Medical Advices for Students

Why is it important to take care of the feet in diabetic patients?

In the development of diabetes, complications are more frequent involvement of nerves and arteries. The altered vascular blood flow and facilitate the development of edema and poorly vascularized areas that hinder the healing of wounds and injuries. Diabetic neuropathy causes numbness, muscular weakness and pain.

Both conditions have a special impact on the feet, increasing the production rate of erosion, perforation, cuts, burns … that if they are not careful become sores, facilitating infection and can lead to gangrene and the need for amputation.

How should foot care in diabetic patients?
To prevent ulcers, injury, infection and necrosis in the feet is very important for diabetic patients maintain good blood glucose control and avoid factors that may increase the risk of vascular and nerve injuries by:

Blood glucose monitoring, corrective maintenance treatment with insulin and / or oral hypoglycemic agents;
Diet to provide the stability of blood glucose levels, avoid obesity and ensures adequate intake of proteins, vitamins and minerals to the body;

• Physical exercise that facilitates the maintenance of proper weight, glucose metabolism and proper blood circulation in the feet;
• To keep a good control of blood pressure and blood lipid levels;
• Do not smoke or consume alcohol or other drugs.

It is also essential daily care for the feet, checking them to monitor if there are wounds, scrapes, blisters or cracks. For daily review is advised with good natural light and inspect well all parts of the plant and the interdigital spaces with the help of a mirror. It should seek medical advice if lesions appear, color changes, pain or swelling in the feet.

Proper foot hygiene and appropriate choice of footwear is the basic strategy to avoid the appearance of scratches, cuts, burns and injuries:

• Wash your feet daily with warm water (not too hot, not exceeding 37 degrees-or cold). Is advisable to check the water temperature with a bath thermometer or your elbow, as is common in the feet may have been lost feeling and is not seen the actual water temperature;
• Dry your feet thoroughly with a soft towel without rubbing, with particular attention to the interdigital spaces. If the skin is very dry you can apply a moisturizer but careful not to apply it in the interdigital spaces.
• Keep feet dry by using non-medicated powder before putting every morning and every time you change of socks or shoes.
• The toenails should be cut with blunt scissors, and straight to avoid ingrown toenails, without hurry or erode cut fingers. It is advisable to use a file to keep the length of the nails and polish the edges.
• No need to cut or remove corns and calluses on their fingers, or use Callico, if necessary should consult a podiatrist.

You should not use ointments, alcohol or disinfectant for wounds of the feet, as they may irritate the skin or change the color of skin and wound, hindering their medical care. Wounds should be washed with soap and water, as recommended by the doctor.

• The feet should not be placed near the fire, stoves or heat sources.
• It should avoid the use of rubber bands, rubber or socks with elastic at the edge and hampering blood circulation.
• Avoid walking barefoot.
• Use sunscreen on my feet if you are exposed to the sun.

How to choose footwear?
Together with the rules of hygiene must be kept good habits, selection and use of footwear:

• The shoes should always be used with socks.
• Do not use sandals, slippers or shoes that leave the feet exposed.
• It should avoid the use of heeled shoes and ending in a point.
• The shoes should be comfortable, that does not fit or cause abrasions or lesions on the feet.
• The shoes are advised of skin without seams, flexible, lightweight, breathable and non-slip floor.
• It is advisable to buy the shoes at the end of the day when feet are more swollen and the shoe that is comfortable at that time, it ensures that it will be along all day.
• New shoes should be used for short periods at first.
• The purchase of orthopedic shoes must be conducted under the criteria and prescription.
• Shoes must be adequately maintained, repaired and ensuring a good status in the soles.
• Call to check inside shoes before putting them on, to avoid having any element (stone, gravel, some part of the shoe …) that can injure the feet.
• You should have more than one pair of shoes to change them and alternate them each day and ensuring good ventilation of the shoe and prevents the pressure always in the same areas of the foot.
• Socks and stockings should be of natural fabrics (linen, cotton, wool) and seamless. You should not use synthetic socks or stockings with elastic or rubber bands. There should be no loose or clenched in the leg and foot.
• It should change socks daily, and if your feet sweat a lot or has exercised much more than once a day.

Very important!

• All diabetic patients must be properly vaccinated against tetanus.
• It is essential that the diabetic patient’s feet will be reviewed by the medical team regularly monitor compliance with his instructions and the injuries of the feet.

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