organization, and using all or parts of the Diabetes Today curriculum as a The Diabetes Section would encourage Similar to other years, in 2007, the diabetes …
Diabetes Foot Care
BAYER HEALTH FACTS
EASY ACCURACY ANSWERED BY BAYER
American Association of Diabetes Educators
DIABETES AND FOOT CARE
Living with diabetes makes it even more important to take care of your personal healthcare needs This is especially true for the care of your feet People who have diabetes are more likely to have problems with poor blood flow and a loss of feeling in the feet This can lead to a variety of foot problems including dry skin, cracked heels, heavy callus formation, changes in the shape of the foot, and skin ulcers The good news is that if you know how to take care of your feet, you may be able to lessen or even prevent these problems Poor blood flow results in less oxygen reaching the cells in the feet If this happens you may experience changes in nail growth, painful foot ulcers and slower healing Some people with diabetes may have nerve damage in the feet, causing problems with feeling This typically occurs as a result of poor blood sugar control over an extended period of time Loss of nerve function means that you may have little or no feeling in your feet in response to temperature, pressure or pain If your feet get too hot, such as with the use
of a hot water bottle or hot bath water, your feet can suffer a burn, and you will not feel it You may not feel injuries such as blisters developing if your shoes are too tight You may not feel anything when you step on a sharp object This loss of feeling makes the feet more likely to be injured without you being aware of it
HOW TO TAKE CARE OF YOUR FEET
There are some simple steps you can take to avoid injury and reduce the risk of damage to your feet Spend some time caring for your feet everyday, and this can help keep them healthy
INSPECTING YOUR FEET:
Check your feet daily This includes the tops and bottoms of your feet and between each of your toes If you have difficulty bending, use a mirror to look at the bottoms of your feet or have someone help you
Look at your feet in a place with good lighting A good time to do this is after you take a bath or shower
Check for changes Look for cuts, scratches, blisters, calluses, corns, ingrown toenails or signs of infection Also look for white, moist, wrinkly skin, especially between the toes
Feel for increased heat in the skin Hot spots may suggest the presence of underlying infection or inflammation If you have nerve
damage in your foot, there may be little or no pain to alert you to these problems Any concerns should be addressed right away by your healthcare professional
BATHING:
Keep your feet clean Wash them daily with a soft warm washcloth and a mild soap Remember to check the water temperature with your wrist or elbow to ensure that the water is not too hot to avoid burning your feet
Do not soak your feet in water or any other solution Soaking will only cause your skin to dry out more
To dry your feet use a soft towel, remembering to dry between each and every one of your toes Do not put lotion between your toes, and never use a hair dryer to dry your feet
Apply lotion to the tops and bottoms of your feet after every wash A mild 5-10 UREA-based lotion will help reduce skin dryness
CORNS AND CALLUSES:
Feet develop corns and calluses as a way of protecting your skin against pressure or friction This may happen if you have poorly fitting shoes, or walk incorrectly If calluses or corns develop they will add to the problem, causing you further discomfort To get rid of corns and calluses you must reduce the pressure on your feet This will often involve obtaining proper,
well-fitting footwear and perhaps the use of special insoles in your shoes The insoles will more evenly distribute your body weight over the sole of your foot
For mild callus buildup, when the foot is dry gently file away any callused area with a pumice stone Afterwards, apply lotion to all callused areas to keep the callus flexible and stop it from cracking
Avoid using do-it-yourself corn or callus removers Do not use corn pads
Never cut your corns or calluses with a razor blade For thick corns or calluses, visit a podiatrist or other qualfied healthcare professional to have them removed, and discuss prevention of future calluses
TOENAILS:
Keep your toenails properly trimmed and smooth Use blunt scissors to cut the nail straight across and then file the corners round with an emery board Do not cut the nails too short; always leave about 1/16 to 1/8 of an inch of free nail beyond the end of your toe The best time to cut your nails is after bathing when they are soft and easy to trim
If you have any problem reaching your nails easily, or if your nails are thick and more difficult to cut, seek help from a healthcare professional trained to care for nails and feet, such
as a podiatrist
If you develop an ingrown toenail, seek medical attention Do not try to treat it yourself
SOCKS:
Wear clean socks every day A sock that is at least 80 cotton or wool is best to absorb the perspiration and allow the skin to breathe Avoid nylon in socks or stockings Socks should fit well, without tight elastic, especially at the top Avoid socks with bulky seams
SHOES:
Never walk barefoot at home or outside Wear shoes and socks in the house and outside every day to protect and support your feet Before you put on your shoes, always shake them out and then carefully feel inside for stones or other loose objects or rough spots that might hurt your feet It is a good idea to keep a pair of slippers beside your bed in case you need to get up in the night That way they will be handy for you to put on
Proper shoes are important Shoes should have a thick, flexible rubber sole with a closed toe and heel The toe box should be wide and deep enough to accommodate your toes Avoid shoes with a pointed toe The inside lining of the shoes should not have ridges, wrin 
