Posts for: January, 2016
Simple steps that help people with diabetes keep their feet healthy
A diabetes diagnosis can be daunting, but a simple attitude adjustment can make a world of difference in how well you fare while living with the disease. When people with diabetes take proactive steps to monitor key health indicators, experts agree that it’s possible to prevent some of the most severe risks of diabetes, including lower limb amputation.
People ages 20 and older who are living with diabetes account for about 60 percent of non-traumatic lower-limb amputations, according to the Centers for Disease Control and Prevention’s (CDC) 2014 National Diabetes Statistics Report.
“The CDC says the occurrence of diabetes-related foot and lower-leg amputation has decreased by 65 percent since 1996,” says Shaun Hafner, DPM, a podiatrist at Reston, Manassas and Leesburg Foot and Ankle Center and member of the American Podiatric Medical Association (APMA). “Working together, podiatrists and their patients with diabetes can reduce the number of amputations even more.”
People with diabetes may be less aware of cuts or wounds on their feet due to the nerve damage related to their disease, Dr. Hafner points out. “Regular and vigilant foot care can help catch problems before they develop into a health crisis.”
APMA offers advice to help people with diabetes protect their foot health:
- Inspect your feet daily, checking the entire foot and all 10 toes for cuts, bruises, sores, or changes to the toenails, such as thickening or discoloration. Treat wounds immediately and see your podiatrist if a problem persists or infection is apparent.
- Exercise by walking, which can help you maintain a healthy weight and improve circulation. Be sure to wear athletic shoes appropriate for the type of exercise you’re doing.
- When you buy new shoes, have them properly measured and fitted. Foot size and shape can change over time, and ill-fitting shoes are a leading cause of foot pain and lesions. Certain types of shoes, socks, and custom orthotics are available for people with diabetes, and they may be covered under Medicare. You can find a list of podiatrist-approved footwear and products for people with diabetes on the APMA website, www.apma.org.
- Keep your feet covered and never go barefoot, even at home. The risk of cuts and infection is too great.
- See a podiatrist to remove calluses, corns, or warts—don’t tackle them yourself, and don’t ask an unlicensed nonprofessional to do it. Over-the-counter products can burn your skin and injure your foot. Podiatrists are specially trained to address all aspects of foot health for people with diabetes.
- Get checkups twice a year. An exam by your podiatrist is the best way to ensure your feet stay healthy.
“For people with diabetes, taking charge of your own foot health can help you avoid foot-related complications like amputation,” Dr. Hafner says. “Working with today’s podiatrist will help you safeguard your foot health.
Diabetes patients urged to take simple precautions to help save their feet
Taking a minute or two every day to inspect your feet and observing a few simple rules can make the difference in sparing diabetes patients from a preventable outcome of the disease – a foot amputation.
“Of all diabetes-related complications, a serious foot ulcer and subsequent amputation might be the most preventable with proper care and vigilance in checking the feet at least once a day for small cuts and other abrasions,” says Steven A. Gordon, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS). “Even those with good control of their blood sugar can experience foot ulcers, especially if neuropathy, a frequent diabetes complication, has caused decreased feeling on the bottom of their feet.”
Loss of sensation inhibits the body’s normal pain response. As a result, walking can apply repetitive, unfelt pressure to a wound, making it larger and deeper. Left untreated, diabetic ulcers lead to serious infections, which may result in amputation.
Dr. Gordon says foot and ankle surgeons use a variety of surgical and non-surgical methods to heal diabetic ulcers, but stressed early intervention yields the most favorable outcomes.
“Daily self-exams are the best protection. Too often, patients fail to check their feet for small cuts or punctures that over time will ulcerate and become infected,” he says. “If you have diabetes and see anything suspicious on your feet, consult a foot and ankle surgeon for diagnosis and treatment. Even a few days can make a difference in preventing serious foot problems from developing.”
An estimated seven in 10 diabetes patients have nerve damage that impairs feeling in their feet. Fifteen percent eventually will develop a foot ulcer. Among those with ulcers, one in four will lose a foot. Each year more than 86,000 amputations are performed as a direct result of diabetes, and studies show half of those who have one foot or leg amputated will lose the other within five years. Proper diabetic foot care, says Dr. Gordon, prevents foot loss.
In some cases, amputation might be the preferred option. If vascular and podiatric surgeries can’t improve blood circulation and foot function, resolve infection or restore foot function, amputation may be the only solution that enables the patient to heal. Today, advances in prosthetics make it possible for patients to return to an active lifestyle, a necessity for keeping diabetes under control.
