2015

National Aboriginal Diabetes Association

To increase awareness of diabetes and foot care management

Disclaimer:

This presentation is offered as educational information and shall not be used as a substitute for seeking medical advice. For more information, see your medical practitioner.

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People with diabetes are prone to having foot problems, often because of two complications of diabetes:

◦ Nerve damage (neuropathy)

◦ Poor circulation

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Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. ◦ High blood sugar can injure

nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet.

You can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle.

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Anyone who has diabetes can develop neuropathy, but these factors make you more susceptible to nerve damage: 1. Poor blood sugar control. This is the greatest risk factor for every

complication of diabetes, including nerve damage. Keeping blood sugar consistently within your target range is the best way to protect the health of your nerves and blood vessels.

2. Length of time you have diabetes. Your risk of diabetic neuropathy increases the longer you have diabetes, especially if your blood sugar isn't well-controlled.

3. Kidney disease. Diabetes can cause damage to the kidneys, which may increase the toxins in the blood and contribute to nerve damage.

4. Being overweight. Having a body mass index greater than 24 may increase your risk of developing diabetic neuropathy.

5. Smoking. Smoking narrows and hardens your arteries, reducing blood flow to your legs and feet. This makes it more difficult for wounds to heal and damages the integrity of the peripheral nerves.

Numbness or reduced ability to feel pain or temperature changes

A tingling or burning sensation

Sharp pains or cramps

Increased sensitivity to touch — for some people, even the weight of a bed sheet can be agonizing

Muscle weakness

Loss of reflexes, especially in the ankle

Loss of balance and coordination

Serious foot problems

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Foot injuries Foot deformity

Loss of feeling for pain, touch, heat or cold

Poor circulation/blood flow

Urinary tract infections

Digestive problems

Sexual dysfunction

A change to the shape of the foot or toes because of: ◦ Corns and Calluses

◦ Thick toenails

◦ Swollen feet

◦ Bunions and Hammertoes

◦ Ingrown toenails

◦ Dry, cracked skin

◦ Charcot joint (swollen, deformed feet)

◦ Amputation

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https://www.youtube.com/watch?v=NYE-wHvTIoU.

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Causes

Seek medical care if you notice:

A cut or sore on your foot that doesn't seem to be healing, is infected or is getting worse

Burning, tingling, weakness or pain in your hands or feet that interferes with your daily routine or your sleep

Dizziness Changes in your digestion,

urination or sexual function These signs and symptoms

don't always indicate nerve damage,

Damage to nerves and blood vessels

Prolonged exposure to high blood sugar can damage delicate nerve fibers, causing diabetic neuropathy. Why this happens isn't completely clear, but a combination of factors likely plays a role, including the complex interaction between nerves and blood vessels.

High blood sugar interferes with the ability of the nerves to transmit signals. It also weakens the walls of the small blood vessels (capillaries) that supply the nerves with oxygen and nutrients.

Nerve damage video: https://www.youtube.com/watch?v=

oq8CUdfib60.

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Podiatrist / Chiropodist ◦ Podiatrist/Chiropodists are primary care providers and are

therefore qualified to assess, diagnose, prescribe and carry out treatments including minor surgical procedures, therapeutic treatments including: laser, ultrasound, iontophoresis, extracorporeal shock wave therapy and electrical treatments.

The scope of practice varies from province to province, but generally practitioners will have several controlled acts. These include the treatment of:

◦ Bony Foot Deformities ◦ Subcutaneous Lesions ◦ Corns / Callus / Warts ◦ Nail Conditions ◦ Biomechanical Dysfunctions ◦ Orthotics / Orthopedic Appliances

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Your mobility and overall health are riding on your feet. Foot care is a necessity that helps you maintain your lifestyle and well-being

Managing your Feet Video: http://health.gov.on.ca/en/public/programs/diabetes/video/vid_feet.aspx.

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Good fitting shoes is important to foot health.

Avoid, ◦ Worn out shoes or socks ◦ Shoes with pointed toes ◦ Shoes that are too tight ◦ Shoes with seams

Do consider, ◦ Shoes with a rounded toe ◦ Shoes with low heels ◦ Firm heel part of the shoe ◦ Removable soft insole

Some people that already have problems with their feet may need to buy special shoes

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Daily foot care routine Foot care kit

Make your personal foot care kit, to include:

Nail clippers, nail file, lotion, pumice stone, and unbreakable hand mirror

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Shoes made of leather or canvas are best

Shoes with laces or

straps are better than a slip on shoe

Inside of the shoe should

be smooth, no seams, stitching

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Never go barefoot Check your shoes for wear,

cracks, tears, rocks, nails, or sand and pebbles

Break in new shoes slowly Never wear wet or damp shoes

do not wear socks that are mended as they can cause sores

Wash your feet in warm water While your feet are wet, use a

pumice stone to keep calluses under control

Dry your feet carefully, using a patting motion

https://www.youtube.com/watch?v=eWfTMpKhuJQ.

Thoroughly check your feet and between the toes to ensure there are no cuts, blisters, cracks, ingrown toenails, etc

Clean cuts and scratches with mild soap and water

Trim your toenails straight across and file any sharp edges.

Apply unscented lotion to your heels and soles. Don’t put lotion between your toes

Wear fresh clean socks and well-fitting shoes every day

Wear white socks(preferably) Wear shoes every day, no flop

flops, etc.

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1. What can cause injury to your feet?

2. When you buy new shoes, what do you look for?

3. What are some things you can do to take care of your feet?

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Mayo Clinic, Diseases and Conditions. http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/basics/symptoms/con-20020865

Taking Care of Your Feet. Indian Health Service diabetes Programs. West Albuquerque, New Mexico. 1987

Foot Care: a step toward good health. Canadian Diabetes Association. CPG.

Foot Care & Your Health. Youville Clinic.

Youtube. Diabetic Neuropathy

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