Patient Education
Let’s take a look at the importance of patient education
regarding diabetic foot care. The goal is to prevent
problems, or if problems have already developed, to catch
and treat them as soon as possible.
Daily self-examination
of the feet is of primary importance.
Patients with diabetes should look for any changes in color,
sores, or dry, cracked skin.
•Self-examination
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Cuts/scratches
•
Ulcers
•
Dry skin
•
Blisters
•
Problems between toes
•
Corns/calluses
•
Plantar warts
•
Ingrown toenails
•
Discolored toenails
•
Redness, warmth, swelling or pain
•
Blue or black skin color
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Specifically, the diabetic person’s daily foot exam should include
checking for :
Cuts/scratches:
Any cuts
or scratches should be washed
with mild soap and water. Antibiotic creams may be used as
recommended by the doctor and sterile bandages applied to protect
cuts. If cuts appear infected, instruct the patient to call their
physician immediately.
Ulcers:
Minor scrapes or cuts that heal slowly -- or sores from
badly-fitting shoes -- can become infected, causing ulcers. These
should be treated right away.
Dry skin:
Moisturizing soaps and lotions can be used effectively to keep skin
soft, but patients should be instructed not to apply these between
toes, as moisture there can cause fungus growth.
Blisters:
If
shoes don't fit properly, blisters can develop. Instruct patients to
leave
blisters intact, cleaning
them and applying
antibacterial cream, then covering them with a bandage.
Cracking, itching, red skin between the toes
can be a sign of athlete's foot fungus. This should be treated
immediately to prevent further infection.
Corns/calluses:
Corns and calluses can be smoothed after bathing using
an
emery board or pumice stone – instruct patients that these are best
removed slowly over several attempts.
Plantar warts:
These can be quite painful, and are
frequently mistaken for
calluses. However, they are caused by a virus and develop on the
foot's underside. A podiatrist should be consulted for their
removal.
Ingrown toenails:
Trimming toenails regularly -- cutting only across the top -- helps
prevent ingrown toenails. When toenails cut into the skin, pain,
redness, and infection may result. Ingrown toenails should
be treated by the patient’s podiatrist.
Discolored/yellowed toenails
that are thick and brittle usually means the nail has a fungal
infection. The patient’s physician can prescribe a long-term
medication to treat the infection and improve the nail's appearance.
Redness, warmth, swelling, or pain:
These are symptoms of inflammation and infection, and can be quite
serious. If the patient notices any
of these symptoms they should consult their doctor immediately.
Blue or black skin color
indicates blood flow problems. If the
foot is cold and blue or black, this should be treated as
an emergency;
the patient should get to the hospital immediately.
In summary, patients should be instructed to call their doctor if
they notice any of the following during their daily foot exams:
Changes in skin color.
Changes in skin temperature.
Swelling in foot or ankle.
Pain in legs.
Open sores that are draining or slow to heal.
Ingrown toenails or toenails infected with fungus.
Corns or calluses.
Dry cracks in the skin, especially around the heel.
Unusual and/or persistent foot odor.