Diabetes management is key in preventing diabetes-related gangrene.

By Podiatry, Ng Teng Fong General Hospital

Diabetes Management

Managing diabetes is a holistic endeavour. Apart from a healthy diet and weight control, diabetics also have to monitor their general health and the health of their feet. Each day, four lower limb amputations are done due to diabetes-related gangrene.

This is because high blood sugar levels cause damage to blood vessels and nerves, particularly in the legs and feet. It is common for diabetics to experience numbness, tingling, weakness or a burning or stinging pain in their lower limbs, especially in the feet. This condition is due to nerve damage or diabetic neuropathy.

Making Foot Care Part of Diabetes Management

The loss of sensation in the feet means that a diabetic person can injure themselves but not know it. They may also not realise the severity of wounds and delay getting help until the late stages. More significantly, because many diabetics suffer from poor blood circulation, wound healing is delayed, and long-standing wounds can become infected. All these underscore the importance of daily foot care at home.

  • Check, please: Check your feet every day for cuts, signs of infection, red spots, cuts, swelling or blisters. Use a mirror or get someone to inspect the bottom of your feet.
  • No sharp edges: Trim your toenails regularly to prevent them from cutting into your toes. Always cut toenails straight across — never into the sides — and file the edges well.
  • Cover up: Wear well-fitted covered shoes to protect the feet from injury. Avoid slippers and open-toed sandals.
  • Tame dry skin: Keep your feet well moisturised. Dry feet well after a bath and apply lotion, making sure it is well absorbed. Avoid the skin between the toes because the skin here is thinner and at risk of splitting.
  • Scrub in the tub: To prevent calluses, use a pumice stone to gently scrub your feet when you shower. Do not self-treat calluses at home. See a podiatrist to trim thick calluses.

Related: Diabetic Foot Care

Diabetic Neuropathy and Skin Changes

Diabetes can affect your nerves and cause numbness     

Diabetes damages the nerves in your feet. Apart from causing numbness, this affects the skin’s ability to control oil and moisture, so it can become excessively dry, peel and crack. Calluses also build up faster on the feet of people with diabetes, especially in areas of the foot that are exposed to prolonged pressure. Thick untrimmed calluses can break down and turn into sores and ulcers. These can increase the risk of chronic wounds and infection.

Those with diabetes should have their feet, and lower limbs checked once a year. Diabetics who suffer from severe numbness in the feet or poor vascular supply should be checked at least once every six months as they are more at risk of developing foot complications.

Original article titled "Best Foot Forward" was first published in ONEHealth Magazine, Issue 8, 2016.

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