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Prevent Diabetes Problems: Keep Your Feet and Skin
Healthy !
a.. What are diabetes problems?
b.. What should I do each day to stay healthy with diabetes?
c.. How can diabetes hurt my feet?
d.. What can I do to take care of my feet?
e.. How can I get my doctor to help me take care of my feet?
f.. What are common diabetes foot problems?
g.. How can special shoes help my feet?
h.. How can diabetes hurt my skin?
i.. What can I do to take care of my skin?
j.. For More Information
k.. More in the Series
l.. Acknowledgments
What are diabetes problems?
Too much glucose (sugar) in the blood for a long time can cause diabetes
problems. This high blood glucose (also called blood sugar) can damage many
parts of the body, such as the heart, blood vessels, eyes, and kidneys.
Heart and blood vessel disease can lead to heart attacks and strokes. You
can do a lot to prevent or slow down diabetes problems.
This booklet is about feet and skin problems caused by diabetes. You will
learn the things you can do each day and during each year to stay healthy
and prevent diabetes problems.
High blood glucose can cause feet and skin problems.
What should I do each day to stay healthy with diabetes?
Follow the healthy eating plan that you and your doctor or dietitian
have worked out.
Be active a total of 30 minutes most days. Ask your doctor what
activities are best for you.
Take your diabetes medicines at the same times each day.
Check your blood glucose every day. Each time you check your blood
glucose, write the number in your record book.
Check your feet every day for cuts, blisters, sores, swelling, redness,
or sore toenails.
Brush and floss your teeth and gums every day.
Don't smoke.
How can diabetes hurt my feet?
High blood glucose from diabetes causes two problems that can hurt your
feet:
1.. Nerve damage. One problem is damage to nerves in your legs and feet.
With damaged nerves, you might not feel pain, heat, or cold in your legs and
feet. A sore or cut on your foot may get worse because you do not know it is
there. This lack of feeling is caused by nerve damage, also called diabetic
neuropathy (ne-ROP-uh-thee). It can lead to a large sore or infection.
2.. Poor blood flow. The second problem happens when not enough blood
flows to your legs and feet. Poor blood flow makes it hard for a sore or
infection to heal. This problem is called peripheral (puh-RIF-uh-rul)
vascular disease. Smoking when you have diabetes makes blood flow problems
much worse.
Make sure you wear shoes that fit well.
These two problems can work together to cause a foot problem.
For example, you get a blister from shoes that do not fit. You do not feel
the pain from the blister because you have nerve damage in your foot. Next,
the blister gets infected. If blood glucose is high, the extra glucose feeds
the germs. Germs grow and the infection gets worse. Poor blood flow to your
legs and feet can slow down healing. Once in a while a bad infection never
heals. The infection might cause gangrene (GANG-green). If a person has
gangrene, the skin and tissue around the sore die. The area becomes black
and smelly.
To keep gangrene from spreading, a doctor may have to do surgery to cut off
a toe, foot, or part of a leg. Cutting off a body part is called an
amputation (amp-yoo-TAY-shun).
What can I do to take care of my feet?
a.. Wash your feet in warm water every day. Make sure the water is not too
hot by testing the temperature with your elbow. Do not soak your feet. Dry
your feet well, especially between your toes
b.. Look at your feet every day to check for cuts, sores, blisters,
redness, calluses, or other problems. Checking every day is even more
important if you have nerve damage or poor blood flow. If you cannot bend
over or pull your feet up to check them, use a mirror. If you cannot see
well, ask someone else to check your feet.
c.. If your skin is dry, rub lotion on your feet after you wash and dry
them. Do not put lotion between your toes
d.. File corns and calluses gently with an emery board or pumice stone. Do
this after your bath or shower.
e.. Cut your toenails once a week or when needed. Cut toenails when they
are soft from washing. Cut them to the shape of the toe and not too short.
File the edges with an emery board.
f.. Always wear shoes or slippers to protect your feet from injuries.
g.. Always wear socks or stockings to avoid blisters. Do not wear socks or
knee-high stockings that are too tight below your knee.
h.. Wear shoes that fit well. Shop for shoes at the end of the day when
your feet are bigger. Break in shoes slowly. Wear them 1 to 2 hours each day
for the first 1 to 2 weeks.
i.. Before putting your shoes on, feel the insides to make sure they have
no sharp edges or objects that might injure your feet.
Take off your shoes and socks so your doctor will check your feet.
