The Society for Vascular Surgery, the American Podiatric Medical Association and the Society for Vascular Medicine collaboratively have published their first-ever set of clinical practice guidelines for treating the diabetic foot.
Peripheral arterial disease, also called PAD, occurs when blood vessels in the legs are narrowed or blocked by fatty deposits and blood flow to your feet and legs decreases.
If you have PAD, you have an increased risk for heart attack and stroke. An estimated 1 out of every 3 people with diabetes over the age of 50 have this condition. However, many of those with warning signs don't realize that they have PAD and therefore don't get treatment.
If you have diabetes, you're much more likely to have PAD, but you can cut your chances of having those problems by taking special care of your blood vessels.
If you have diabetes, complications from the disease such as a non-healing wound on your foot, can put you at significant risk for amputation of a foot or leg. Diabetic foot care is a simple list of things you can do daily—at home, guided by your doctor—to protect your feet against wounds and avoid amputation. Neuropathy- wounds-
DAILY ATTENTION AND ONGOING CARE ARE IMPORTANT
Your risk for wounds on your feet leading to amputation increases the longer you have diabetes. Proper foot care is important for the rest of your life.
Why?
Your feet experience a lot stress every day as you put on shoes and walk. With diabetes, your feet are particularly prone to wounds because:
- Nerve damage leads to neuropathy and the loss of feeling; wounds on your feet can easily go unnoticed. If not treated immediately, a small wound can progress to a bigger wound.
- Decreased circulation makes your skin and tissue weaker. This means wounds can form more easily and be slow to heal.
- Joint and bone abnormalities can deform the foot and make certain areas more likely to form wounds. Pressure on your feet from ill-fitting shoes can contribute to these deformities.
- High sugar levels make you very vulnerable to simple wounds becoming infected
Proper diabetic foot care has 3 simple components:
1. SKIN AND NAIL CARE
- Wash your feet daily with mild soap. Dry your feet gently; do not rub too vigorously.
- Apply lotion to avoid dry or cracked skin.
- Trim toenails when wet because that’s when they are softer. Trim nails straight across. Do not trim your skin or cuticles. If you have trouble, you may want to see a podiatrist.
2. DAILY FOOT INSPECTION
- Check your feet every day at the same time—make it part of your daily routine. Look carefully for wounds on the top and bottom of each foot, all of your toes (top, bottom and tip) and between your toes. If you can’t see all parts of your feet, use a mirror or ask someone to inspect them for you.
- Skin between toes can easily crack and wounds can be overlooked. Make sure to pull apart your toes and look carefully.
- Be sure to check the ball of each foot; it is subject to a lot of pressure and is a common area for calluses and wounds to develop.
- If you notice any cuts, scrapes, areas of discoloration, or calluses on your feet, notify your health care provider immediately.
- Trust your instincts. If either foot, or part of either foot, feels different in any way, let your health provider know.
3. PROPER FOOTWEAR
- Your shoes should be comfortable and not cause any increased pressure on any bony areas.
- If you have noticed any deformities in your feet, you may want to see a podiatrist for help in choosing proper footwear.
ADDITIONAL STEPS TO AVOID FOOT INJURY
- Avoid extreme heat of any kind: do not soak feet in hot water, do not use hot water bottles or heating pads/blankets.
- Never walk barefoot anywhere.
With proper foot care, you can avoid wounds, infections and foot or leg amputation.