Foot problems are not an inevitable consequence of diabetes. The risk can be lessened significantly by following a few simple precautions:
- Keep your blood sugar under control to help minimize cardiovascular and blood circulation problems
- Lose weight, don’t smoke and adhere to prescribed dietary, medication and exercise regime
- At least once a day, examine your feet for cuts and other small wounds you may not feel
- Never walk barefoot, outdoors and indoors
- Cut nails carefully – straight across and not too short; never trim corns and calluses yourself
- Wash your feet every day in lukewarm water; dry carefully
- Choose comfortable shoes with adequate room for the toes
- Wear clean, dry, non-bulky socks; change daily
- Shake pebbles or bits of gravel out of your shoes before wearing
- Seek treatment from a foot and ankle surgeon if minor cuts and sore spots don’t seem to be healing
For more information on diabetic foot conditions, contact Dr. Gordon's office at 703-437-6333, or visit the ACFAS consumer Web site, FootHealthFacts.org.
Foot care advice for new moms and babies
Few things in life are as darling as a newborn’s little feet, and most new moms take great joy in counting 10 tiny, perfect toes. But foot health can be a source of anxiety for both new and expectant mothers, who may wonder about the best ways to care for their baby’s feet, and how to cope with changes in their own feet.
“Pregnancy creates many changes in the body and can even affect the size of a woman’s feet,” says Steven Gordon, DPM, a podiatrist at Reston Podiatry Associates and member of the American Podiatric Medical Association (APMA). “And even though newborns aren’t walking yet, it’s understandable that mothers may have some concerns about how to best take care of their baby’s feet.”
The discomforts of pregnancy are common and well-known, ranging from back pain and frequent bathroom trips to feet that are swollen and sore.
“It’s not at all unusual for a woman to gain a shoe size while pregnant,” Dr. Gordon says. “Increased weight puts more pressure on the foot, the arch flattens a bit, and the foot elongates. Just a quarter-inch increase in foot length is enough to prompt a change in shoe size.”
While it’s probably impossible to completely avoid foot challenges during pregnancy, moms-to-be can take steps to minimize them:
- Control weight gain. Added weight is the most likely cause of foot expansion. Do your best to follow your obstetrician’s guidelines for how much weight you should gain throughout the pregnancy.
- Avoid high heels. Sure, you see celebrities accessorizing their baby bumps with stilettos, but a lower heel during pregnancy will relieve pressure on the foot. Also, lower heels will provide you with greater stability during a time when newly gained weight might throw off your balance. It’s easy to find plenty of pretty, stylish lower heels—1 to 2 inches in height—that will look and feel great while you’re pregnant.
- Comfort and support should be key considerations any time you choose footwear, but they are even more important for pregnant women. With extra weight and pressure on your feet for nine months, you need a shoe that provides support and cushioning. Avoid thin-soled shoes (including flip-flops and ballet flats); look for shoes with thicker soles and plenty of cushioning inside the shoes. Whatever shoe you choose, it should bend only at the ball of the foot, and you should never be able to twist the sole or bend it anywhere else.
While it’s common for women’s feet to enlarge during pregnancy—and remain that size even after delivery—generally that size increase occurs only with a first pregnancy. So you shouldn’t worry that your feet will continue to grow with subsequent pregnancies. Instead, many new moms will worry about their new baby’s feet.
“The good news is, as long as the baby’s feet are healthy at birth, most newborns won’t require special care for their feet,” Dr. Gordon says. “Caring for your baby’s feet is much like caring for the rest of his or her body.”
Don’t worry if your baby’s feet look discolored or wrinkled or even have flaky, peeling skin when he or she is born. After nine months in protective fluid within the womb, they’re bound to look a bit different from yours. Your pediatrician will look for any obvious abnormalities of your baby’s feet and legs and will let you know what to do if he or she finds any cause for concern.
Use baby nail clippers to keep your child’s toenails trimmed, cutting straight across to prevent ingrown toenails. Be sure to thoroughly dry baby’s feet after a bath, and choose soft, anti-microbial socks that don’t wrinkle or bunch to keep those little feet warm and protected.
When your baby starts to walk, bare feet are best inside the house as he or she learns the finer points of getting around. Outside, put him or her in a lightweight, flexible shoe made of natural materials.
If foot problems run in your family, have your child examined by a podiatrist when he or she begins to walk. Your podiatrist can inspect your child’s feet to ensure they’re growing normally.