Remember that old, black, thick scab on your toes? Or that small blister from an ill fitting shoe? Maybe a dry skin which gets irritated and opened up...

Simple cases you may think, but for people with diabetes, those problems can be the first step toward infection, chronic ulceration, and possibly losing their limbs, if left untreated. Over the years, I've been telling our patients that they should always take good care of their feet. This is because people with diabetes suffer from some special conditions such as:

a) Loss of sensation in feet - because of your diabetes, you may suffer from lack     of sensation in your feet. This could result to small and sometimes even bigger     injuries without your knowledge and if not treated promptly may result to     chronic (or non-healing) ulcers.

b) Inadequate blood supply to feet - in most cases, when you hurt yourself, blood     reaches into the affected area to bring in infection fighting white blood cells     and helps in the early recovery of the tissues. But if the blood vessels are     damaged due to your diabetes condition, blood supply to the feet may be     reduced resulting to slower healing and increased risk infection.

Definitely, your lifestyle must change. Those who are smoking should QUIT smoking, those who are not exercising, MUST EXERCISE and CONTROLLING YOUR DIABETES MUST ALWAYS BE A PRIORITY. Always bear in mind that any cut, sore, bruise or blister must be treated in time to prevent the development of any foot ulcers. Even if you feel no pain in your feet, examine them carefully. This must be done daily.


IMPORTANT FOOT WEAR FACTS:

a) Always wear cotton socks with your shoes to prevent blisters and sores.

b) Make sure they are soft, comfortable and preferably seamless.

c) Shop for shoes in the afternoon when your feet are slightly larger.

d) Buy shoes that will stretch a little to accomodate your foot rather than plastic     or vinyl.

e) Try to avoid shoes that have narrow, pointed tip or high heels.

f) Always check the insides of your shoes before putting them on to make sure    that the lining is smooth and that there are no foreign objects inside.


EXERCISE is essential. Warning: avoid those forms which put undue stress on your feet. Walking, swimming or bicycling may be appropriate choices. Always wear comfortable shoes.

If in case an ulcer develops, what can I do to help it heal?

Most ulcers can be healed if identified and treated in time. Treatment may include:

1. Cleaning the wound - see your health professionals. They are the best persons     who can perform the procedure.

2. Treating Infection - Your doctor will give you the appropriate antibiotics which     you can take. WARNING: Avoid self-medicating and putting the oral antibiotic     directly into the ulcer.

3. Relieving the pressure on the wound - One step may destroy the wound bed.     Take the necessary action to prevent damaging the sensitive healing stage.

4. Dressing the wound - Use appropriate dressing. Avoid using hydrogen peroxide     or betadine solution to clean the wound. Saline soaked dressing can be the     cheapest form of dressing and at the same time can be very beneficial.

Excellent diabetes control together with the adequate education of the patient and team management will allow effective treatment and prevention. For foot problems, visit our Limb Saving and Wound Care at Rm. 366 Diabetes Educational Clinic, Makati Medical Center. We are open from Monday - Friday, 8 am - 5 pm. Tel. #893-6070.