[Fat Bear Science] Don’t think that taking care of your feet is something only girls do. Experts say that diabetics should take better care of their feet.

Clinically, diabetic foot is one of the most common complications of diabetic patients. In severe cases, amputation may lead to limb disability, affecting the quality of life. So how can we effectively prevent and treat diabetic foot?

Expert Profile

Pu Danlan, deputy chief physician of the Department of Endocrinology and Nephrology, the Affiliated Tumor Hospital of Chongqing University, holds a master's degree in medicine. She is a member of the Adrenal Group of the Endocrinology Branch of the Chinese Medical Association, a member of the Endocrinology Committee of the Chongqing Medical Association, a member of the Thyroid Group of the Endocrinology Branch of the Chongqing Medical Association, a member of the Adrenal and Secondary Hypertension Group of the Endocrinology Branch of the Chongqing Medical Association, a member of the Critical Care Endocrine Metabolism Group of the Diabetes Committee of the Chongqing Medical Association, and an expert in the Expert Review Pool of the Chongqing Science and Technology Bureau.

Clinic hours: Tuesday all day, Thursday all day

Diabetic foot is the main cause of amputation and disability among diabetics

Feet are an essential part of the human body, and people cannot do without a pair of healthy feet in their daily activities. However, if the patient has diabetes for more than 5 years, or the patient's blood sugar is not well controlled for a long time, the feet are prone to serious complications such as infection, ulcers, and gangrene, which is the main cause of lower limb amputation and disability in diabetic patients.

The amputation rate of diabetic foot disease is 15 times that of non-diabetic patients. More than 50% of patients with non-traumatic amputations each year are diabetic patients. The treatment of diabetic foot ulcers is very expensive. The average cost of treating a single ulcer is $4,600 in the United States, and the cost of treatment in my country ranges from several thousand to tens of thousands of yuan. However, if it can be properly prevented and treated in the early stage, 45-85% of patients can avoid amputation.

Three factors can cause diabetic foot

Why does diabetic foot occur? This is because diabetes induces lower limb blood circulation disorders, diabetic peripheral neuropathy, and changes in the morphology and function of diabetic feet.

01Diabetic lower limb blood circulation disorder

Long-term diabetes can affect the blood supply to the lower limbs and feet. Early symptoms include leg cramps, pale feet, cold toes, low skin temperature, and severe cases may cause limping due to pain. Insufficient blood supply to the lower limbs will also lead to a decrease in the foot's ability to resist infection and wound healing, and even cause ulcers and necrosis.

Therefore, once the above symptoms are found, you should go to the hospital in time to check for weakened or disappeared foot vascular pulsation, foot Doppler vascular examination, reduced skin temperature, ankle blood pressure, toe blood pressure, etc.

Diabetic peripheral neuropathy02

Diabetes can also damage the nerves in your legs and feet. Neuropathy can cause you to experience unusual sensations in your feet, such as pain, numbness, burning, or tingling.

At the same time, when autonomic neuropathy occurs, the feet cannot transmit signals correctly due to damage, and they have no feeling for cuts, burns, bruises, abrasions, blisters, etc.

At this time, the risk of developing serious foot diseases will be greatly increased, and you should go to the hospital as soon as possible to do a 10g nylon thread sensation test, a 40g needle sensation test, a temperature sensation test, a vibration sensation test, etc.

03Changes in the morphology and function of diabetic feet

Long-term diabetes can also cause some changes in the morphology and function of the feet, especially when improperly protected and wearing inappropriate shoes, which may lead to hallux valgus, bunions; club toes, claw toes; corns, calluses and calluses; heel pain, flatfoot walking pain; abnormal pressure, friction and ulcers on the feet.

These common foot diseases can not only affect the normal function of the feet, but also easily lead to subsequent injuries and infections.

