Keeping Your Feet Healthy

How poorly controlled diabetes mellitus can affect the lower

extremities:

The good, the bad and the ugly

Keeping Your Feet Healthy

Neurologic and Vascular Compromise Predisposes Diabetics to Foot UlcersChanges are caused by poor blood glucose control

aldose reductase sorbitol (sugar alcohol)NAD NADPH (oxidative stress on tissue)

Result is a change in tissue quality and small vessel disease

Keeping Your Feet Healthy

• 4 changes seen:– neuropathy– angiopathy– immunopathy– dermopathy

• 3 types of neuropathy:– autonomic– motor– sensory

• Importance:– if you can’t feel your feet, you

can’t feel if they’re injured– if you injure your feet, it will

take less force to cause ulcers– if you ulcerate the skin, it will

be harder to heal– if the ulceration reaches bone,

it may mean amputation– the amputation level may be

proximal to injury to heal site– it is unusual to have one

amputation not lead to others

Keeping Your Feet Healthy• Never ignore a red mark, a

bruise or blister

• Never ignore an ingrown nail or local trauma

• Never let color changes to the feet or legs go untreated. A ‘little’ thing can become a big thing--with unfortunate results--

Keeping Your Feet Healthy

Don’t ignore changes or injuries to the foot or legs

arterial

cellulitis

blister

high pressure points

Keeping Your Feet Healthy

Feet should be checked dailyShoes should be worn at all timesShake out shoes before wearingWear proper fitting shoesNever use hot water to batheCheck glucose levels and keep a logVisit primary care doctor on a regular basis--bring log with youVisit foot care specialist at least once a year--sooner if there is a problemAttend diabetic classes and learn about what you can do to stay controlled and wellAvoid complications by living right, eating right, exercising and staying under control