How can I get my doctor to help me take care of my feet?
a.. Tell your doctor right away about any foot problems.
b.. Ask your doctor to look at your feet at each diabetes checkup. To make
sure your doctor checks your feet, take off your shoes and socks before your
doctor comes into the room.
c.. Ask your doctor to check how well the nerves in your feet sense
feeling.
d.. Ask your doctor to check how well blood is flowing to your legs and
feet.
e.. Ask your doctor to show you the best way to trim your toenails. Ask
what lotion or cream to use on your legs and feet.
f.. If you cannot cut your toenails or you have a foot problem, ask your
doctor to send you to a foot doctor. A doctor who cares for feet is called a
podiatrist (puh-DY-uh-trist).
What are common diabetes foot problems?
Anyone can have corns, blisters, and athlete's foot. If you have diabetes
and your blood glucose stays high, these foot problems can lead to
infections.
Corns and calluses are thick layers of skin caused by too much rubbing
or pressure on the same spot. Corns and calluses can become infected.
Blisters can form if shoes always rub the same spot. Wearing shoes that
do not fit or wearing shoes without socks can cause blisters. Blisters can
become infected.
Ingrown toenails happen when an edge of the nail grows into the skin.
The skin can get red and infected. Ingrown toenails can happen if you cut
into the corners of your toenails when you trim them. If toenail edges are
sharp, smooth them with an emery board. You can also get an ingrown toenail
if your shoes are too tight.
A bunion forms when your big toe slants toward the small toes and the
place between the bones near the base of your big toe grows big. This spot
can get red, sore, and infected. Bunions can form on one or both feet.
Pointy shoes may cause bunions. Bunions often run in the family. Surgery can
remove bunions.
Plantar warts are caused by a virus. The warts usually form on the
bottoms of the feet.
Hammertoes form when a foot muscle gets weak. The weakness may be from
diabetic nerve damage. The weakened muscle makes the tendons in the foot
shorter and makes the toes curl under the feet. You may get sores on the
bottoms of your feet and on the tops of your toes. The feet can change their
shape. Hammertoes can cause problems with walking and finding shoes that fit
well. Hammertoes can run in the family. Wearing shoes that are too short can
also cause hammertoes.
Dry and cracked skin can happen because the nerves in your legs and
feet do not get the message to keep your skin soft and moist. Dry skin can
become cracked and allow germs to enter. If your blood glucose is high, it
feeds the germs and makes the infection worse.
Athlete's foot is a fungus that causes redness and cracking of the
skin. It is itchy. The cracks between the toes allow germs to get under the
skin. If your blood glucose is high, it feeds the germs and makes the
infection worse. The infection can spread to the toenails and make them
thick, yellow, and hard to cut.
All of these foot problems can be taken care of. Tell your doctor about any
foot problem as soon as you see it.
How can special shoes help my feet?
Special shoes can be made to fit softly around your sore feet or feet that
have changed shape. These special shoes help protect your feet. Medicare and
other health insurance programs may pay for special shoes. Talk to your
doctor about how and where to get them.
How can diabetes hurt my skin?
Drinking fluids helps keep your skin moist and healthy.
Diabetes can hurt your skin in two ways:
1.. If your blood glucose is high, your body loses fluid. With less fluid
in your body, your skin can get dry. Dry skin can be itchy, causing you to
scratch and make it sore. Also, dry skin can crack. Cracks allow germs to
enter and cause infection. If your blood glucose is high, it feeds germs and
makes infections worse. Skin can get dry on your legs, feet, elbows, and
other places on your body.
2.. Nerve damage can decrease the amount you sweat. Sweating helps keep
your skin soft and moist. Decreased sweating in your feet and legs can cause
dry skin.
What can I do to take care of my skin?
a.. After you wash with a mild soap, make sure you rinse and dry yourself
well. Check places where water can hide, such as under the arms, under the
breasts, between the legs, and between the toes.
Keep your skin moist by washing with a mild soap and using lotion or
cream after you wash.
b.. Keep your skin moist by using a lotion or cream after you wash. Ask
your doctor to suggest one.
c.. Drink lots of fluids, such as water, to keep your skin moist and
healthy.
d.. Wear all-cotton underwear. Cotton allows air to move around your body
better.
e.. Check your skin after you wash. Make sure you have no dry, red, or
sore spots that might lead to an infection.
f.. Tell your doctor about any skin problems.
For More Information
Diabetes Teachers (nurses, dietitians, pharmacists, and other health
professionals)
To find a diabetes teacher near you, call the American Association of
Diabetes Educators toll-free at 1-800-TEAMUP4 (1-800-832-6874), or look on
the Internet at www.diabeteseducator.org and click on "Find a Diabetes
Educator."