kles or seams Lace up or Velcro brand closure shoes are best; try to avoid slip on shoes
Shop for shoes when
your feet are the largest afternoons are better than early morning Avoid shoes that are too tight or pinch If you are shopping for new shoes and you have numb feet, cut out an outline of each foot from stiff paper, and insert the outline into the pair of shoes you are thinking of buying to help you determine if they fit
Wear new shoes for only short periods at first maximum of 1-2 hours a day and carefully inspect your feet after wearing the shoes to look for rubbed, red spots that might indicate a problem area
CIRCULATION:
If you smoke get help to quit Smoking damages blood vessels and increases the risk of circulation problems in people with diabetes
Exercise each day if you are able Be sure to check with your doctor before you start any exercise program Also, dont sit in one position for too long Move your legs and feet every few minutes, and avoid crossing your knees or ankles for long periods of time
Wear warm socks and shoes or boots when you are outside in the winter to avoid frostbite Remember, the temperature sensation in your feet may not be reliable
Avoid using heating pads or hot water bottles that can burn the skin Use wool socks to keep your feet warm
instead
TREATMENT OF INJURIES:
If you stumble or bump into a hard object, look at your feet to be sure that there is no damage If you have poor sensation in your feet, you may not feel any pain that normally makes you aware of a serious injury
If your foot is injured, refrain from walking on it even if it doesnt hurt, as that can cause more damage
Treat blisters, cuts and scratches right away Never use strong chemicals such as boric acid, hydrogen peroxide, or any antiseptic Such chemicals can actually damage healing tissue Do not open blisters yourself as it can lead to infections Simply clean the wound with soap and water and consult your healthcare professional regarding further treatment Cover all open injuries with a sterile dressing
Call your doctor if there is any sign of heat, redness, swelling, pus or pain in or around an open sore
BLOOD SUGAR MANAGEMENT
Keeping your blood sugar levels close to normal 90 130 mg/dL will reduce your risk of developing complications Once you have an injury to your feet, it is necessary to maintain good blood sugar levels in order for the injury to heal Monitor your blood sugar levels as discussed with your doctor
PROFESSIONAL
CARE FOR YOUR FEET
Your feet require regular attention Make sure that your doctor or diabetes educator checks your feet during every visit It is helpful to remove your shoes and socks while waiting for the doctor to enter the exam room Always seek help from a healthcare professional at the first sign of a problem Podiatrists are healthcare professionals who specialize in the care and treatment of your feet These specialists can treat your foot problems, or fit you with special shoes or inserts if you require them Ask your doctor or diabetes educator if you should visit a podiatrist
HOW MOISTURIZERS WORK
Creams and moisturizers contain a combination of oils and moisture They cover the skin to prevent the loss of moisture already present in the skin Petroleum-based creams help slow down the moisture loss People with diabetes often have dry skin that is low in moisture content Simply retaining the moisture is not enough Urea-based creams attract moisture below the surface of the skin and help to prevent moisture loss Washing will not alter the effectiveness of the cream and if used as directed the moisturizer will last between applications See the following chart for urea
concentration in Dermal TherapyTM creams
MAKE SKIN CARE PART OF YOUR EVERYDAY ROUTINE
Dermal TherapyTM products actively restore moisture and result in smooth, healthy-looking skin To help you with your foot care and other skin care needs, the following chart will help you select the right product for your needs These products can be found at your local pharmacy in the Hand and Body or Diabetes section If you have difficulty locating Dermal TherapyTM Skin Care Products call 1-877-716-1733
TM DTR Dermal Therapy Research Inc, London, Ontario, Canada
Symptom
Product
Description
UREA Content
Cracked Dry Heels
Heel Care Moisturizes and softens hard, dry callused heels and feet Moisturizes and softens lancet-hardened fingertips, and dry cuticles
25 UREA
Lancet Finger Hardened Care Fingertips Characteristic of frequent tester Dry Hands, Elbows Knees Characteristic of diabetes Hand, Elbow and Knee Cream
20 UREA
This unique 15 UREA and Silk Protein cream effectively moisturizes these problem areas The combination of UREA and Silk Protein moisturizer enables very dry skin to feel smooth again Soothes and refreshes hot, tired feet Formulated using camphor, menthol, mint and
other ingredients
15 UREA
Overall Dry Itchy Skin
Extra Strength Body Lotion
10 UREA
Hot Tired Feet
Foot Massage Cream
1 UREA
A very important part of good diabetes management is the proper care of your feet You can reduce the risk of or avoid serious problems with good foot careYour healthcare team will be able to answer any questions you may have about foot and skin care, and help you to make the right choices for you Just remember–the power to manage your diabetes is in your hands For more information about Diabetes Care Systems and support from Bayer, or help with your diabetes testing supplies, call our toll-free Customer Service Help Line at 1-800-348-8100 24 hours, 7 days a week
You can also visit our web site at: wwwBayerDiabetescom/us
For more help in managing your diabetes, see a diabetes educator To find an educator: wwwdiabeteseducatororg
2007 Bayer HealthCare LLC, Diabetes Care, Tarrytown, NY 10591 0391908 Rev 4/07
