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Diabetes management must focus on head-to-toe health

Published 11:11am Saturday, May 11, 2013

by Dr. Daniel K. Peak

Diabetes affects 25.8 million people, or 8.3 percent of the U.S. population. It is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.

About 60 percent to 70 percent of people with diabetes have mild to severe forms of nervous system damage that may result in impaired sensation or pain in the feet or hands. In 2008 alone, more than 70,000 people with diabetes had a leg or foot amputated. While diabetes can lead to serious complications and premature death, by taking steps to control the disease, including being extra aware of foot health, people with diabetes can manage the disease and lower their risk for complications, including lower-extremity amputations.

Why diabetes affects the feet

Diabetes has the potential to harm your feet because blood flow is reduced to certain areas of the body, especially limbs such as the legs. This makes it harder injuries to heal. Also, diabetes-related nerve damage may cause you to no longer feel pain in your feet, and you may not realize you have a wound or injury that needs treatment.

Protecting Your Feet

Over half of diabetes-related amputations can be prevented with regular exams and patient education which includes the following simple tips from the Centers for Disease Control and Prevention.

* Have your doctor check your feet at least four times a year.

* Check your feet each day. Because you may not feel foot pain, look at the tops and bottoms of your feet and toes every day to check for scratches, cracks, cuts or blisters. Call your doctor if you have any sores.

* Wash your feet daily. Don’t soak your feet, as it can dry out your skin, which can lead to infections. Be sure to dry your feet carefully, especially between the toes. Rub a doctor-recommended lotion on the tops and bottoms of your feet.

* Trim your toenails carefully. After washing and drying your feet, trim your toenails. Trim the nails to follow the natural curve, but don’t cut into the corners. If you can’t see well, or if your nails are thick or yellowed, get them trimmed by a foot doctor or another health care provider. If you see redness around the nails, see your doctor.

* Never cut or use a razor on corns or calluses. Ask your doctor how to use a pumice stone to rub them.

* Protect your feet from heat and cold. Hot water or surfaces are dangerous to your feet. Test your bath water with your elbow and wear shoes and socks when you walk on hot surfaces. In summer, use sunscreen on the tops of your feet, and in the winter, wear socks and warm footwear to protect your feet.

* Always wear shoes and socks. Never walk barefoot—even indoors.

v Wear shoes that fit well and protect your feet. Don’t wear shoes that have plastic uppers, and don’t wear sandals with thongs between the toes. Always wear stockings or socks made of cotton or wool.

* Be physically active. Physical activity helps increase the circulation in your feet.

Daniel K. Peak, MD, is an internal medicine physician at Southampton Memorial Hospital

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