Personal solutions for everyday life. Looking after your feet

Transcription

1 Personal solutions for everyday life. Looking after your feet

2 Looking after your feet Diabetes can affect the nerves and blood supply to the feet. Over years, the nerve endings to the feet can be affected by high blood glucose levels, and this affects the sensations in the feet. You may lose the ability to feel pressure, pain and heat in your feet. Pain is useful as it alerts us to danger. When we lose these sensations it becomes very easy to damage the feet without being aware of it. This nerve damage is called neuropathy. People with diabetes also seem to be more at risk of developing narrowing of the blood vessels. This can happen throughout the body, but it is particularly common in the legs. Wounds or sores may be very slow to heal as a result. The risk of having narrowed blood vessels is increased if you have high blood pressure, high levels of cholesterol in your blood, or if you smoke. How problems develop Problems can develop if cuts and sores go unnoticed. Cuts and sores may not heal, and can become infected. Infection tends to happen more often in people with diabetes, particularly if blood glucose is not well controlled. Once infection is present, it can be more difficult to treat. Pressure on an area can cause corns and calluses, for example this can be caused by wearing shoes that are too small. If these corns and calluses aren t spotted and treated, the skin in the area eventually breaks down and an ulcer forms. Ulcers are open sores in the skin. It takes time for them to heal, and they canget infected. If ulcers on your feet aren t treated, they can lead to more serious problems, and an amputation may be necessary.

3 Your diabetes team A diabetes team is a group of healthcare professionals with specialist knowledge and experience of supporting people with diabetes. For example, teams may include diabetologist / endocrinologists (hospital specialists who deal with hormone disorders such as diabetes), family doctors, specialist diabetes nurses, dieticians, ophthalmologists (for specialist eye care) and podiatrists (for foot care). A podiatrist (also known as a chiropodist) is a healthcare professional who specialises in diagnosing and treating foot problems. Podiatrists are qualified to care for foot problems in people with diabetes. At risk feet When your diabetes team check your feet, they will check the level of sensation and the circulation in your feet. Based on the results of these tests, your general health, and how your feet look, your team will discuss with you whether you currently have a low risk of foot problems such as ulcers or whether you are at risk of developing problems. If you are classed as being at risk or having risky feet, you ll have frequent foot checks and you ll be given specific information on how to care for your feet. The information within this leaflet is general information, but it is particularly important if you have been told that your feet are at risk because of poor blood supply or nerve damage (neuropathy).

4 Keeping your feet healthy Check your feet every day - if you spot any cuts, sores, corns, calluses, blisters, ingrown toenails or ulcers, contact your diabetes team immediately (even if you don t feel any pain) Keep your feet clean If you experience any of the following sensations: pins and needles, stabbing pains, burning sensations or intense aching, you should mention this to your diabetes team at your next visit as this could be symptomatic of painful diabetic neuropathy Wear shoes that are the right size (people with neuropathy can sometimes wear shoes that are too small so they can feel them) Before you put your shoes on, check inside them for rough edges and objects Don t walk barefoot in case you step on something or cut your foot and don t notice Don t soak your feet or use a foot spa Use a moisturiser on your feet - ask your diabetes team to recommend one Avoid direct heat against your feet (for example, don t put your feet against a hot water bottle or a radiator) Keep your blood glucose (blood sugar) at your target level (write a note of your targets in the space below) Have your feet checked at least once a year (more often if you are classed as being at risk ) Stop smoking (smoking affects your circulation) Your blood glucose levels Your fasting blood glucose should be: 1-2 hours after food, your blood glucose should be:

5 Checking your feet Look at your feet every day, and pay special attention to the areas between your toes and around the heel. Use a mirror to look at the bottom of your feet. Check the temperature and colour of your feet. If you spot any changes, or if you think there s a change in the level of feeling in your feet, tell your diabetes team. Keeping your feet clean Wash your feet every day. Dry them thoroughly, especially between your toes. Use a moisturising cream to keep your skin supple (your diabetes team will advise you on the ones to use). Supple skin is less likely to crack. But don t moisturise between your toes or you could end up with the fungal infection called athlete s foot (if you think you might have this, ask your pharmacist or family doctor for advice). Change your socks, tights or stockings every day. Corns and verrucas Don t use the following on your feet: corn remedies razors verruca remedies tools to remove rough skin If you have a corn or verruca, speak to your diabetesteam.

6 Trimming your toenails Your diabetes team will advise you on trimming or filing your toenails. Following their advice may help you prevent any damage to the surrounding skin. If you develop an ingrown toenail, speak to your diabetes team. If you are classed as being at risk of ulcers, or if you can t see or reach your nails, don t attempt to trim your nails yourself. Your diabetes team will do this for you. Footwear Check inside your shoes or slippers for rough seams and objects before you put them on. Regularly check that the soles of your shoes and slippers are still thick enough to protect your feet. Wear socks that fit snugly. Too tight and they will restrict circulation. Too loose and the ridges may cause the start of a foot wound. Also, wear socks and tights that don t have a pronounced seam at the toe. Don t wear slippers for too long as they don t give you much protection. And if you have problems with sensation in your feet, don t wear sandals as these give less protection than shoes.

7 Buying shoes Always get your feet measured (if you have reduced sensation in your feet your natural inclination will be to wear shoes that are too tight) Make sure new shoes are wide enough, deep enough, and that there s enough room around your toes Check the seams inside the shoes as they may rub if they stick out Lace-up shoes with soft uppers give good support and protection If the shape of your feet has changed, you may need to have special shoes made to protect them Ask your diabetes team for advice if you have any queries Watch the temperature If diabetes has affected the sensation in your feet, you may not notice when they re getting too hot. So don t sit too near fires or heaters. And don t put your feet against a hot water bottle or a radiator. Turn off electric blankets and remove hot water bottles before you get into bed. It s best to wear bed socks, or heat the whole room rather than just your feet. When you have a bath, run the cold water first, and check the temperature with a bath thermometer before you get in.

8 Other information Other leaflets in this series include specific explanations of some of the terms used here. Leaflets on blood testing, hypos, travel, impact on sexual health, driving and employment, illness, and complications may be particularly helpful for you. Ask your diabetes team for the ones you want. Further information is available from Customer Care Contact numbers and notes Lilly UK Answers Lilly House Priestley Road Basingstoke Hampshire RG24 9NL Tel: (01256) Provided as a service for patient care UKDBT01185 June 2012