Diabetic foot

Diabetes is considered the epidemic of the 21st century and one of its frequent complications is diabetic foot.

Diabetic foot is a result of peripheral nerve conduction deficit (neuropathy) and of the narrowing of the peripheral blood vessels (vasculopathy). This lack of sensitivity in the extremities, combined with poor blood circulation, make diabetic patients especially vulnerable to foot health complications.

What are the risk factors of diabetic foot?

There are a set of risk factors for developing diabetic foot which, if not controlled, can lead to serious complications, such as ulceration, infection, necrosis or even the partial or total amputation of the limbs:

• Poor control of blood sugar levels and duration of the diabetes > 10 years.
• Signs of neuropathy: pain, a burning sensation, numbness, insensitivity…
• Peripheral vascular disease.
• Changes in the skin: dryness, cracks, ingrown nails, mycotic nails, chronic foot infections.
• Kidney failure and microalbuminuria.
• Failure to examine the foot, due to a reduction of vision acuity and difficulty in flexing the joints.
• Bad habits: poor foot hygiene, smoking, alcoholism, inappropriate footwear.

Diabetic foot care

To prevent foot injuries, it is important for diabetics to follow certain precautions on a daily basis:

• A healthy diet, regular exercise and the correct management of diabetes with insulin or drugs.
• Avoid tobacco.
• Comfortable shoes. It is important to wear wide and light leather shoes, with laces and a 2-4 cm heel. It is also preferable to always wear natural fibre socks, to favour the natural perspiration of the foot and avoid moisture.
• Self-examining the feet. It is important to frequently examine your feet and look for possible cuts, scratches, hot or cold areas, swelling, inflammation or discolouration to the skin.
• Foot hygiene. It is advisable to wash feet daily with lukewarm water and a mild or slightly acidic soap. When drying them, you have to do it delicately and not neglect the spaces between the toes.
• Hydration for the feet. Keeping feet hydrated will help to prevent lacerations; but the areas between the toes should not be hydrated so as to avoid excess moisture.
• Nail care. Nails should be cut straight, without curves, and with special pedicure scissors with a round tip to avoid them becoming ingrown.
• Improve blood flow. Walking and certain exercises contribut to a greater blood supply to the lower limbs.
• Avoid sources of heat. Never directly expose your feet to stoves, braziers, radiators or electric blankets, because due to the loss of sensitivity that people with diabetes can experience, they could burn themselves and not realise.
• First aid in the event of an injury. If a foot injury is detected, wash it with soap and water and apply a healing treatment.
• Diabetic foot care. Under no circumstances should foot ulcers be treated by yourself, you should go to a specialised health centre as soon as possible.
• Care for feet deformities. If you have claw toes, bunions or other foot disorders, you must go to a specialist so that they can prescribe a series of preventive measures such as the use of pads or protectors.