Diabetes Experts Urge
Better Foot Care

The good news is that up to 85 percent of diabetic amputations can be prevented.

The Pan American Health Organization (PAHO), in partnership with the International Diabetes Federation, is using this year's World Diabetes Day (Nov. 14) to raise awareness of the importance of good foot care, especially for people with diabetes.

Foot problems are among the most common complications of diabetes and, if not treated in time, can lead to severe consequences, including amputation. "Most people take their feet for granted," says Alberto Barceló, acting head of PAHO's Noncommunicable Diseases unit. "Most of us can get away with it, but people with diabetes really need to pay attention to their feet."

The problem is rooted in the long-term effects of raised blood glucose levels. People with diabetes are at high risk of nerve damage and problems with the blood supply to their feet. Nerve damage makes it difficult to feel pain, and therefore injuries may go unnoticed. Poor blood supply can slow down the healing process for wounds. These problems can lead to foot ulcers, which, if they become infected, may ultimately lead to amputation.

"The message is that even if foot problems are painless, they can be very serious in people with diabetes," says Barceló.

The International Diabetes Federation has developed a set of foot-care recommendations for people with diabetes. They include:

• Check feet daily for cuts, blisters, bruises or changes in color, swelling, and open sores. If you find anything, consult a health care provider.
• Protect feet with well-fitting shoes. Do not go barefoot, to avoid injuries.
• Check for rocks, sharp objects, and rough spots before putting on shoes.
• Buy new shoes late in the day, when feet tend to be more swollen.
• Wear clean socks every day; make sure they're not too tight and have no holes.
• Wash feet with soap and water, including between your toes. Dry them carefully, especially between the toes.
• Cut toenails straight across and file any sharp edges.
• Get feet checked regularly by a health care professional.

Experts also say that people with diabetes should avoid pointy-toed shoes and high heels, use warm—not hot—water to wash their feet, avoid heaters and hot water bottles to warm the feet, avoid over-the-counter corn removers, and give up or don't start smoking, which interferes with the supply of blood to the feet.

There are a number of warning signs people with diabetes can watch for, including:

• Swelling of the foot or ankle
• Very cold feet or legs
• Red, blue, or black discoloration
• Pain in legs while at rest or walking
• Open sores, no matter how small
• Wounds that won't heal
• Ingrown toenails.

More information on diabetes and foot care is available from the International Working Group on the Diabetic Foot (info@iwgdf.org).