For diabetics, foot-care tips

On Call

April 02, 1996|By Dr. Simeon Margolis | Dr. Simeon Margolis,SPECIAL TO THE SUN

I have been worried ever since my doctor discovered my diabetes three years ago, because my mother had a lower leg amputated as a result of this disease. What can I do to avoid an amputation?

Diabetes is often complicated by a decrease or loss of sensation in the feet (peripheral neuropathy) and accelerated hardening of the arteries (atherosclerosis) that obstructs the delivery of blood to the feet. With the poor sensation, minor injuries or blisters often go unrecognized and untreated. Reduced blood supply prevents healing, leading to infections and the development of ulcers. Severe infections, large ulcers and death of tissue (gangrene) then may require amputation.

The following foot-care rules are recommended for all patients with diabetes:

Check your feet daily for cuts, sores, blisters and red spots.

Be sure your doctor checks your feet regularly.

Wash your feet with warm -- not hot -- water. Dry the feet gently, and be sure to dry beneath the toes. Do not soak the feet except briefly to soften the nails before trimming them.

Trim the toenails by cutting straight across with a toenail clipper. Use an emery board or file to smooth sharp edges that might cut the next toe.

Never walk barefoot.

Check with your doctor before applying any over-the-counter medicines to your feet. Do not use corn plasters or liquid corn or callus removers.

If corns or calluses are rubbing against your shoes, sand them gently with a pumice stone or seek help with a podiatrist. Do not use a razor blade.

Before putting on shoes, examine the insides for small stones or other foreign material.

Choose the right shoes. Be certain they fit properly -- the shoe should be about a half-inch longer than your longest toe when you are standing. The toe-box should be wide and shaped like your foot. Select shoes made of soft leather. Consider specially fitted (orthotic) shoes if you have recurrent foot problems.

When a foot problem occurs, rest and elevate the foot and do not hesitate to check with your doctor.

Keep your blood glucose under control to delay or prevent peripheral neuropathy.

Do not smoke cigarettes or eat a lot of fat.

For more information, call the National Institutes of Health, National Diabetes Outreach Program [(800) 438-5383] for the "Feet Can Last a Lifetime" packet. The Pedorthic Football Association [(410) 381-7278] can provide the names of suppliers of orthotic footwear.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

Pub Date: 4/02/96

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