What you need to know about physiotherapy and podiatry.
Diabetes is a serious concern across the world. According to the Ministry of Health (MOH), there are more than 400,000 Singaporeans diagnosed with diabetes and the number is estimated to reach 1 million if current trends continue.
So, if you know of a loved one with diabetes, take some time to answer these 5 questions below. You might help to prevent and delay serious foot complications.
Often, when we ask our new long term diabetic patients if they had gone for a foot screening appointment annually, they typically reply saying “No!” or “Nobody told me to go!”.
Diabetes can cause damage to the nerves and blood vessels which leads to reduced sensation and blood flow to the feet. That is why people with diabetes are far more likely to have a foot or leg amputation.
How does this happen?
Exposure to high levels of glucose over prolonged periods can cause a condition called PERIPHERAL NEUROPATHY, which is irreversible damage to nerves that extend to the arms, hands, legs and feet. The result is numbness, tingling and pins and needles sensation in the toes and feet. People with diabetes are also at a higher risk of developing PERIPHERAL ARTERIAL DISEASE, a condition that happens when the blood vessels in the legs become blocked due to fat deposits. The result is reduced blood flow to the legs which can cause symptoms such as slow healing wounds, cold feet and calf cramps during walking.
That is why patients with diabetes should have a DIABETIC FOOT SCREENING at least once a year to allow for early detection of foot problems. Ask your doctor about diabetic foot screening or visit a Podiatry clinic to have your feet checked. Prevention is definitely better than cure!
The next time you know of a loved one who has diabetes and he or she complains of a painful and annoying corn on the foot, make sure you are not causing their feet more harm by getting them CORN PLASTERS.
The main ingredient in a corn plaster is SALICYLIC ACID, a keratolytic which peels away the keratin that makes up the thick layer of dead skin on top of a corn. When corn plasters with a higher concentration of salicylic acid are used on fragile and thin skin in older people, it can lead to ulceration as the underlying skin gets thinner and thinner. Foot ulceration needs to be prevented in patients with diabetes as they can lead to serious infections. So think twice the next time you want to get corn plasters for your family or relatives with diabetes! Make sure to read the information at the back of the corn plaster. In all likelihood it will read: DO NOT USE IF YOU ARE DIABETIC.
Podiatrists have come across way too many patients who describe cutting hard skin on their feet with a pair of scissors or pen knife. And most of them are elderly patients who cannot see clearly!
It is understandable that elderly patients do not want to trouble their children with what they think is a minor foot problem, but they often end up with a bigger problem on their feet (literally!). These include delayed healing and infection developed from a wound caused by use of dirty scissors.
If the callus is mild, use a pumice stone or foot file to gently file away the hard skin after showering, when the skin is still soft. Get your elderly family member to consult a podiatrist who will carefully remove the calluses or corns with a sterile blade so that they can walk without pain after the treatment if filing is not effective. Do not let a small problem turn into a big one!
Podiatrists often see diabetic patients who suffer from foot wounds due to poorly fitted shoes.
Most diabetic patients fail to notice changes in their foot shape, such as the development of bunions, hammer toes, high arched and flat feet – all of which increase the chances for irritation of the foot in the shoe.
Do not choose shoes based on how fashionable or convenient it is to wear and give it more thought the next time you go shoe shopping! There are definitely more options for wider fitting shoes to accommodate bunions or hammer toes. You can always ask a podiatrist for footwear recommendations.
Remember: Shoes are meant to protect and not harm your feet.
Follow these simple rules:
1. Choose shoes with 1 extra thumb space from your longest toe. You can remove the shoeliner from the shoe to make sure that your feet sit nicely on the shoeliner and that the length and width of your feet matches the shoeliner.
2. Avoid wearing slippers or slip on shoes as your feet can slide in and out easily, causing friction and abrasions to your feet.
What makes a good pair of shoes?
• Shoes with laces or velcro straps that provide stability and prevent the feet from sliding around and cause friction.
• Shoes that have adequate depth and removable shoeliners can accommodate insoles or padding to prevent calluses or corns from recurring.
Thickening and curving of the nails are very common nail changes associated with diabetes and aging.
As the toenail thickens, it can put pressure on the end of the toes and cause pain, especially when wearing covered shoes. Involuted or curved nails can also cause pain and become ingrown as they pinch the skin at the corners. Improper cutting such as cutting the nails too short at the corners and leaving a sharp nail edge behind can also be problematic.
Nails that grow in a peculiar shape can make it difficult for self trimming. A podiatrist can help to trim those thickened and curved nails by using special clippers and electric burrs to trim and thin down the nails to reduce discomfort.
One final word of advice to patients with diabetes with younger children around the house:
Please check the bottom of your feet every day to make sure there are no small pieces of lego or toys stuck underneath your foot!
You might not be feeling any pain because of nerve damage caused by diabetes and not because you are a “MAN OF STEEL” (Superman).
Hope you have found the article helpful for your loved one with diabetes. Contact us if you need to consult a Podiatrist!