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Sole Love - How to Prevent Diabetic Foot Amputation

Health Xchange – Fri, Nov 21, 2014

Health Xchange - Sole Love - How to Prevent Diabetic Foot Amputation

As a podiatrist (foot specialist), I work on a daily basis with diabetic patients dealing with foot problems. Some of these are severe problems such as diabetic foot ulcer and pre- and post-amputation conditions. The good news is that these issues can be prevented. It requires good self-management and proper use of your podiatry service.

Know your feet

Remember that out of sight should not be out of mind. We don't look much at our feet but with diabetes you have to. Looking after your feet is as important as looking after the rest of your body.

Checking your feet on a daily basis is the best way to know if there is anything wrong with them. If you see any changes, such as blisters, red areas, unusual blemishes, swelling or cuts, contact your podiatrist or doctor immediately.

Develop a foot care regime

Conditions like foot corn, callus, ingrown nails or blisters are often painful but simple to treat. In a person with diabetes they can quickly develop into something more sinister. With diabetic nerve damage, they may not be painful and can turn into a diabetic foot ulcer. Once such an ulcer develops, there is a risk of infection, which can occasionally be very difficult to treat in people with a reduced blood supply to their feet.

Following the regime below will go a long way towards preventing problems:

Apply moisturising cream to the feet and legs every day. However, do not apply it in between the toes as the skin there is thinner and can macerate and split more easily.
File toe nails regularly to a normal length and thickness. This should be done at least once a week.
File any hard skin patches on the sole of the feet, on the tip of the toes or on the upper side of the toe joints to keep them from building up. This should be done at least once a week. Removing hard skin prevents foot ulcers from forming underneath.
Check both feet every day, especially the soles and in-between the toes. Being familiar with what your feet look like makes it easier to spot any changes.
Don't self-diagnose or wait-and-see. Always see your podiatrist if you notice a change in your feet or if you are concerned.

Related video: What can you eat if you have diabetes?

Wear good footwear

Poor fitting shoes are likely to cause problems such as corns, calluses and blisters. These can all result in more serious problems over time. Follow these preventive tips:

Wear comfortable shoes that fit your foot size and foot shape as well as offer good protection and support. Strong supportive shoes with laces or straps are the best (see pictures below).
Slippers or women's ballet shoes offer poor support or protection, if at all. They can also cause a build-up of foot corn and hard skin.
Before wearing your shoes always feel around the inside of the shoe for any foreign objects or rough or protruding stitching. If you have a loss of sensation, these may go unnoticed and cause injury.
Avoid walking barefoot. Again, if you have a loss of sensation, stepping on a sharp object could result in complications.

Attend foot checks

Foot examinations check for:

Loss of sensation
Level of blood flow to the feet
Changes to the foot shape (development of pressure points)
Other foot conditions such as diabetic foot ulcer

Regular foot checks by a podiatrist, nurse or doctor will ensure that any changes in your foot condition that may present a risk get promptly noticed. Treatment or management advice can then be given to assist with continued good foot health.

Exercise regularly

Try the following:

When sitting, spend some time moving your ankles in a circular motion and wiggling your toes.
When standing, go up and down on your toes a few times every minute.
Avoid putting your feet up when sitting. Gravity helps to get blood to the feet.
Avoid crossing the legs when sitting as it can pinch off blood supply.

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By Gavin O'Donnell, Podiatrist, Podiatry Department, Singapore General Hospital (SGH), a member of the SingHealth group, for HealthXchange.com.sg.

Articles on HealthXchange.com.sg are meant for informational purposes only and cannot replace professional surgical, medical or health advice, examination, diagnosis, or treatment.