DIABETIC FOOT CARE TORONTO, ONT.
DOWNTOWN TORONTO FOOT CLINIC
According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.
Our foot clinic has recently invested in the NC-STAT which is a computerized nerve testing system for the early detection of diabetic peripheral neuropathy (DPN). This is cutting edge technology and our foot clinic was one of the first to aquire it.
Foot conditions are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.
With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.
Here's some basic advice for taking care of your feet:
- Always keep your feet warm.
- Don't get your feet wet in snow or rain.
- Don't put your feet on radiators or in front of the fireplace.
- Don't smoke or sit cross-legged. Both decrease blood supply to your feet.
- Don't soak your feet.
- Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
- Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.
- Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.
- Wash your feet every day with mild soap and warm water.
- Wear loose socks to bed.
- Wear warm socks and shoes in winter.
- When drying your feet, pat each foot with a towel and be careful between your toes.
- Buy shoes that are comfortable without a "breaking in" period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don't wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don't lace your shoes too tightly or loosely.
- Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.
When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced "sharko") foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn't hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.
The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot's movement and supports its contours if you don't put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.
The goal of our services is to keep Diabetic’s feet healthy, to keep you walking and active, to prevent foot amputation, and to benefit your overall health!”
An Ounce of Prevention is Worth a Pound of Cure…
was never as true as for diabetic feet. This is why every diabetic should see a foot specialist: chiropodist as soon as he/she is diagnosed. After an initial assessment, a baseline of information is established. A chiropodist will perform a foot and lower leg examination: neurological (nerves); vascular (blood); dermatological (skin) and musculo/skeletal (muscle, ligament, joints, and bone). Your chiropodist will teach you how diabetes affects your feet, find out whether you are likely to have serious foot problems, and will set up a foot care program for you.
The importance of proper, preventative foot care cannot be overstated!
How Does Diabetes Affect Your Feet?
Atherosclerosis (Blood Vessels) Blood vessel damage caused by high glucose levels and high blood pressure can also lead to poor blood circulation in legs and feet. Poor circulation slows down healing and increases chance of foot infection.
Neuropathy is nerve damage and related foot problems due to blood vessel damage to the nervous system. Forty to fifty percent of people with diabetes are affected by neuropathy. The risk of neuropathy increases with age of patient, with duration of diabetes and increases with severity of hyperglycaemia-high blood sugars. After 20 years 42% of diabetics will have neuropathy.
Damaged nerves in the feet make them less sensitive to pain with loss of feeling you can hurt feet without knowing it. Once there is an injury the skin having lost it’s sensation does make a scab to heal the tissue and become a wound/ulcer. Neuropathy can cause the shape of your foot to change (Charcot changes) and decreases sweat production which creates dry skin prone to cracking and increased risk of infection. Diabetic peripheral neuropathy is associated with an increased risk of foot ulceration. A diabetic may not feel a minor cut or abrasion until hours later, if at all. For example, a diabetic may step on a pebble or sharp object and not even feel it due to numbness brought on by impaired nerve conduction. A person with diabetes may also develop callouses on the bottom of the feet due to improper gait or shoes, and not realize it.
As a result, the skin may break down and possibly ulcerate. Poor blood circulation to the area will prevent healing, and infection may set in. Time is of the essence since undetected foot infections may travel very rapidly up the leg of a diabetic. The end result can be ulceration, severe infection and possibly amputation.
Call today to make an appointment with your chiropodist!
- 15% of all diabetics develop foot ulcers!!!
- 50% of all lower extremity amputations are diabetic related complications!!!
- 25% of all hospitalizations for diabetes occurs because of foot problems!!!
A few simple steps a day can help prevent foot problems
Protecting Your Feet! Take Care of Your Feet For A Lifetime!
Check your feet every day by examining your bare feet daily by checking the tops, bottoms and in between the toes, as well as the nails. Look for cuts, bruises, swelling, cracks, sores, blisters, redness or any other changes in colour. If it is difficult to see the bottoms, use a mirror. If you cannot see your feet, enlist a family member or a close friend to check them for you.Wash your feet every day in warm, not hot, water with mild soap. Dry them thoroughly,especially between the toes. Do not soak your feet for more than 15 minutes at a time.
Keep your skin soft and smooth. Rub a thin coat of skin lotion/cream over the tops and bottoms of your feet, but not between your toes. E.g. of lotion: Uremol and Dermal Therapy
Smooth corns and calluses gently. Do not use over-the-counter products or sharp objects on corns and calluses. Do not apply corn and wart medicines on your feet. If your feet are at low risk for problems use a pumice stone to smooth it out. If your feet are at medium and/or high risk then see you chiropodist for professional treatment.
Cutting your nails. If you can see and reach your toenails, trim them each week or when needed. Trim your toenail straight across and file the edges and corners with an emery board or nail file. If you can not reach see or reach your feet or have neuropathy see your local chiropodist.
Change your socks daily. Wear seamless socks, or wear inside out. Wear socks at night if your feet get cold.
Wear shoes and socks at all times. Never walk barefoot. Wear well fitting shoes or slippers at all times. The sole of slippers should be protective enough that a thumbtack would not pierce through. Feel inside your shoes before putting them on each time to make sure the lining is smooth and there are no foreign objects inside. Wear shoes at the beach or on hot pavement. To learn more about what features in shoes are most appropriate for you and your feet contact your local chiropodist.
Keep the blood flowing to your feet. Put your feet up when sitting. Wiggle your toes and move your ankles up and down for five minutes, two or three times a day. Don’t cross your legs for long periods of time. Don’t smoke.
Protect your feet from hot and cold. Don’t test bath water with your feet. Don’t use hot water bottle or heating pads.
See your foot specialist on a regular basis.
Do not cut your toenails if your eyesight is poor and you have trouble cutting them. Never attempt to remove corns or callouses. Do not apply corn or wart medicines to your feet. Do not put hot water bottles or heating pads on your feet. Do not soak your feet for more then 15 min – it dries the feet removing natural oils. Do not apply cream in between the toes – bacteria and fungus loves dark and moist areas.