Understanding the Do's and Don'ts of Diabetic Foot Care

Persons with diabetes routinely attend diabetes teaching clinics where they receive valuable diabetes education. A lot of different information is presented including lists of Do’s and Don’ts of foot care. In order to follow or adhere to a list of do’s and don’ts of foot care it is important to understand the list. As a diabetic foot care specialist I commonly ask new patients what they have learned about foot care. Some are able to repeat a list of do’s and don’ts. When I respond by asking, “Why should do this or why shouldn’t you do that?” the common answer is because, “If I don’t I could lose my leg or Uncle Joe lost a leg to diabetes…”

It is a fact that persons with diabetes have a higher risk for leg amputation than persons without diabetes. It is also true that persons with diabetes are individuals. The effect of diabetes will vary from individual to individual. Likewise the feet will be affected on an individual basis. Some persons will be at extremely high risk for foot problems and amputation; whereas, others may not be at much more risk than an average person without diabetes.

There are four risk factors that increase a person’s risk for diabetes related foot troubles. First and foremost is peripheral neuropathy or loss of feeling. Without feeling the individual may not be aware of foot troubles until it is too late. Prior history of foot troubles, circulatory troubles and deformity (hammertoes, bunions, thick toe nails, calluses etc) comprise the other three risk factors. Health care providers can screen for these factors very easily. The more risk factors the greater the risk for eventual troubles.

Persons with diabetes who are found to be at increased or high risk for foot troubles must take steps to prevent diabetic related foot problems. As a person with diabetes it is thus extremely important to know your risk status for foot troubles. If you understand the risk factors and implications then it is easy to understand why “you should do this or shouldn’t do that”. So the next time someone asks you why you should or shouldn’t do this or that try responding by saying “because I have or don’t have neuropathy, deformity, prior history and circulatory troubles and my risk is …” If your foot health care provider has not discussed your individual risk for foot problems then bring it up at your next scheduled visit.

Do:

Have your shoes professionally fitted Inspect your feet daily Dry between your toes Wash your feet daily Have your feet checked regularly by a foot health care professional (frequency of visits is on an individual basis) Use moisturizing creams if your feet are dry

Don’t:

Walk barefoot Cut the corners of your nails Cut your own corns or calluses Soak your feet Smoke

Timothy P. Kalla, BSc, DPM, FACFAS

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