Complications of Diabetes: Foot Care, Foot Ulcers and Infections

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Complications of Diabetes: Foot Care, Foot Ulcers and Infections
October, 2002
Information provided (reviewed) by Martha Funnell, MS, RN, CDE,
Michigan Diabetes Research and Training Center
Published by McKesson Clinical Reference Systems

What are foot ulcers?

Foot ulcers are open sores that can happen to people with diabetes. The ulcers can range from minor sores to serious damage of tissues if the sore becomes infected.
How do they occur?

When you have diabetes, the flow of blood to your feet can be affected. When less blood is flowing, it is harder for the body to fight off infections and heal itself. As a result, sores on your feet may not heal and can become infected. Without treatment, theses infections can cause serious damage.

In addition, diabetes can cause damage to the nerves in the feet. You may not sense pain if you hurt your foot or get an infection. This makes it hard for you to know that you have a sore that needs treatment, unless you are looking at your feet each day.
What are the symptoms of a foot infection?

The initial symptoms are swelling, redness, or pain. You may notice a sore on your foot. It may heal but later return in the same place. Sores that are not treated are the main cause of amputuations for people with diabetes.
How are they treated?

Antibiotics or other medications can be put on the sore or infected part of your foot. These medicines will help fight infection, get rid of dead skin, and help new, healthy skin to grow.

You may have to stay off your feet for a while to prevent further irritation of the sores or infections.

Antibiotics given intravenously may be needed. If antibiotics don't heal the infection, survery on the ulcerated area may help.
How can I help prevent foot ulcers and infections?

Protect your feet using the guidelines below.

Check your feet. Look at the tops and bottoms of your feet at the end of each day to make sure you have no reddened areas, cuts, or scrapes that could become infected.

Bathing and drying:

* Use warm (not hot) water to wash your feet. Then dry your feet carefully, especially between the toes. Apply cream or lotion after your feet are dry to keep the skin soft and free of dry skin.
* If your feet sweat a lot, keep them dry by dusting with talcum powder.

Treating corns and calluses:

* Tell your doctor right away if you develop a corn or callus.
* Don't treat corns or calluses yourself. Ask your doctor about using over-the-counter products for these problems.

Toenail care:

* Cut your toenails carefully, cut or file your nails straight across and then use an emery board to smooth the sharp corners. Do not cut the sides or the cuticles.
* Clean your nails carefully.
* If your nails are thick or hard to cut, ask your doctor's office for help.

Foot warmth:

* Wear cotton socks to bed if you need extra warmth for your feet.
* Avoid using hot water bottles or electric heaters to warm your feet. Because you may not fully sense hot and cold with your feet, you may burn your feet accidentally and develop an infection.
* Avoid putting your feet where they could accidentally be burned; for example, on hot sand at the beach, in hot bath water or whirlpools, or near a fireplace. Use sunscreen on the tops of your feet.

Footwear:

* Take your shoes and socks off at each visit to your provider so that the doctor can easily look at your feet.
* Wear shoes at all times, even in your house, at the beach or by a pool.
* Wear comfortable shoes that fit well. Change to a different pair of shoes at least once during the day.
* Ask your doctor about specially made shoes, especially if you have foot problems.
* Avoid wearing new shoes for more than an hour a day until they are thoroughly broken in.
* Avoid tight-fighting shoes, socks and hose.
* Wear clean socks and change them at least once a day.

In addition to these foot care guidelines, keeping your blood sugar and your blood pressure close to normal helps prevent foot problems.

You may want to ask for more information from:

* American Diabetes Association, Inc.
1701 Beauregard
Alexandria, VA 22311

1-800-DIABETES, or 1-800-342-2383

http://www.diabetes.org
* American Podiatry Association
20 Chevy Chase Circle, NW
Washington, DC 20015

Developed by McKesson Clinical Reference Systems.
Published by McKesson Clinical Reference Systems.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.