Most diabetics know they have to take special care of their feet, but may not always know why.
The first reason is that diabetes can disturb the body’s built-in ‘”early warning system” pain.
How often have you heard someone say, “My feet hurt”? Probably more times than you could possibly count. Pain is nature’s way of signalling something is wrong, but diabetes may reduce sensation in the feet, so a diabetic may not feel pain when a foot is hurt, though he can feel touch.
Secondly, diabetes can also affect blood circulation in the lower limbs, making the feet feel numb. If you are a diabetic, you should do all you can to promote good circulation. Walking is the best exercise for this, and other points will be explained below.
Third, high blood sugar lowers resistance to infection. The body’s means of destroying invading germs is impaired and damaged tissues heal more slowly. It is easy for germs to enter through a small cut in the foot which has escaped attention.
If circulation is poor, the infection may gain ground quickly. Soon, what began as a small, easily treatable cut in the skin may become a large, spreading inflammation and the diabetic is in trouble. The inflammation in turn may even lead to gangrene and the loss of part or all of the foot.
This serious sequence of events can be averted in the early stages by following a few simple rules of foot care. They should never be neglected.
- Examine your feet each day and report all lender areas, blisters or discolored areas to your doctor, no matter how trivial they may seem to you. A painless sore is just as important.
- Wash the feet daily and dry thoroughly. “Anhydrous lanolin” can be rubbed in if the skin is dry or cracking. This grease is unattractive but is very good. When the skin is supple again you can switch to ordinary toilet lanolin which is more pleasant.
- Cut the toenails straight across and not too short. The corner should never be cut out of sight. If nails tend to be ingrown, leave the task to a chiropodist.
- Don’t treat corns and calluses yourself. “Bathroom surgery” is harmful.
- If some toes overlap, separate them with lambswool (which can be bought in packets from the chemist). Don’t encircle the toe with wool, however, as it can shrink and cut the skin.
- Wear wool or cotton socks. Synthetic socks prevent perspiration escaping and make the skin soggy and vulnerable to tinea (a fungus infection).
- Wear leather shoes, or synthetic shoes with air holes in the uppers if leather proves too expensive. New shoes should be worn for only half an hour the first day, increasing by one hour daily.
- Avoid excessive heat and cold. Don’t get too close to fires or turn an electric blanket too high. Remove hot water bottles from bed before getting in.
- Don’t walk around barefoot, it is too easy to injure your feet.
- Don’t smoke, this is bad for your circulation and makes any existing blood-vessel problems worse.
- Try your best to keep your blood sugar perfectly under control. This will prevent, or at least minimize, any damage to nerves which conduct feelings of pain. Even patients who already have numbness in the feet can expect benefit from good diabetic control. It will halt deterioration and keep you on your feet.
- A yearly check on your blood fats is worthwhile, because these can be too high in some diabetics and are believed to lead to hardening of the arteries. Changes in diet, and perhaps special tablets, can help. Ask your doctor if you need them.
- Slippers do not give support: don’t wear them instead of shoes.
- Keep slim! if you are overweight this increases the risk of foot damage as well as arterial disease.
- Prevent calluses on the ball of the foot by exercises, such as curling and stretching the toes at least 20 times a day.
Remember, there are basically three things which may injure your feet: burns, pressure and cuts. Corrosive “corn cures'” and strong antiseptics like iodine can burn the feet as well as hot water bottles and radiators.
Pressure comes mostly from too-tight shoes and badly cut toenails. Cuts and sores can come from walking in thongs as well as going barefoot or trying do-it- yourself chiropody.
Here are some tips for improving blood circulation:
- Walk and exercise: bend the foot up and down as far as it will go six times and do this three times a day.
- Massage well with lanolin.
- Do not wear garters or sit with your feet crossed.
- If you have had a severe foot infection, keep off your feet five or more minutes each hour. Legs may also he raised to an angle of 45 degrees for a shun time, several times a day.