Foot care

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Foot care involves taking special steps to avoid foot problems such as sores, cuts, bunions, and calluses. Good care includes daily examination of the feet, toes, and toenails and choosing shoes and socks or stockings that fit well. People with diabetes have to take special care of their feet because nerve damage and reduced blood flow sometimes mean they will have less feeling in their feet than normal. They may not notice cuts and other problems as soon as they should. They will also heal less well than others. However, foot care is needed and applies to all individuals with foot problems, not only to those with diabetes.

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Persons with diabetes should avoid the temptation to soak their feet in hot water when there is an open wound or crack in the skin, as this practice may lead to maceration of the skin, delayed healing and spread of infection and possible amputation. When a diabetic foot is placed in hot water it is in a perfect medium for bacteria to thrive as bacteria multiplies in a warm, dark, and moist environments. In the presence of an open wound where an infection is present the blood sugar is most often elevated, providing even greater fuel for the bacteria. Meticulous cleansing of the wound and normalization of blood sugars during this time is mandated to prevent complications which can lead to amputation. (Diabetes is the leading cause of amputations in non war time conditions.) Many amputations can be avoided by early recognition of loss of skin integrity and early evaluation and treatment by a healthcare professional.

Charlotte Hodge, RN, NP, Certified Diabetes Educator

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