Diabetic foot is one of the most common and devastating complications of diabetes mellitus, affecting millions worldwide. It occurs as a result of nerve damage (neuropathy) and peripheral vascular disease caused by consistently high blood glucose levels. This leads to loss of protective sensation, increased vulnerability to trauma, ulcers, infections, and in worst cases, limb amputation. While timely diagnosis and treatment of diabetic foot are critical in managing diabetic foot problems, there are several mistakes that patients often make which exacerbate the condition. This blog discusses the key errors to avoid when dealing with diabetic foot disease.
Not Performing Daily Foot Inspections
One of the biggest mistakes people with diabetes make is failing to examine their feet on a daily basis. Every day, diabetic patients must inspect their feet thoroughly on all surfaces including the soles, heels, sides and between the toes. Check for any cuts, blisters, calluses, discoloration, swelling or break in skin integrity. Use a mirror to examine the bottoms of your feet if unable to bend over. Also feel for any unusual sensations like numbness, tingling or pain. Catching any problems when they first appear prevents progression to more serious complications. Make self-foot checks a mandatory part of your daily diabetes self-care routine.
Ignoring Basic Foot Care
Many diabetics do not take basic preventive foot care seriously enough. Simple self-care habits like washing feet daily with mild soap and warm water, drying thoroughly especially between the toes where moisture breeds bacteria, moisturizing to prevent cracks, and trimming toenails straight across to avoid ingrown nails make a big difference. Do not try to cut calluses or corns yourself, see a podiatrist instead. Always wear clean, non-restrictive socks and well-fitted shoes. Walking barefoot, even at home, is risky. Perform foot exercises to improve circulation and sensitivity. Elevate legs when sitting. Skip hot tubs or heating pads which can burn insensitive skin. Commit to diligent foot hygiene and protection.
Letting Blood Sugar Levels Remain High
Allowing blood glucose levels to remain consistently elevated for long periods leads to diabetic neuropathy and peripheral arterial disease – the prime culprits behind diabetic foot problems. Tight glycemic control is vital. Monitor glucose several times daily and maintain levels as close to normal as possible through medication, exercise and diet. Get HbA1c tested every 3 months to ensure it remains under 7%. Work closely with your doctor to optimize diabetes management and prevent vascular complications that diminish circulation and sensation in the feet.
Not Quitting Smoking
Smoking constricts blood vessels, reducing oxygen supply to tissues. This worsens the impairment of peripheral circulation in the feet due to diabetes. Nicotine also weakens immune systems and damages skin integrity. This makes diabetics who smoke much more vulnerable to serious foot infections as well as post-amputation mortality. Quitting smoking, along with controlling blood sugar and cholesterol, is imperative for diabetics, especially those with foot problems. Nicotine replacement therapy, counseling, prescription medications and support groups can help you kick the habit for good. Talk to your doctor.
Delaying Podiatrist Visits
Seeing a podiatrist, a foot specialist, is a must for all diabetics even if you have no apparent foot problems currently. Get a comprehensive podiatric evaluation annually to identify risk factors early. The podiatrist will examine feet for loss of sensation, signs of abnormal pressure points, circulation issues, deformities, calluses etc. Custom orthotics may be prescribed to offload pressure and prevent ulcer formation even before they occur. Proper preventive foot care education will be provided. Nail care and debridement of calluses can be safely performed. Do not delay podiatry visits.
Postponing Medical Attention
Many diabetics ignore or self-treat foot problems hoping they will resolve on their own, leading to dire consequences like infection spreading from an ulcer into tissues and bones. Do not attempt to self-medicate foot ulcers, ingrown nails, blisters, calluses, swelling or any other problems. Seek expert medical care at the first sign of anything abnormal. An infected diabetic foot ulcer can rapidly spiral out of control, so early intervention makes a big difference. Aggressive treatment is needed to prevent tissue death, gangrene and ultimately amputation. Foot preservation should be the goal. Never delay.
Discontinuing Follow-Up Treatment
Assuming problems are cured after initial treatment and abandoning follow-up care frequently occurs but jeopardizes healing. Even if a wound looks healed, keep applying prescribed antibiotic or medicated creams as directed to prevent recurrence of infection. Use custom orthotics continuously – get replacements when they wear out. Adhere to all instructions from your podiatrist diligently – keep follow-up appointments for wound checks, dressing changes, lab tests, foot imaging etc. Do not discontinue preventive foot care practices either. Consistency in follow-up treatment and self-care prevents complications.
Being Overweight
Excess body weight means feet endure greater impact and mechanical pressures with daily activities, as well as more skin friction. This greatly magnifies risk of diabetic foot complications. Being overweight also promotes fat deposits that can press on and damage peripheral nerves. Losing extra pounds reduces inflammation and joint pains too. Work on shedding pounds with a nutritionist’s help – follow a healthy low-calorie diabetic diet and get regular exercise. Losing 5-10% of your body weight can significantly lower risks of serious foot problems. Keep your weight within normal limits.
Using the Wrong Footwear
Diabetics must be very careful in selecting appropriate footwear. Never wear shoes that are too tight, too shallow or lack cushioning and support. Avoid sandals, open-toed shoes, high heels and slippers. Opt for athletic shoes or walking shoes with cushioned soles and ample interior room for toes. Shop for new shoes later in the day when feet are swollen. Gradually break-in new shoes to avoid blisters. Examine the insides before wearing to ensure no objects are lodged within. The proper footwear prevents skin injuries in diabetics unable to feel them.
Conclusion
For people with diabetes, diligent foot care and early intervention when problems arise are crucial to avoiding complications in diabetic foot treatment like non-healing ulcers, gangrene and amputations. Being aware of the common pitfalls discussed in this blog will allow you to take the necessary precautions and make wise decisions that protect your feet. With vigilance and preventive self-care as well as prompt treatment when required, you can live well with diabetes and maintain healthy feet for life.
