Prevent diabetes problems: Keep your feet and skin healthy

Here I go again with another blogupdate.  This update is unique of its type.  I will try to give you some heads up about this project that has been running in my head for quite sometime. We are starting to take some action after having some long discussions with the senior residents at the diabetes center that I volunteer at two days out of my super busy schedule with academia. The senior residents not only showed their complete support but offered to translate all my efforts to Kurdish language. 

Here is what I put together.  I plan to have this information in a pamphlet /seminars format for our patients at the center. The goal out of this information is to bring awareness to the patients about the complications of having uncontrolled sugar over a long period of time. Once they reach an awareness state, then they should be granted the needed skills and knowledge to prevents these complications from happening.

I will try to keep this post in a lay language as much as possible considering that most of you are not in the health profession. 

So what are some diabetes problems and how too much of a high sugar can cause problems?,  is what I want to start filling you in. 

Too much glucose in the blood for a long time can cause diabetes problems.  This high blood glucose, also called blood sugar, can damage many parts of the bloody, such as the heart, blood vessels, eyes, and kidneys. Heart and blood vessels disease can lead to heart attacks and strokes.  You can do al lot to prevent or slow down diabetes problems (sounds familiar with me wanting to empower my patients?)

Organs most impacted by having a high sugar in the blood

This information is about feet and skin problems caused by diabetes.  You will learn the things you can do each day and during each year to stay healthy and prevent diabetes problems.

High blood glucose can cause feet and skin problem 

What should I do each day to stay health with diabetes?

Follow the healthy eating plan that you and your doctor or dietitian have worked out.

Be active a total of 30 minutes most days. Ask your doctor what activities are best for you.

Take your medicines are directed

Check your blood glucose every day.  Each time you check your blood glucose, write the number in your record book.

Check your feet everyday for cuts, blisters, sores, swelling, redness, or sore toenails.

Brush and floss your teeth every day.

Control your blood pressure and cholesterol.

Don’t smoke

How can diabetes hurt my feet?

High blood glucose from diabetes causes two problems that can hurt your feet:

Nerve Damage: one problem is damage to nerves in your legs and feet. With damaged nerves, you might not feel pain, heat, or cold in your legs and feet.  As ore or cut on your foot may get worse because you do not know it is there.  This lack of feeling is caused by nerve damage, also called diabetic neuropathy.  Nerve damage can lead to a sore or an infection.

Poor blood flow: The second problem happens when not enough blood flows to your elgs and feet. Poor blood flow makes it hard for a sore or infection to heal.  This problem is called peripheral vascular disease also called PVD.  Smoking when you have diabetes makes blood flow problems much worse.

These two problems can work together to cause a foot problem.

For example, you get a blister from shoes that do not fit.  You do not feel the pain from the blister because you have nerve damage in your foot.  Next, the blister gets infected.  If blood glucose is high, the extra glucose feeds the germs. Germs grow and the infection gets worse.  Poor blood flow to your legs and feet can slow down healing.  Once in a while a bad infection never heals. The infection might cause gangrene.  If a person has gangrene, the skin and tissue around the sore die.  The area becomes black and smelly.  

To keep gangrene from spreading, a doctor may have to do surgery to cut off a toe, foot, or part of a leg.  Cutting off a body part is called an amputation.

What can I do to take care of my feet?

Look at your feet ever day to check
for problems 

Wash your felt in warm water everyday.  Make sure the water is not too hot by testing the temperature with your elbow.  Do not soak your feet.  Dry your feet well, especially between your toes.

Look at your feet every day to check for cuts, sores, blisters, redness, calluses, or other problems. Checking every day is even more important if you have nerve damage or poor blood flow.  If you cannot bend over or pull your feet up to check them, use a mirror.  If you cannot see well, ask someone else to check your feet.

If your skin is dry, rub lotion on your feet after you wash and dry them.  Do not put lotion between your toes.

File corns and calluses gently with an emery board or pumice stone.  Do this after your bath or shower.

Cut your toenails once a week or when needed.  Cut toenails when they are soft from washing.  Cut them to the shape of the toe and not too short.  File the edges with an emery board.

Always wear slippers or shoes to protect your feet form injuries.

Always wear slippers or shoes to protect your feet.

Always wear socks or stockings to avoid blisters. Do not wear socks or knee-high stockings that are too tight below your knee.

