Saturday, December 20, 2008 Vesagas: Diabetic foot care By Paul John A. Vesagas, R. N. Careline
YOU may imagine insulin, that workaholic, energy-unlocking hormone, as a key that allows the entry of glucose to the doors of the body's cells to enable them to function properly. So what happens when that key is destroyed, or has lost its ability to function? You're right: the onset of diabetes is almost always certain.
There are two types of diabetes mellitus (DM) but we'll leave this part to the doctors. The important thing is knowing that you or your loved one is diabetic so that proper responses to various known diabetes complications can be taken.
One of the many complications that a diabetic would most likely deal with is nerve damage, which leads to decreased blood flow to the nerves of the arms and legs, thereby leading to loss of sensations to these areas. The loss of sensations to the feet places the diabetic person at risk for injuries, which are aggravated by poor wound healing to the area. Loss of sensation could trigger a diabetic person, for example, to mindlessly scratch a wound that in turn can become infected and lead to more serious problems.
Again, we'll leave to the doctors to explain why high blood sugar levels cause nerve damage. The important thing is that it can and that feet problems seem to hound most diabetics. One theory is that the nerves to our feet are the longest ones in our body, making it more arduous for blood to circulate in these parts.
Nevertheless, experts offer some helpful foot care and other advices that you can follow to avoid wounds, infection on a wound, or worse, losing a limb.
• Inspect your feet daily for calluses, corns (specially shaped calluses of dead skin that occurs on thin surface of the skin on toes), blisters, abrasions, redness and nail abnormalities.
• No "bathroom surgery" please. Never trim corns or calluses-that's your doctor's job.
• If you are a smoker, then it may be wise to stop now. Smoking restricts blood flow in your feet.
• Bathe the feet daily with warm (never hot) water. Do not soak the feet for prolonged periods (soaking is drying). Dry feet carefully, especially in between toes.
• Massage the feet with moisturizers but avoid in between the toes as this may encourage fungal infections.
• Wear well-fitting, non-compressive shoes and socks- long enough, wide enough, soft, supple and low-heeled.
• Buy shoes with a wide toe box for room to wiggle toes without friction.
• Buy shoes in the afternoon-feet are larger in the afternoon than in morning.
• Avoid rubber or plastic-soled shoes as they cause the feet to perspire and aggravate fungal infections.
• Cut toenails straight across to prevent ingrown toenails.
• Avoid heat, chemicals and injuries to feet.
• If any injury occurs to the foot, wash the area with mild soap and water. Cover it with dry dressing. Never apply iodine solution or alcohol to area as these may irritate further the foot.
As a general rule, any injury to the diabetic foot should be referred immediately to the physician.
Aside from possible amputation, foul odor may be the least of your worries in a neglected diabetic foot. But when it comes to this, spare yourself and your housemates from that unpleasant smell by regularly cleansing the wound.
Hospitals commonly use sterile salt solution mixed with 10 percent Zonrox bleach to get rid of the foul odor during wound dressings. It may be prudent, however, to refer to your doctor first before using this rather spartan concoction.
Risking truism, it may be vital to caution again that in severe neglect, the foot may die due to both infection and poor wound healing. In such cases, doctors may have the foot amputated because infection may ascend to the legs and invade other organs nearby. Meticulous foot care for diabetics surely is a must!
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