Follow a Daily Foot Care Program
If you have had a lower extremity amputation due to diabetes or vascular problems, you can dramatically reduce the chances of amputation of the sound foot/leg by following a preventative diabetic foot care program. This includes daily examination of the foot for any signs of injury, and immediate examination by a physician whenever a problem is discovered. Your family, physician and prosthetist must all work with you to prevent problems with pain, infection, and even additional amputation.
Basic care includes washing your foot everyday and drying it thoroughly, especially between the toes. A nurse or podiatrist should trim the toenails. Never cut or use over-the-counter removal products for corns or calluses; see your podiatrist instead. Protect your feet by wearing socks and shoes at all times. Never go barefoot! Keep shoes next to the bed and get in the habit of automatically slipping them on as soon as you stand up. It’s also important to protect your feet from hot and cold. Wear shoes at the beach or on hot pavement and don't put your feet into hot water. Test water before putting your feet in just as you would before bathing a baby. Never use a hot water bottle, heating pad, or electric blanket on your foot…you could burn the skin without even realizing it.
Help keep the blood flowing to your feet by putting them up on a footstool, the sofa, or another chair. Wiggle your toes and move your ankles up and down for five minutes, two or three times a day. Avoid crossing your legs for long periods of time.
If you are an older adult you will probably need both a physician and a family member to help you maintain your foot care program. This is particularly true if you have problems with your eyesight. Don’t be embarrassed about needing extra help; protecting your sound foot is too important to leave to chance. Older adults with peripheral neuropathy need to have their sound foot examined daily by someone else.
There are three broader strategies you can incorporate in your foot care plan:
- Take care of your diabetes by keeping blood glucose in the target range
- Be more active and include exercise in your daily routine
- Don’t smoke
Shoes and Socks
People with diabetes should wear comfortable shoes that fit correctly and do not create focused pressure points. Weight-bearing forces should be evenly distributed across the bottom of the foot. Insoles should be made of a cushioning fiber or gel and should be replaced when they become compressed. Special diabetic shoes may be recommended in some cases, but are not always necessary. Get in the habit of checking inside the shoe before putting it on to make sure the lining is smooth and that there are no objects inside.
Socks are a protective layer between your skin and the shoe material. Don’t wear shoes without socks unless you are certain the shoe material will not rub or abrade the skin. Wear clean, dry socks that are not too elastic/tight or so bulky that they bunch up in the shoe.