Diabetes Mellitus (DM) is a systemic disease in which blood glucose accumulates in the bloodstream and cannot get into the cells. There are 2 forms of diabetes; Type 1 and Type 2 diabetes. In Type 1 diabetes, a chemical called insulin which regulates blood glucose’s entry into the cells is not produced. Insulin is normally produced by an organ in our body called the pancreas. When the pancreas does not function well, this chemical (insulin) is not produced and blood cannot get into the cells. Therefore, glucose stays in the blood and also spills over into the urine. Type 1 DM is usually genetic.
In Type 2 diabetes, although insulin may be normally produced by the pancreas, the cells remain insensitive to insulin. Therefore, blood glucose cannot get into cells and accumulates in the bloodstream. Type 2 DM is therefore not dependent on insulin production and could be treated with oral medications or a combination of oral medications & insulin.
The effects of longstanding uncontrolled blood glucose can affect vision, kidneys, blood circulation and leave the arms and the legs void of sensation. Specifically as it relates to the foot, diabetes manifests in the following ways:
-Loss of feeling in the feet: Sensory Peripheral Neuropathy
-Dry, cracked heels and skin which provides the chance for a wound to occur, forming an entry portal for bacteria into the body: Autonomic Neuropathy
-Clawing of the toes, resulting in high pressure areas in the toes as it rubs against shoes. Callus at the bottom of the feet can also result as the toes push down on foot bones (metatarsals): Motor Neuropathy
– Blood circulatory problems can also ensue. This problem can cause delayed wound healing in the event that a callus should break down into a wound
So how can individuals with Diabetes take care of the feet?
There are ways in which individuals with Diabetes can take care of their feet to avoid some of these complications as outlined below:
• Make checking feet part of your everyday routine. When checking feet, look out for cuts, sores, red spots, swelling, and infected toenails
• Wash feet every day by using warm (not hot) water. However, do not soak feet because skin will get dry
• Dry feet well. Be sure to dry between the toes
• Keep the skin soft and smooth
• Rub a thin coat of skin lotion or cream. However, do not put lotion or cream between the toes
• Smooth corns and calluses gently
• Check with your foot doctor before using a pumice stone. If you have to use a pumice stone, use it directly after bathing or showering when the skin is soft
• Do not cut corns and calluses
• Do not use razor blades, corn plasters, or liquid corn and callus removers – they can damage the skin
• Trim Toenails regularly with clippers after bathing/showering. Trim the nails straight across and smooth with an emery board or nail file. Do not cut into the corners of the toenail. If toenails are thick or yellowed, or nails curve and grow into the skin, have a foot doctor trim nails instead
• Protect the feet by wearing socks and shoes at all times. Make sure your socks are clean, lightly padded and fit well. Socks that have no seams are best. For shoes, check that there is nothing in the inside of the shoe that could cause damage before putting them on. In addition, check that the lining of the shoe is smooth
If properly done, these steps can help reduce the chances of an ulcer occurring in an individual with Diabetes Mellitus. For further consultation on DM foot, contact us