom December 2001 ADVANCE for Nurse Practitioners
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