Wear shoes that fit well.  Shop for shoes at the end of the day when your feet are bigger.  Break in shoes slowly.  Wear them 1 to 2 hours each day for the first few weeks.

Before putting your shoes on, feel the insides to make sure they have no sharp edges or objects that might inure your feet.

Take off your shoes and socks
so your doctor will check your feet

How can my doctor help me take care of my feet?

• Tell your doctor right away about any foot problems
• Your doctor should d a complete foot exam every year
• Ask your doctor to look at your feet at each diabetes checkup.  To make sure your doctor checks your feet, take off your shoes and socks before your doctor comes into the room.
• Ask your doctor to check how well the nerves in your feet sense feeling.
• Ask your doctor to check how well blood is flowing to your legs and feet.
• Ask your doctor to show you the best way to trim your toenails.  Ask what lotion or cream to use on your legs and feet.
• If you cannot cut your toenails or you have a foot problem, ask your doctor to send  you to a  foot doctor.  A doctor who cares for feet is called a podiatrist.

What are common diabetes foot problems that you should watch out for?

Anyone can have corns, blisters, and other foot problems.  If you have diabetes and your blood glucose stays high, these foot problems can lead to infections.

Corns and calluses are thick layers of skin caused by too much rubbing or pressure on the same spot.  Corns and calluses can become infected.

Blisters can form if shoes always rub the same spot.  Wearing shoes that do not fit or wearing shoes without socks can cause blisters.  Blisters can become infected.

Ingrown toenails happen when an edge of the nail grows into the skin.  The skin can get red and infected.  Ingrown toenails can happen if you cut into the corners of your toe nails when you trim them.  You can also get an ingrown toenail if your shoes are too tight.  If toenails edges are sharp, smooth them with an emery board.

A bunion forms when your big toe slants toward the small toes and the place between the bones near the base of your big toe grows big.  This spot can get red, sore, and infected.  Bunions can form on one or both feet.  Pointed shoes may cause bunions. Bunions often run in the family. Surgery can remove bunions.

Plantar warts are caused by a virus.  The warts usually form on the bottoms of the feet

Hammertoes form when a foot muscle gets weak.  Diabetic nerve damage may cause the weakness.  The weakened muscle makes the tendons in the doot shorter and makes the toes curl under the feet.  You may get sores on the bottoms of your feet and on the tops of your toes.  The feet can change their shape.  Hammertoes can cause problems with walking and finding shoes that fit well.  Hammertoes can run in the family.  Wearing shoes that are too short can also cause hammertoes.

Dry and cracked skin can happen because the nerves in your legs and feet do not get the message to keep your skin soft and moist.  Dry skin can become cracked.  Cracks allow germs to enter and cause infection.  If your blood glucose is high, it feeds the germs and makes the infection worse.

Athletes’ foot is a fungus that causes itchiness, redness, and cracking of the skin.  The cracks between the toes allow germs to get under the skin and cause infection.  If the blood glucose is high, it feeds the germs and makes the infection worse.  The infection can spread to the toenails and make them thick, yellow, and hard to cut. 

Tell your doctor about any foot problems as soon as you see it.

How can special shoes help my feet?

Special shoes can be made to fit softly around your sore feet or feet that have changed shape.  These special shoes help protect your feet.

How can diabetes hurt my skin?  

Diabetes can hurt your skin in two ways:

Drinking fluids helps keep your
skin moist and healthy

• If your blood glucose is high, your body loses fluid.  With less fluid in your body, your skin can get dry . Dry skin can be itchy, causing you to scratch and make it sore.  Also, dry skin can crack.  Cracks allow germs to enter and cause infection.  If your blood glucose is high, it feeds germs and makes infections worse.  You may get dry skin on your legs, feet, elbows, and other places on your body.

•  Nerve damage can decrease the amount you sweat.  Swearing helps keep your skin soft and moist.  Decreased sweating in your feet and legs can cause dry skin.

What can I do to take care of my skin?

• After you wash with a mild soap, make sure you rinse and dry yourself well.  Check places where water can hide, such as under the arms, under the breasts, between the legs, and between the toes.
• Keep your skin moist by using a lotion or cream after you wash.  Your doctor can suggest you one.
• Drink lots of fluids, such as water, to keep your skin moist and healthy
• Wear all cotton underwear.  Cotton allows air to move around your body better.
• Check your skin after you wash.  Make sure you have no dry, red, or sore spots that might lead to an infection.
• Tell your doctor about any skin problems.