When you were initially diagnosed with diabetes, your doctor may have immediately followed it up with a reminder to always check your feet. However, what does it mean? Do you have to comply and check your feet every day?
Diabetes and amputation
According to the American Diabetes Association, every 30 seconds at least one person worldwide loses a limb due to diabetes-related complications. Among the most common complications are foot ulcers.
In a 2012 study on the Management of Diabetic Foot Ulcers, researchers found that foot ulcers appear in four to 10% of people with diabetes. However, the majority of foot ulcers—around 60–80%—will heal. Meanwhile, five to 24% of those afflicted will eventually lead to lower limb loss within less than two years of the initial evaluation.
In 2014 alone, the National Diabetes Statistics Report found that 108,000 adults had lower limb amputations due to diabetes complications. This means that five out of every 1,000 people with diabetes had to undergo lower limb amputation.
Why amputation instead of salvaging the limb?
People with diabetes have higher chances of experiencing Peripheral Artery Disease (PAD), which causes the blood vessels to narrow and reduce blood flow to the lower limbs. The majority of those who had to undergo amputation surgery had PAD.
Furthermore, PAD is known to cause peripheral neuropathy—a condition that prevents a person from feeling pain.
Without the ability to feel pain, most people with diabetes fail to detect the presence of a wound on their feet. And without proper treatment, the wound or ulcer could get infected.
Since PAD reduces blood flow, it also slows down wound healing, making it harder for the body to fight infection. Because of this, wounds and ulcers may not heal, which eventually leads to tissue damage or gangrene. If the infection spreads to the bone and cannot be stopped, amputation becomes necessary.
Preventing a second amputation
However, the outlook is not all grim. Lots of people with diabetes can mitigate their risk or even prevent amputation of their sound side with proper diabetic management, wound care, and regular foot care.
First, manage your blood sugar. This boils down to watching what you eat. Go for a healthy diet that includes lean meats, whole grains, vegetables, and fruit. Fiber is essential as it helps slow down the body’s absorption of sugar.
Make a conscious effort to reduce stress and exercise for at least 30 minutes every day. Maintaining normal blood pressure and healthy weight is crucial. Also, check your blood sugar levels regularly and take your insulin.
Practice foot care
Practicing proper foot care is so important. When you inspect your feet daily, make sure to check for cuts, redness, localized swelling, or any issues with your toenails. Use a hand mirror to take a peek at the bottom of your feet, and call your podiatrist if you notice anything unusual.
When bathing your feet, avoid hot water; only use lukewarm water during your daily foot bath. Afterward, apply a foot or prosthetic moisturizer but avoid the areas between your toes. This is because prosthetic moisturizers are formulated to reduce friction, which may make it difficult to walk when applied between the toes.
It's usually not recommended for people with diabetes to trim their toenails themselves. Make it a point to request your podiatrist to trim your toenails during your monthly visit. However, if you wish to do it yourself, cut carefully and beware of cutting too close to your skin as you may develop ingrown toenails.
If you have calluses or corns, avoid treating them yourself, which means no "bathroom surgery" or medicated pads. Visit your podiatrist who's better equipped to apply the treatment.
Avoid re-wearing socks. You absolutely need to change your foot socks every day and make sure they're clean and dry before putting them on.
Lastly, make it a habit to inspect your shoes before wearing. Your feet might not be able to feel a pebble or other sharp foreign object, which can cause injuries.
What you can do
Although diabetes can often make you feel out of control, there are still things you can do. One, you can lower your risk and limit future issues by taking better care of yourself—eating a healthy diet, reducing stress, and exercising regularly. Also, make it a point to visit your endocrinologist for regular checkups.
More importantly, make checking your foot a part of your daily routine. It only takes a few minutes; this simple act can save you from wounds, infection, and further complications.What do you think about these tips? Is there anything else you’d like to add? Let us know in the comments section below.