Diabetic Footcare

Diabetes is a condition that affects more than 400 million adults globally, and this number is expected to increase to above 640 million, which equates to one in ten adults, by 2040. In Singapore, over 400,000 Singaporeans live with the disease. The lifetime risk of developing diabetes is one in three among Singaporeans, and the number of those with diabetes is projected to surpass one million by 2050. [Read full article here].

 

Poorly controlled, diabetes can lead to serious complications, such as foot ulcers, which, in turn, can lead to lower limb amputations. Singapore has one of the highest diabetes-related lower limb amputation rates in the world, with an average of four such amputations conducted here daily. In Singapore, hospitals perform around four diabetes-related amputations a day, or roughly 1,500 a year. [According to a report in 2015].

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Podiatry services are a vital component of the health care plan of diabetes sufferers, with frequent Podiatry visits resulting in maintenance of foot health and the quality of life for those with diabetes. Long-erm primary podiatric care can certainly reduce and prevent diabetic foot disease.

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A podiatrist would have treated a number of nail conditions and abnormalities that occur among the general population. But whenit comes to working with a diabetic patient, noticing and identifying variations become much more crucial. This is because change can happen more rapidly in the diabetic foot, and pathologies in diabetic toenails can ultimately lead to skin breakdown, foot ulcerations and infection.

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Why is this the case? 

 

Changes in the diabetic toenails are usually due to:
 

• Poor circulation

• Trauma – which often goes unnoticed due to neuropathy (loss of sensation)

• General susceptibility to bacterial/ fungal infections – resulting from high levels of glucose in the blood
   

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How to care for a diabetic foot at home?

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• Inspect your feet daily.

  • Check for cuts, blisters, redness, swelling or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your podiatrist if you notice anything.

• Bathe feet in lukewarm, NEVER in hot water.

  • Keep your feet clean by washing them daily. Use only lukewarm water—the temperature you would use on a newborn baby.

• Be gentle when bathing your feet.

  • Wash them using a soft washcloth or sponge. NEVER use rough/ abrasive cleaning tools. Dry by blotting or patting and carefully dry between the toes. 

• Moisturize your feet but not between your toes.

  • Use a moisturizer daily to keep dry skin from itching or cracking. But don't moisturize between the toes—that could encourage a fungal infection, due to excessive moisture build up.

• Cut nails carefully.

  • Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toenails. If you have concerns about your nails or unable to attend to your nails, consult your podiatrist.

• Never treat corns or calluses yourself.

  • No “DIY surgery” or medicated over the counter pads/plasters.

  • You should NEVER use any acid based topical treatments as well.

  • Visit your podiatrist for appropriate treatment.

• Practice good hygiene.

  • If you wear socks, change them daily.

    • Consider socks made specifically for patients living with diabetes. These socks have extra cushioning, do not have elastic tops, are higher than the ankle and are made from fibers that wick moisture away from the skin.

  • If your feet get cold at night, wear socks. Never use a heating pad or a hot water bottle.

• Shake out your shoes and feel the inside before wearing.

  • Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on.

• Keep your feet warm and dry.

  • ​ Don’t let your feet get wet in the rain. 

  • Consider using an feet powder on the soles of your feet if you have excessive sweating of the feet.

• Never walk barefoot.

  • Not even at home! Always wear shoes or slippers. You could step on something and get a scratch or cut.

• Take care of your diabetes

  • ​. Keep your blood sugar levels under control.

• Do not smoke.

  • ​ Smoking restricts blood flow in your feet.

• Get regular foot assessments.

  • ​ Seeing your podiatrist on a regular basis can help prevent the foot complications of diabetes.​

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