Diabetic Foot Care Article

Diabetic Foot Care
How Can Diabetes Hurt My Feet?

High blood glucose from diabetes causes two problems that can hurt your feet:

  • Nerve damage

One problem is damage to nerves in your legs and feet.

With damaged nerves, you might not feel pain, heat, or cold in your legs
and feet. A sore or cut on your foot may get worse because you do not
know it is there. This lack of feeling is caused by nerve damage, also
called diabetic neuropathy. Nerve damage can lead to a sore or an
infection.

  • Poor blood flow

The second problem happens when not enough blood flows to your legs and feet.

Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral vascular disease, also called PVD. Smoking when you have diabetes makes blood flow problems much worse. These two problems can work together to cause a foot problem.

Just to summarize:

Effects of nerve damage and PAD

  • May not feel pain
  • May not be able to sense temperature
  • Have slow wound healing
  • Minor injuries can develop into serious infections if not detected early and treated promptly
Foot Skin is Unique

Skin on the sole of the human foot is unique. The skin on the sole of our feet lacks hair and pigmentation found on the rest of the body and has a high concentration of sweat pores. A series of creases cross the sole of the foot and contain the thickest layers of the skin on the human body to support the weight that is carried upon them. Like the
palms of our hands, sweat pores on the soles of our feet lack sebaceous glands. The soles of the human foot are extremely sensitive to touch due to the high concentration of nerve endings. The sole of the foot is sensitive to materials that are walked on, ticklish and to some erogenous zones.

Why don’t scars completely heal?

The outer layer of skin, the epidermis, renews itself once every 28 days. It’s comprised of cells that keeping pushing upwards toward the surface, where they die and are rubbed and worn off by bathing and clothing. Scars form when the epidermis and a layer of skin below are damaged and replaced by scar tissue. The scar tissue is much tougher than normal and doesn’t produce new cells like the surrounding tissue, so scars never change and aren’t rubbed off like other old skin cells.

Calluses

The forming of calluses is caused by the accumulation of dead skin cells that harden and thicken over an area on the foot. The forming of a callus is the body’s natural defense mechanism against excessive pressure and friction. Calluses are most commonly found on ball-of-the-foot, the heel and/or inside or outside of the big toe. Some calluses develop a deep seated core called a nucleation. This specific type of callus is painfully sensitive to pressure.

Calluses develop when a specific area of the foot is subjected to excessive and direct pressure. Some common causes of calluses forming are: high heeled shoes, shoes that are too small or too tight, obesity, abnormalities in walking motion, flat feet, high arched feet, bony prominences, and the loss of the protective fat pad on the bottom of the foot.

Cutting calluses with a knife, scissors or razor blade are common methods used to alleviate the pain of calluses. Cutting calluses with knifes, scissors or razor blades is very dangerous and may worsen the condition resulting in accidental and unnecessary injury. Diabetics should never try this type of treatment.

To relieve the excess pressure that causes calluses, weight should be redistributed equally through the use of orthotic devices. Effective orthotic devices transfer pressure away from sore spots and high pressure areas and allow calluses to heal. It is recommended that orthotic devices be constructed from materials that absorb shock and friction forces. Women should resist the urge to wear high heeled shoes.

Using Dr. Greenfield’s Diabetic Footcream twice daily can help keep foot skin soft and supple. Apply Dr. Greenfield’s Diabetic Footcream in the morning after bathing or before dressing. Liberally apply Dr. Greenfield’s Diabetic Footcream to feet in the evening and prolong the benefits of the treatment by placing socks on feet before retiring. As a deterrent to friction, apply Dr. Greenfield’s ChafeShield product to pressure points inside shoes and to the corresponding areas on feet, socks and stockings.

When problems persist, consult your foot doctor.

Diabetic Foot Blisters

A blister is a small pocket of fluid within the upper layers of the skin, typically caused by forceful rubbing. Most blisters are filled with a clear fluid called serum or plasma. Fluid collects between the epidermis—the upper skin layer and the layers below. This fluid cushions the tissue underneath, protecting it from further damage and allowing it to heal.

Foot blisters are prevalent after walking long distances or when wearing new or poorly fitting shoes. Blisters are more likely to form on damp skin rather than dry or wet skin. Blisters are more likely to form in warm conditions.

When treating blisters it is important to resist the urge to “pop” them. The skin covering the blister helps protect the area from infection. Use an antibacterial ointment and soft bandages to help protect the skin and prevent infection.

Using Dr. Greenfield’s Diabetic Footcream twice daily, mornings and evenings helps keep feet soft and supple. Dr. Greenfield formulated ChafeShield as an antifriction product. We recommend that Dr. Greenfield’s ChafeShield be applied to friction points on the feet, onto the exterior of socks or stockings and contact points within shoes.

Diabetic Foot Ulcers

Diabetic foot ulcers are sores or wounds that most commonly occur on the ball of the foot or on the bottom of the big toe. Ulcers on the sides of the foot are usually caused by poorly fitting shoes. Remember, even though some ulcers do not hurt, seek appropriate care at the first sign of foot problems. Nerve damage can result in a loss of sensation known as peripheral neuropathy. Poor blood flow slows healing and increases the risk of infection. Neglecting foot ulcers can result in infections, which in turn can lead to loss of a limb. Seek appropriate care at the first sign of foot problems.

Your health care provider will recommend a treatment regimen based upon your ulcer. The Health care provider may take x-rays of your foot to determine if the bone infected. The health care provider may clean out any dead and infected tissue. The health care provider may culture the wound to find out what type of infection you have, so they can prescribe the antibiotic that will work best. You may need to be hospitalized.

Staying off your feet is very important. Walking on an ulcer may cause it to become larger and force the infection deeper into your foot. Your health care provider may put a special shoe, brace, or cast on your foot to protect it.

If your ulcer is not healing and your circulation is poor, your health care provider may need to refer you to a vascular surgeon. Good diabetes control is important. High blood glucose levels make it hard to fight infection.

After the foot ulcer heals, treat your foot carefully. Scar tissue under the healed wound will tear easily. You may need to wear special shoes after the ulcer is healed to protect this area of the foot and to prevent the ulcer from returning.

Routine use of Dr. Greenfield’s Diabetic Footcream helps keep skin on the feet soft and supple. Strategic application of Dr. Greenfield’s anti-friction product Chafeshield to pressure points on feet and corresponding areas in shoes and footwear can help prevent foot ulcers from forming.
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