Diabetics need to pay attention to self-care of their feet

There are five key points to prevent diabetic foot disease, which are the 5P principles recommended by the American ADA:

■ Podiatric Care, regular follow-up and examinations by specialist medical staff;

■ Protective Shoes, comfortable shoes with protective functions, must have a specific and sufficient depth;

■ Pressure Reduction, insoles with pressure relief function, even custom-made insoles;

■ Prophylactic Surgery, preventive surgical correction;

■ Preventive Education: preventive knowledge education for patients and medical staff.

Specifically, how should diabetics perform self-care for their feet?

1 Check your feet every day, paying special attention to the soles, between the toes and deformed areas of the feet, such as various injuries, abrasions, blisters, dry skin, cracks, corns and calluses (calluses), skin temperature and color, abnormal toenails, swelling, ulcers, infection, fungal infection, etc.

But it should be done under good light. If your eyesight is not good, wear glasses. Use a mirror or ask someone for help if you can't see clearly.

2. Insist on using the correct method to wash your feet. Do not soak your feet too much. Use neutral soap, measure the water temperature with your hands or a thermometer, wipe the moisture between your toes with a light-colored towel, and check for bleeding and exudation. Keep the toes dry. If the toes turn white due to moisture, wipe them with an alcohol swab.

3. Choose the right exercise method. Appropriate exercise can help patients lose weight, stay healthy, lower blood sugar, and promote blood circulation in the feet, helping the feet maintain a healthy shape and function. Walking is one of the options for diabetics, but excessive walking will increase local pressure on the feet, so you should be moderate.

4. Keep the skin of the feet healthy. Nerve damage reduces sweat secretion, which can cause dry skin, cracks, and even infection. Therefore, diabetics can use skin care ointment or cream and massage the feet appropriately, but be careful not to apply the care cream between the toes or on ulcers. For severe heel cracks, special crack cream containing urea can be used.

5. Trim your nails carefully. Do not go to a public bathroom for a pedicure. When trimming your nails, make sure you can see clearly. Do not let your nails grow too long. Cut off the sharp parts. Trim straight and avoid cutting too deep on the edges. In addition, do not use corn ointment to treat corns and calluses on your own. Do not get too close to heat sources such as heaters, do not walk barefoot on hot sand or concrete, do not use foot warmers, and do not use electric blankets.

6 Choose a pair of comfortable shoes and socks. Diabetics can ask a podiatrist to design a pair of foot disease prevention and protection shoes with the characteristics of light and fit, good ventilation, smooth inside, shock-absorbing soles, and biomechanical insoles. You can also choose a pair of comfortable shoes yourself.

It is recommended to buy shoes in the afternoon, because the feet will be swollen in the afternoon. If they fit you in the morning, they may not fit you in the afternoon. Do not wear sandals with exposed toes, and do not wear shoes barefoot. Wear socks made of natural materials such as cotton and wool. They should not be too small or too large, especially the top should not be too tight, otherwise it will affect the blood circulation of the feet. The inner seams of the socks should not be too rough, otherwise it will cause damage to the feet.

7 Emergency treatment of foot injuries If the foot is accidentally injured, for small wounds, clean the wound with clean water or salt water, wipe it dry gently, cover it with medical dressings, and change the dressings every day. If the wound does not show signs of improvement within 24-48 hours, or there is redness, heat, swelling, etc., even if you do not feel any pain, you should go to the hospital immediately to see a doctor for treatment.

To prevent the occurrence of foot diseases, it is necessary to comprehensively control blood sugar and metabolic abnormalities; self-check your feet every day; perform proper foot hygiene care; choose a pair of comfortable diabetic shoes; and go to the hospital at least once a year to check for diabetic foot complications.

Text/Fat Bear Photos/Internet (Please contact us to delete) Review/Pu Danlan

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Chongqing Science Popularization Base/Chongqing Health Promotion Hospital

Chongqing Municipal Science and Technology Commission Science and Technology Communication and Popularization Project

National Health Commission National Basic Public Health Service Health Literacy Project