Soaking feet, wearing shoes, and trimming toenails are common, but they can be a disaster for patients with diabetic foot...

Author: Wu Weiwei, Chief Physician of Beijing Tsinghua Chang Gung Hospital affiliated to Tsinghua University

Reviewer: Li Guangwei, Chief Physician, Fuwai Hospital, Chinese Academy of Medical Sciences

Vice Chairman of the Chinese Medical Association Endocrinology Society

Patients with diabetic foot sometimes feel their feet are very cold and want to soak them in hot water.

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For normal people, soaking feet is a way to maintain health, but for patients with diabetic foot, soaking feet carries certain risks. It’s not that you can’t soak your feet, but there are certain things you need to pay attention to when doing so.

1. What should patients with diabetic foot pay attention to when soaking their feet?

First, the water temperature.

Water temperature is a very important issue for patients with diabetic foot. Normal people will take their feet out if they feel the water is too hot when washing their feet. However, patients with diabetic foot have peripheral neuropathy, which makes them dull and insensitive to water temperature. They do not feel the heat obviously, so if they soak their feet in overheated water, they will get burned.

Therefore, if patients with diabetic foot want to soak their feet, they should do the following:

First, control the water temperature. The water temperature should be below 38 degrees, not 40 degrees. Above 40 degrees may be acceptable for normal people, but it is very dangerous for patients with diabetic foot. If there is no thermometer at home, ask your family to test the water temperature with their hands to avoid scalding your feet.

Second, the soaking time should be controlled. If the water temperature is well controlled, the heat will still accumulate if the feet are soaked for too long. Just wash your feet for two or three minutes and that's it. Medically speaking, soaking your feet does not help much with diabetic foot, but washing your feet to keep them clean and avoid foot infection is very important.

Third, after washing your feet, you must dry your feet and use a soft cotton towel to dry the water between your toes. If the water between your toes is not dried, this place is prone to breeding bacteria. Once bacteria breed, tinea pedis or foot infection will occur, which is a devastating disaster for patients with diabetic foot.

Fourth, some patients with diabetic foot have very dry and cracked feet. After washing their feet, they must apply medications such as Vaseline to prevent the skin of the feet from drying out and cracking.

In addition to foot soaking, patients with diabetic foot also need to pay attention to choosing shoes and socks, trimming toenails, and massaging the soles of the feet.

2. What should patients with diabetic foot pay attention to when choosing shoes and socks?

In the case of diabetes combined with diabetic foot, you must wear loose and soft shoes, and avoid shoes that are too tight, too narrow, or have too hard soles. Shoes that are too tight, too narrow, or have too hard soles can cause deformation of the foot joints and bones, and sometimes cause tissue damage and bruises for patients with diabetic foot.

In addition, it is recommended that patients with diabetic foot do not wear open-toed sandals in the summer, because open-toed sandals have a potential risk of walking carelessly or being hit by doors when opening and closing doors, causing foot injuries, which may be a disaster for patients with diabetic foot.

The second is socks. It is recommended to wear cotton socks and try to avoid wearing socks made of chemical fiber fabrics. Cotton socks are relatively sweat-absorbent and can prevent sweat from accumulating on the feet and causing bacterial infections. For example, tinea pedis or other bacterial infections. Cotton split-toe socks are very good and can keep the gaps between the toes dry.

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3. Can patients with diabetic foot have foot massage or pedicure?

Foot massage is gentle and can be done by patients with diabetic foot. However, vigorous massage must be performed with caution, because patients with diabetic foot have dulled senses, deformed bones and joints, and even ulcers in some parts. Improper or vigorous massage techniques can aggravate the injury.

Pedicures are also very cautious for patients with diabetic foot. Most pedicure shops will carefully ask if you have diabetes. If they know you have diabetes, they will often recommend that you do not have pedicures.

Once the pedicure is damaged, such as the nail groove is damaged when trimming the nails, or the skin on the soles of the feet is damaged when trimming the soles of the feet, it will be a disaster for patients with diabetic foot.

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If you don't have a pedicure and you trim your own nails, it is recommended that you do not cut your nails too short or cut them into a flat head. If your nails are cut too short and there is a break in the nail groove, it is easy for bacteria to breed and cause paronychia.

Diabetic vascular disease may not be particularly serious at present, but paronychia can cause diabetic foot to develop directly to stage four, the ulcer stage, and even lead to amputation.

Therefore, it is very important for patients with diabetic foot to protect their affected feet.

Finally, I would like to remind everyone that if diabetic patients have foot injuries, ulcers, paronychia, accidentally get pierced by glass or nails, or have small wounds on their feet, they should see a doctor immediately.

If you don't like going to the hospital, you can disinfect and change the dressing yourself with iodine. If it doesn't heal in two weeks, don't wait any longer. You must go to the hospital to see a vascular surgeon to see how to treat the wound and intervene as early as possible. Some lesions may not require surgery, but intravascular interventional treatment can be done to heal the ulcer and rupture as soon as possible. If it doesn't heal, it will have very serious consequences.