Education and Health
Diabetic and foot care
Diabetes causes lesions in various parts of the body, especially when poorly controlled, compromising the function of some organs and tissues such as the kidneys, eyes, arteries, nerves, muscles, skin and feet. The person with diabetic foot symptoms in the legs that should be valued, they are: tingling; needles; numbness; feeling cold; decreased sensitivity to pain or heat or touch; pain or burning mostly at night, at bedtime; areas of anesthesia; cramps and weakness. Initially these symptoms are not perceived but precede the onset of wounds, ulcers or infections.
The skin becomes dry with cracking and abnormal nail growth increasing the chance of infection. In some diabetics occur even atrophy of the muscles of the legs with bone deformities known as bunions, "claw," fingers "hammer", overlapping fingers and changes in the arch of the feet. These changes in points of support generate calluses and these may precede ulcers. Many injuries are not perceived by diabetics as pressure from a tight shoe, minor trauma caused by nails or pebbles in the shoe during walking, sharp objects on the floor or the tip of the scissors to cut the nails. These injuries develop into ulcers that usually have infections that precede gangrene and amputations.
Amputations can be found in the toes or below the ankle or to the level of the thigh, will depend on the circulatory problems and local conditions that member. In Brazil it is estimated 55,000 annual amputations for diabetic foot.
Prevention is the main way to avoid complications, starting with the control of blood glucose (blood sugar), visual examination of the feet and periodic medical examinations.
The diabetic should examine your feet daily in a well lit place, chilblains looking for, cuts, calluses, cracks, wounds or skin color change. You can use a mirror to improve vision. If the person is not able to examine your own feet, ask for help from a family member or caregiver. The doctor needs to be told if there is any suspicion of injury.
Feet should always be cleaned with warm water and never hot avoiding burns, dry with soft towel without rubbing. Keep your skin hydrated, but do not use creams between the fingers or around the nails. Wear socks without seams with cotton fabric or wool, do not use synthetic fabrics like nylon.
Cutting the nails must be precise not to hurt. The nails are washed and dried before cutting them, looking for a square cut, with slightly rounded side without removing the cuticle. Very careful with manicures or pedicures preferring trained professionals thus preventing injury and infection. The ideal is not cut corns or use abrasives. Always seek the advice of the doctor.
The ideal shoes are those enclosed, soft, comfortable and hard and firm soles. If there are foot deformities, seek out a professional for guidance. Women's shoes should have square heels, with a maximum height of three cm. Avoid tight, hard shoes, plastic, synthetic choir with fine tip, very high heels and sandals that leave unprotected feet. If you buy new shoes, use them at home for an hour every day until they are tender.
Always protect your feet, right on the beach and swimming pools. Avoid using local heat as hot water bottles and proximity to the fire.
Periodic control of diabetes, maintaining blood glucose within an appropriate range and foot care, are determining factors in preventing serious foot problems in diabetics.
Dr. Diva Leonor Monteiro, medical clinic by the Brazilian Society of Internal Medicine.
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