Many people know someone who is diabetic who has had a toe, or even a foot or leg amputated. This is the worst-case scenario and points at the critical importance of foot care for a diabetic.
Diabetes affects every system in the body, including the nervous and circulatory systems, and the immune system. Dysfunction in these three systems sets up a catch-22 situation that can have serious consequences. A diabetic may have neuropathy, or nerve death, in the feet. This means his feet are not very sensitive, and he may not notice if he has stepped on something sharp, or has a wound on his foot. Poor circulation means he doesn't have enough blood to help the wound heal, and if infection sets up in the wound, the suppressed immune system may not be able to fight it off.
Because of these circumstances, a diabetic should take good care of her feet. Those who are married can enlist their spouse's help in this, but a single person should also make foot care a priority. It starts with the diabetic choosing comfortable, well-fitting shoes. A podiatrist may be able to help with this choice, but the shoes should not pinch or press on the feet. A diabetic should also wear cotton socks or pantyhose with shoes, to minimize friction against the foot. Diabetic women should be very careful about wearing high heels. These can restrict circulation.
The diabetic should check his shoes every day. People can step on tacks, nails, staples, or even gravel, and these can work their way into a shoe, injuring the foot. Any foreign objects should be removed from the shoes. Shoes should also be inspected for pressure marks inside, and if these cannot be eliminated with the use of moleskin or orthotics, the shoes should not be worn.
The diabetic, or her spouse, then need to check her feet. A single person can use a mirror for this job, if necessary. The feet should be closely inspected, even between the toes, for any wounds or redness that may mean a shoe is putting pressure on the foot. Toenails should be kept neatly trimmed, to minimize the risk of ingrown toenails, of tearing a toenail, or scratching oneself on the leg or foot with them.
If the feet are in good shape, the diabetic should then apply a moisturizing lotion to the feet. Spouses or family members can make this into a foot massage, which is also good, since it promotes better circulation.
Any kind of wound should be immediately washed, then treated with antibiotic ointment and a dressing or adhesive bandage applied. The wound should be checked every day until it has healed. If it does not heal, or gets worse, the diabetic should see his doctor. Some wounds require surgical intervention, and the diabetic may need to take antibiotics and stay off the foot until the wound has healed.
In many cases, preventative foot care for diabetics can help them avoid amputation and its attendant risks. For a diabetic, good foot care is vital to good quality of life.
