Diabetic foot is one of the dreaded complications of diabetes, but did you know that even before one develops it there are many foot care regimes and routines one can follow to avoid that inevitability?. Read on to learn more about diabetic foot care….
An interesting fact for you. Do you know the first thing anyone notices when you walk into the room? Is it the million dollar smile? Or the expensive clothes you had recently purchased to wear? Not even the flowery scent of freshness you just sprayed over yourself. Believe it or not it is actually your feet! Yes your feet and shoes are the first things anyone notices and if they are in top shape you are sure to set a great first impression.
Now feet has had prime importance in Indian culture from aeons galore. When we meet or greet our elders we take blessings by falling on their feet. Massaging your dad’s feet to borrow some money is a childhood get ‘rich quick technique’. Stepping into a new home with your right feet is said to bring loads of good luck! Now culture has been replaced by modernity. Handshakes have replaced the older greeting customs however feet still creeps up into our daily lives in unique ways. New parents savour their young one’s growth journey nowadays by taking a print of their pretty toes!
‘Thinking on one’s feet’ has become the mantra for elevating yourself at work. ‘Keeping ones feet firmly on the ground’ became synonymous with being humble despite achieving great heights. Every student dreams of standing on ‘ones feet’ one day and sweeping their sweethearts ‘off their feet’. If you do not know to dance you have ‘two left feet’, trying out a new thing or hobby is to ‘wet ones feet’ and always try doing that before you end up being ‘six feet under’! So you get the idea the feet is such a versatile part of our body and our culture!
Now when it comes to our health our feet continues to remain a forgotten distant cousin. It does not receive as much care and caress as say our face or even hands for that matter. A lot can be understood with just the way a persons feet looks. One does not need complex blood tests or X-rays and scans to discern common issues with the feet. Instead what one needs is a good eye for detail.
Here I have written a few common diseases which are diagnosed just by looking at ones feet
1. Cracked heels- a sign of dry skin. It can also occur if you are standing too long on your feet or are obese. Switch from open heeled footwear to closed heels and moisturise well to get rid of them.
2. Calluses and corns- Ill fitting shoes can cause calluses and corns on the feet. Usually seen as thickened skin and reduces if the source of constant skin friction is removed.
3. Gout- a form of arthritis usually begins at the feet. The great toe is the starting point where an acute attack can show swelling and pain.
4. Athletes foot- also known as Tinea pedis, is a very common fungal infection of the foot. Usually seen as white patches between the toes and is caused due to constant moisture in the feet.
5. Swelling of feet- can be due to many reasons like tight shoes, long hours of travel, prolonged standing or even pregnancy or certain anti-hypertensive medications. However, it can also be an early indicator of more sinister and serious illnesses like heart failure or renal failure which should not be ignored.
6. Ingrown toe nails- did you know that if you cut your toe nails straight across instead of in a curved fashion you can avoid getting these painful ingrowns?
7. Diabetic foot ulcer- around 15% of diabetics can develop a foot ulcer at some point in time. If not treated early it can lead to worsening of ulcer, infection and even gangrene and foot amputation!
8. Discoloured feet- a poor blood circulation of the legs can show as purplish feet especially around the toes. Such changes should be caught early before the toe turns completely black and gangrenous.
9. Varicose veins- have you seen the greenish veins popping out of your feet sometimes going up your legs. This indicates the valves which control blood flow of your legs have become weaker leading to stasis of blood and swelling of the veins. Varicosity can be hereditary, or due to certain occupations like policemen or lab technicians or even painters who stand for long hours or even in pregnancy and those who do heavy weight lifting. It could lead to an ulcer formation, swelling of legs and also sometimes can dislodge the blood clots to the heart causing even a heart attack!
10. Toe nail fungus- seen as yellowish or discoloured toe nails they are quite difficult to get rid off. If a course of anti fungal treatment does not work then surgical removal of the toe nail is the only way to go! Be wary of unsanitary parlours using unclean instruments for pedicures.
These were just a few examples of issues we can very obviously notice with our feet. However, there are several conditions which go unnoticed by the common eye like plantar fasciitis or diabetic neuropathy where despite appearing to look normal the feet can show distressing pain, pins and needle sensation and burning sensation.
Foot problems in a diabetic patient
When diseases like diabetes sets in depending upon the duration of the disease and the level of control a variety of symptoms of organ damage can set in. If you ask any lay person they will straight away tell you that diabetic foot means gangrenous feet which ultimately leads to foot or leg amputation. But in reality there are several signs which indicate poor health of the feet even before the dreaded ‘diabetic foot’ sets in.
The common foot conditions in a diabetic is caused because of these two reasons:
1. Diabetic neuropathy- long standing uncontrolled diabetes can lead to nerve damage of the feet known as diabetic neuropathy. The most common reason leading to sleepless nights for a diabetic patient. This can present as numbness or tingling sensation or even burning sensation over the feet a la ‘pins and needles sensation’. Vibration is the first sense to be lost followed by temperature and pain. If you cannot feel any pain then it becomes even more difficult to identify any injury or ulcer and so the sordid cycle continues!
2. Reduced blood flow- diabetics are more prone for sluggish blood flow at the feet. This again can result in ulcer formation, poorer wound healing and ultimately gangrene!
How to take good care of your feet when you are diabetic? diabetic foot care should be taught to all diabetics during their regular check ups by the physician just like how diabetic diet and physical activity is advised. Please read here to know more about health checkup packages for a diabetic
A simple foot care regimen can save millions from developing permanent disability and avoid unnecessary and expensive surgical interventions. So ‘put your foot down’ and let’s start by practising some of these easy habits daily.
Simple foot care regimen to be followed every day by patients for diabetic foot care:
1. Wash feet daily with soap and warm water at night time before going to bed.
2. Pat your feet dry using a towel and ensure your feet remains dry at all times.
3. Check for cuts, bruises, calluses, corns colour changes, ulcers or fungal patches thoroughly over the feet and between the toes. For those who cannot see the underside of their feet place a mirror on the floor and look for these changes.
4. Trim your toenails regularly. Trim them straight across instead of curved to avoid in grown toe nail and infections.
5. Apply a good moisturiser like petroleum jelly or even plain coconut oil to the feet just after bath to avoid skin cracking and dryness. But don’t apply between your toes!
6. Wear footwear at all times. That includes indoor and outdoors. Even a small injury can take long too long to heal for a diabetic so better to be safe.
7. Avoid wearing ill fitting shoes which are too tight. The MCR (micronised rubber) slippers are said to be good for the feet and can be easily purchased according to your size at any medical store. A closed well fitting shoes is recommended for a diabetic patient and diabetic food care.
8. Visit a doctor- in case you notice numbness of the feet or any ulcer however small it’s best to get it treated promptly by visiting your physician. Early treatment can save limbs.
9. Get ‘on your feet more’- exercises like brisk walking can help boost blood flow of the feet and is good to avoid vessel diseases. After all your feet can take you places and it’s the feet that bears the brunt of your weight. So take the ‘load off your feet’ quite literally and get a little lighter, even a few pounds can make a world of difference!
So if you are a diabetic yourself or have elders at home who are diabetic teach them these simple diabetic foot care regimen to take care of their feet by themselves and let your feet do all the talking!It will of course take some time to ‘find your feet’ (pun intended) but you will get there eventually. Adios!