Dietitians
To find a dietitian near you, call the American Dietetic Association
toll-free at 1-800-366-1655, or look on the Internet at www.eatright.org and
click on "Find a Nutrition Professional."
Government
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
is part of the National Institutes of Health. To learn more about feet and
skin problems, write or call the National Institute of Arthritis and
Musculoskeletal and Skin Diseases Information Clearinghouse, 1 AMS Circle,
Bethesda, MD 20892-3675, 1-877-226-4267 (toll-free); or see
www.niams.nih.gov on the Internet.
To get more information about taking care of diabetes, contact
National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
Phone: 1-800-860-8747
Fax: 703-738-4929
Email: ndic@info.niddk.nih.gov
Internet: www.diabetes.niddk.nih.gov
National Diabetes Education Program
1 Diabetes Way
Bethesda, MD 20892-3600
Phone: 1-800-438-5383
Fax: 703-738-4929
Internet: http://ndep.nih.gov
American Diabetes Association
1701 North Beauregard Street
Alexandria, VA 22311
Phone: 1-800-342-2383
Internet: www.diabetes.org
Juvenile Diabetes Research Foundation International
120 Wall Street
New York, NY 10005-4001
Phone: 1-800-533-2873
Internet: www.jdrf.org
More in the Series
The "Prevent Diabetes Problems" series includes seven booklets that can help
you learn more about how to prevent diabetes problems.
a.. Keep Your Diabetes Under Control
b.. Keep Your Eyes Healthy
c.. Keep Your Feet and Skin Healthy
d.. Keep Your Heart and Blood Vessels Healthy
e.. Keep Your Kidneys Healthy
f.. Keep Your Nervous System Healthy
g.. Keep Your Teeth and Gums Healthy
For free single copies of these booklets, write, call, fax, or email the
National Diabetes Information Clearinghouse
1 Information Way
Bethesda, MD 20892-3560
Phone: 1-800-860-8747
Fax: 703-738-4929
Email: ndic@info.niddk.nih.gov
These booklets are also available at www.diabetes.niddk.nih.gov on the
Internet.
Acknowledgments
The National Diabetes Information Clearinghouse thanks the people who helped
review or field-test this publication.
For American Association of Diabetes Educators
Lynn Grieger, R.D., C.D.E.
Arlington, VT
Celia Levesque, R.N., C.D.E.
Montgomery, AL
Teresa McMahon, Pharm.D., C.D.E.
Seattle, WA
Barbara Schreiner, R.N., M.N., C.D.E.
Galveston, TX
For American Diabetes Association
Phyllis Barrier, M.S., R.D., C.D.E.
Alexandria, VA
Linda Haas, Ph.C., R.N., C.D.E.
Seattle, WA
Kathleen Mahoney, M.S.N., R.N., C.D.E.
Drexel Hill, PA
Randi Kington, M.S., R.N., C.S., C.D.E.
Hartford, CT
For Centers for Medicare & Medicaid Services
Baltimore, MD
Jan Drass, R.N., C.D.E.
For Diabetes Research and Training Centers
Albert Einstein School of Medicine Norwalk Hospital
Norwalk, CT
Jill Ely, R.N., C.D.E.
Sam Engel, M.D.
Pam Howard, A.P.R.N., C.D.E.
Indiana University School of Medicine
Indianapolis, IN
Madelyn Wheeler, M.S., R.D., F.A.D.A., C.D.E.
VA/JDF Diabetes Research Center
Vanderbilt School of Medicine
Nashville, TN
Ok Chon Allison, M.S.N., R.N.C.S., A.N.P., C.D.E.
Barbara Backer, B.S.
James W. Pichert, Ph.D.
Alvin Powers, M.D.
Melissa E. Schweikhart
Michael B. Smith
Kathleen Wolffe, R.N.
For Grady Health System Diabetes Clinic
Atlanta, GA
Ernestine Baker, R.N., F.N.P., C.D.E.
Kris Ernst, R.N., C.D.E.
Margaret Fowke, R.D., L.D.
Kay Mann, R.N., C.D.E.
For Indian Health Service
Albuquerque, NM
Ruth Bear, R.D., C.D.E.
Dorinda Bradley, R.N., C.D.E.
Terry Fisher, R.N.
Lorraine Valdez, R.N., C.D.E.
Red Lake, MN
Charmaine Branchaud, B.S.N., R.N., C.D.E.
For Medlantic Research Center
Washington, DC
Resa Levetan, M.D.
For Texas Diabetes Council
Texas Department of Health
Austin, TX
Luby Garza-Abijaoude, M.S., R.D., L.D. |
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