Foot care for patients with diabetes is important, especially for elderly patients, because they have higher risk for chronic or infected wounds compared to healthy people. And the wounds can be serious, or even result in loss of toes or legs if the wounds have not been taken care of. Prevention of wounds on the legs in diabetes patients can be done with very good care by daily inspection of the feet. And it is important to hurry to consult a doctor if there is something wrong with the feet.

Why can the patients with diabetes get wounds easier compared to healthy people?

      1. In case of patients with chronic diabetes, the peripheral nerves in the extremities (hands and feet) usually become damaged , which decreases the sensation of pain, and causes numbness of the toes. The patients don’t feel any pain when they have injured and the wounds often go unnoticed. The damaging of the nerves can cause feet muscle to become atrophied and change in shape. Delayed treatment can put the patient at risk for further complications such as skin ulcers, ingrown toenails or calluses, which can lead to the breakdown of skin and surrounding tissue.

      2. Patients with diabetes usually have a lack of circulation in the extremities, because the artery walls become thicker which causes lack of oxygen in the legs, and the skin of the legs becomes thinner. This affects to a delayed healing of wounds, or legs become sore during walking. In some severe case peripheral blood vessel are blocked which causes bruising in the toe muscles, and have to be cut over extended periods.

      3. For patients with high levels of blood sugar for a long period, the skin can become infected with fungus, especially the area between the toes, and the skin can be scratched and infected with other microorganisms later.

How to prevent diabetic wounds?

         Prevention of diabetic wounds is critical for diabetic patients to ensure a normal and active healthy lifestyle. It is important to remember that diabetic wounds can be disabling and life threatening in some cases. Prevention is as follows:

      1. Daily inspection of the feet for cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality.

      2. Gently cleaning of the extremities with normal soap and water as they are more prone to ulcers and injuries, cleaning the feet with too cold or hot water is not recommended.

      3. Performing foot massage with Vaseline oil or lotion to soften the skin, and to prevent dry skin and itching, as this can cause scratching until the wounds occur, but do not apply oil between the toes.

      4. Do not use a knife or a sharp edge to trim the hard corns or keratosis.

      5.Always keep feet dry.

     6. In case of getting small injuries, clean the wound with clean water. Do not use a concentrated disinfectant or Iodine, as to it can cause larger wounds. If the wound become swollen it requires a doctor’s attention.

7. Carefully trim the nails with a safe nail trimmer (refer to an expert if the patient requires extra care or if there are skin lesions), cut nails in a light environment where the nails can be clearly seen. It is recommended to cut the nails after a bath, because the nails are softer and easier to cut. Cut the nails along the margin only, do not cut the nail groove.

      8. Always wear dry, clean socks to help protect your feet, and never walk barefoot (avoid tight socks that may reduce the blood circulation to the feet).     

     9. Always wear comfortable shoes. And walk for only 0.5-1 hour in brand-new shoes, try to have a spare couple of pairs of shoes.

    10. Avoid walking barefoot, wear soft shoes and not slippers.

    11. Do not place a hot water bag on the feet, wear socks which are not too tight during cold weather.

    12. Do not sit cross-legged, because the blood vessels will be compressed which causes poor blood circulation.

    13. Do regular foot exercise in order to enhance blood circulation in the feet.

    14. Control diabetes with blood glucose, maintain at levels between 80-130 mg/dL.

    15. Consult a doctor if there is any abnormal condition.

For more information, please call Diabetes Center, Nonthavej, hospital. 0-2596-7888.

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• Q: What is the cause of foot wounds for the patient with diabetes? How to detect the food wounds in the early stage?
• A: Foot wounds are found in diabetic patients 5 times more than healthy people. It usually occurs by abnormal shape of the feet, combined with constriction of the peripheral artery. The signs include numbness of the toes, because nerves are damaged by the diabetic disease and this causes chronic ulceration. It can become worse by infection, so lower extremity amputations might be needed and in some cases patients even die. 
•                  The best way to treat a diabetic foot ulcer is to prevent its development in the early stage. Therefore, the patients with diabetes consult see a doctor to check the pulse in the leg, and be screened for coronary artery constriction with Ankle-Brachial Index (ABI) once a year. It is an easy way to diagnose the peripheral artery disease.
•                    The diabetic foot ulcer or wound caused with peripheral arterial disease can be treated with non-surgical and Endovascular Surgery with stent implantation.
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• Appointments with our doctors at Surgery and vascular center
• Tel. 0-2596-7888 ext 2139, 2145