Diabetic Foot Care

Diabetes mellitus (DM) has been recognized as a medical condition since the first century AD when Cappadocia coined the term diabetes, meaning siphon. Cappadocia realized that diabetics produced excessive amounts of urine, siphoning off normal body fluids. The term mellitus, meaning honey, was added in the 18th century when physicians realized that the urine of diabetics was sweet. Literature actually describes physicians tasting urine to confirm this condition. In 1921 Banting and Best recognized the role of pancreatic enzymes in the regulation of blood sugars, bringing the first hope to many thousands of patients that a cure may indeed be possible becomes brittle and dry. If left untreated, the dryness may progress to fissures of the skin that crack and become infected.

Diabetic foot infections are obviously a challenge to treat. The complexity of impaired wound healing, peripheral neuropathy, poor circulation and dysfunction of the nervous system is a challenge for all physicians.

By far the most important method of caring for foot ulcers and infections is prevention and careful regulation of blood sugar levels. The tools of prevention are education and awareness. The following are tips for daily diabetic foot care.

1. Visually inspect the foot when the socks go on and when the socks come off. With a slow progressive loss of sensation due to peripheral neuropathy, the eyes become the next most effective tool to assess the status of the skin on a regular basis. If you can't see the bottom of the foot, put a mirror on the floor.

2. Frequent changes of shoes and socks (2-3 times/day). If you have a pressure point in a particular pair of shoes that could effect the skin, change the shoes. There's no simpler way to be kind to the feet.

3. Apply skin cream on a daily basis to the feet. Whether it's an over-the-counter or prescription skin softener, do it every day. Dryness is a major source of diabetic foot infections.

4. Wash and dry between the toes on a daily basis. The best location for bacteria to congregate on the foot is in between the toes. If you can't reach them, have someone else do it for you on a regular basis.

5. Treat fungal infections. Many fungal infection look like dry skin and can promote soft tissue infection. If you have a dry skin problem that does not respond to skin softeners, seek the help of a qualified podiatrist.

6. Make sure your shoes are your friends. It's well worth the time, effort and money to be sure that your shoes are not going to cause harm. Blisters and calluses in advanced diabetes can result in significant complications. Don't cheat yourself by buying inexpensive shoes. Seek the help of a certified Pedorthist.

7. When questions arise, don't wait. Act. Seek the help of your family physician or podiatrist.

Symptoms: Patients with hyperglycemia (elevated blood sugars) usually present with the symptoms of frequent urination (polyuria) and thirst (polydypsea). Recent onset diabetics also notice an increase in the number of times they urinate each night (nocturia). Elevated levels of glucose in the urine results in an attempt by the body to dilute the urine in the kidney with more water from the body (osmotic diuresis). This results in excessive urination. As a result of excessive urination, diabetics will have a frequent thirst an a need to drink increased amounts of fluids. Chemical imbalance can occur as a result of osmotic diuresis. Other symptoms include fatigue, blurring of vision, irritability and weight loss.

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