An estimated 29.1 million people (9.3 percent of the population) have diabetes, and nearly 28 percent are undiagnosed. Age, diet, activity level, obesity and heredity are all risk facts for diabetes. People with diabetes can also experience co-existing conditions such as stroke, blindness, heart disease, kidney failure and lower-limb amputation.
In 2010, about 73,000 non-traumatic lower-limb amputations were performed in adults aged 20 years or older with diagnosed diabetes. This accounts for 60 percent of non-traumatic lower-limb amputations. People with an amputation have a 50 percent mortality rate within five years. Diabetes related amputations may result from chronic wounds caused by diabetes, especially diabetic foot ulcers. It is estimated that 15 percent of all diabetics will develop a diabetic foot ulcer.
The 10 Commandments of Foot Care
- Never go barefoot.
- Never assume that circulation and sensation is normal. Sensation is often blunted and minor injuries are not appreciated and become major injuries.
- Never soak your feet. This leads to maceration and ulceration.
- Never apply heat to your feet.
- Never cut toenails, always file. Cutting your toenails can lead to ingrown nails or broken skin, causing infection.
- Never use strong medicines on your feet. Epsom salts, iodine, betadine, etc. are irritants that can cause breaks in the skin.
- Never wear shoes that don’t fit properly. Never buy shoes that need “breaking in;” always buy shoes that fit properly at the time of purchase.
- Never allow corns or calluses to go untreated by a professional.
- Never perform “bathroom surgery” on your feet. Using razor blades, knives, or scissors can be very dangerous and lead to serious infection.
- Never keep feet too moist or too dry. Change your shoes twice daily to prevent excess moisture and allow feet to breathe. Feet that are too moist can become macerated; feet that are too dry can develop cracks.
There are several common factors of diabetic foot ulcers including neuropathy, peripheral arterial disease (PAD), deformities and Charcot foot. Neuropathy is a result of damage to peripheral nerves and often causes weakness, numbness and pain in hands and feet. Similarly, PAD is caused by narrowed arteries which reduces blood flow to the limbs. Charcot foot is a deformity that results from nerve damage in the foot or ankle potentially causing injuries to go untreated leading to the breakdown of joints.
The Methodist Wound Treatment Center recommends the following to help prevent diabetic foot ulcers:
- Annual foot examinations by a healthcare provider
- Daily self-inspections of the feet, or have a family member perform the inspection
- Regular care of the feet including cleaning toenails and taking care of corns and calluses
- Choose supportive, proper footwear (shoes and socks)
- Take steps to improve circulation such as eating healthier and exercising on a regular basis
Proper wound care techniques are imperative to heal diabetic foot ulcers. Debridement, the removal of damaged tissue, is widely recognized as one of the most important methods of advanced wound care. Relieving pressure from the wound, also known as off-loading, should be included in the treatment of diabetic foot ulcers, as well. Finally, controlling possible infection is necessary because the diabetic foot ulcer can be an entry point for bacteria.
Schedule an appointment or learn how we may be able to help avoid amputation, contact the Methodist Wound Treatment Center at (865) 835-3740.