Foot Care

If you have undergone amputation as a result of diabetes, it is probable that you already know that amputation of the other limb is a potential risk. Diabetes can cause the following foot problems:

• Damage to the nerves in the feet which prevents you from feeling sensations of pain, heat, and pressure.
• Reduced blood supply to your feet and legs which can cause problems with fighting infections and healing cuts on your feet.
• Joints to become stiff or deformed.
• Skin to become thick or callused in certain spots.

Most diabetes-related amputations occur after a wound on the foot does not heal and becomes infected. Some of the most common causes of wounds or ulcers are:

Infections between the Toes

If you develop tinea (a fungal infection), the skin between the toes will look soggy and will peel and crack. If tinea occurs on the soles and sides of the feet, it may look red and scaly. Even mild tinea in between the toes can result in severe infections if left untreated.

To prevent tinea:

• Wash and dry the foot every day, especially between the toes.
• Do not put moisturizing cream between the toes.
• Wear socks.
• Treat moist skin (if it appears white and soggy) by wiping between the toes with methylated spirit. If the condition does not resolve in a few days, see your podiatrist or doctor for advice.

To treat tinea:

• Wash and dry feet well every day, especially between the toes.
• Apply an anti-fungal lotion or gel from the chemist as directed.
• If the condition does not resolve in four weeks or if the area becomes red or swollen, consult your doctor or podiatrist.

Toenail Problems such as Ingrown Toenails

Seek advice from your doctor or podiatrist as to whether it is safe for you to cut your own toenails. This will depend on your circulation, whether you can see and reach your feet easily, and whether you have normal nails. If you have thick or ingrown toenails, always see a podiatrist for treatment and nail cutting.

If cutting your own toenails:

• Nails should be cut straight across.
• Check for sharp edges and file them smooth using a nail file.

Burns

If you have lost some sensation in your feet because of diabetes, it is quite easy to burn your feet without realizing it. This happens more in winter.

To avoid burns:

• Always sit 2 to 3 meters from the heater.
• Never use hot water bottles.
• If you use an electric blanket, use the low setting and turn it off before you get into bed.
• Never walk barefoot – in summer, the ground may be hot enough to burn your skin.
• Do not soak your feet in hot water.

Hard Skin (Calluses and Corns) on Your Feet

Calluses or corns indicate that there is pressure on that area of skin. Over time, the skin under the callus will break down causing a wound. If you notice that you have a callus, see your podiatrist who can safely remove it, leaving the soft skin intact. The podiatrist can then help you to avoid the problem in the future. Do not cut callus yourself as you could cause an infection. Never apply corn plaster; they contain acids that will burn the skin.

Cracked Heels

Rub a moisturizing cream into your feet to stop them from getting dry and cracked. Cracks can become infected if not treated. Do not put the cream between the toes and use it twice a day if your feet are very dry. There are special creams containing urea for very dry and cracked heels. Your pharmacist or podiatrist can advise you about these. If the cracks in your heels are bleeding, see your podiatrist for treatment and do not apply urea creams.

Sometimes problems with your feet occur, despite your efforts. If you develop a problem with your foot, see your doctor or podiatrist. Prompt action will usually prevent the condition from becoming worse.