According to the Federation of Diabetics"between 2000 and 2009, the prevalence rate of diabetes in USA has continued to increase. It has even progressed faster than expected. In 2009, it was estimated that more than 3.5 million people were affected."
With blood sugar remaining too high(hyperglycemia)in the long run, this can lead to damage to the nerves and arteries of the lower limbs causing complications in the feet.
This problem is the leading cause of amputation (excluding accidents) with 8,000 cases per year in 5-10% of diabetics have or will have their toe, foot or leg amputated. These complications, as with most complications of diabetes, develop without any symptoms at first.
Even if you don't feel anything, it is therefore important to carry out regular medical follow-up of your feet in order to detect the appearance of complications and to limit their aggravation, thanks to appropriate management. Balanced diabetes helps to limit the risk of developing these complications. sensitivity to the feet is the most common symptom of diabetic neuropathy.
The sensations of hot, cold and pain fade. The position of the foot when walking is not always felt. The weight can be worn over more fragile areas and can lead to significant deformations.
Neuropathy also makes the skin of the feet drier, thinner and more fragile, which promotes the appearance of sores.
"A minor problem at first is likely to get worse because it went unnoticed and has not been treated"
Diabetes promotes the deposition of cholesterol on the walls of the arteries of the lower limbs and helps to form the atheroma plaque. In this case, there is difficult circulation of blood in the legs and feet. Pain or cramps appear when walking.
Examine your feet
Look for possible lesions (sores or ulcers, blisters, crevices), signs of infection or deformities of the toes; nails, to check if they are not too long and thus avoid injuring other toes, or too short, which may promote an ingrown nail; to spot a possible dryness and thinness of the skin that weakens it, the presence of redness or horn (sign of friction or marked support).
Your doctor may also refer you to a podiatrist.
He carries out the necessary care and explains what you can do to protect your feet.
At the end of the consultation, he assesses the risk of injury to your feet, which translates into a grade (grade 0 - no injury - at grade 3 when the lesions are significant).Health Insurance reimburses the care prescribed by the doctor and performed by a podiatrist for grade 2 lesions (up to 4 sessions per year) and 3 (up to 6 sessions per year).
How do you take care of your feet on a daily basis?
It is possible to take daily action to reduce the risk of complications to the feet. In particular, it is advisable to:
Make a very careful toilet of the feet It is recommended to wash your feet every day with lukewarm water, using a mild soap, and to dry them well, especially between the toes, with delicacy.
To avoid ingrown nails, you can cut (or have your nails cut) (square, with slightly rounded corners).
A moisturizer can also reduce dry skin.
Protecting your feet from injury, temperature variations and friction It is recommended never to walk barefoot (including on the carpet, poolside or at the beach). Sandals don't always protect your feet enough.
Suitable shoes
It is essential that your shoes are adapted: your doctor or podiatrist advises you to buy comfortable, flexible and wide shoes. It's best to buy your shoes at the end of the day when your feet are swollen. Shoes that are closed and respect the curve of the arch (without a high heel) are recommended. Before putting your shoes on, put your hand inside to make sure there are no pebbles or objects that could injure your feet.
If you have new shoes, it is best not to wear them too long the first few days.
The choice of socks is also important. Natural fibre socks (cotton, wool, Scottish yarn) are preferred. Thick socks protect the feet, especially when it's cold (including at night). In order not to interfere with the circulation of blood, it is best not to wear tights or stockings that are too tight at the toes.
Watch out for burns
It is advisable to avoid putting your feet in direct contact with a heat source (boiler, radiator, etc.). If you have a decrease in sensitivity, you may not feel the burns.
If you expose your feet to the sun, don't forget sunscreens to avoid sunburn.
In case of injury:
It is advisable to wash the wound with clear water, disinfect with a sterile compress and apply a colourless disinfectant that shows the appearance of the wound. Due to the fragility of the skin, a little adhesive dressing is preferred (dry sterile compress, paper sparadrap, non-elastic fabric band). Also avoid piercing the bulbs.
Care for your feet on a daily basis:
Especially do not use scissors, blades, or coricides to remove the horn (corns, hardwoods, horn. A greasy moisturizer or Vaseline should be applied daily to prevent this horn from reproducing or cracking. Remove the horn after washing the feet (then softer) with non-aggressive instruments, pumice stone or small electric battery wheel (found in the pharmacist or in mail order catalogues).
Do not cut your nails too short, do not go to the sides, use round-toed scissors, and do not hesitate to resort to pedicure-podo.
To avoid fungus,wash your feet every day and dry them well between your toes, change diabetics socks regularly and put on closed "Charentaise" style slippers when arriving home. In case of fungus, prefer an anti-mycosic powder and avoid creams or gels that promote maceration.
