Diabetic Footcare Advice

You tend to develop more problems with your feet as you get older because your skin becomes thinner and starts to lose its elasticity. You may have developed some degree of arthritis over the years due to old injuries and simple wear and tear; also you may find that injuries take longer to heal.

Choosing suitable footwear

As you get older you need shoes which will provide adequate support by holding your foot  firmly in place.  Choose a natural material such as soft leather or cotton which is breathable and will mould to your natural foot shape. Make sure you get your feet checked for size, check both feet, and that your shoes are not too tight. Lace-up shoes or Velcro fasteners will probably be more comfortable than slip-on shoes. You need to have enough support that your heel is held firmly in place and that you are not gripping with your toes to keep your sandals on.  Look at buying open toes Velcro fastening sandals which may be more comfortable, particularly if your feet swell during the day. Go for shoes with lace-up fastenings or an adjustable strap: they keep the heel in place and stop the toes being pushed to the front of the shoe. Your feet should be able to keep their natural shape when in shoes. There should also be a centimetre between the end of your longest toe and end of shoe. Your shoes should also be roomy enough to accommodate any swelling, so go for a wide, deep pair if necessary.

Watch this free health care video on diabetic footcare . 

Improving circulation and keeping warm

Exercise is the best way to improve circulation and warm your feet. If you are less mobile, even a small amount of walking, or armchair exercises are beneficial. You could try leg raises whilst sitting in your chair or try holding a bottle of water in each hand and raising your arms. Start off slowly and gradually increase to a level of comfort. These exercises will help to keep your arm and leg muscles mobile. There are also a number of portable mini pedal type machine that will allow you to do so from the comfort of your own chair. Wear warm, natural fibre socks preferably non elasticated, or stockings but avoid seams rubbing on any corns. Bed socks at night are also a good idea to make you more comfortable. Avoid anything too tight, either socks or footwear which may restrict your circulation or cramp your toes, and don't get your feet too close to a direct source of heat, such as a fire as this can lead to chilblains, look for special diabetic socks.  Massage will also help and can help lower your blood pressure.

Diets Diabetes advice:

Beneficial foods & Nutrients

• Garlic  - improves circulation
• Ginger - improves circulation
• Goji Berries / Wolfberrries - Improves circulation
• Pumpkin seeds - a good source of phytoestrogens which help improve circulation
• Radishes - stimulate circulation
• Sesame seeds / Tahini   - a good source of phytoestrogens which help improve circulation
• Tumeric - Improves circulation and inhibits blood clumping
• Cayenne Pepper - Improves peripheral circulation and reduces blood clotting tendencies
• Chlorophyll - naturally found in green plants and vegetables - improves circulation, especially to the legs
• Irons - found in meat, poultry, pulses, helps transport oxygen throughout the body, which can alleviate the symptoms of fatigue, light headedness and weakness
• Silicon - found in grains such as oats, barley and rice as well as vegetables. Helps keep blood  warm and maintains the elasticity of arterial cell walls
• Sulphur. Naturally found in eggs and lettuce, cabbage which stimulates circulation
• Vitamin B3/Niacin is found in many products such as yeast, meat, fish, milk, eggs and improves the circulatory system
• Vitamin E is found in plant oils such as soya, corn and olive oil and nuts and helps healing to the circulatory system
• Iodine, most easily found in sea salt, conditions the hair skin nails and teeth
• Zinc is found in pumpkin seeds, and red meat and is required to help in wound healing

Lastly avoid smoking, and eating excess salt, saturated fats.

Diabetes

If you are a diabetic you are fifteen times more likely to have a limb amputated or suffer with diabetic leg and foot ulcers. However the risk of complication is significantly reduced if your blood sugar levels, blood pressure and cholesterol are properly monitored and controlled.

There is a gradual condition called neuropathy which causes the loss of sensation in your toes and feet. This may lead to injury or damage to your feet whilst you are unaware of it. If unnoticed and not treated appropriately this can have potentially serious consequences and could lead to an amputation. This is less likely if you regularly visit a Chiropodist or Podiatrist who will check to see your ability to feel pressures on the soles of your feet and toes each visit.  Prevention is better than cure and if you know that you have lost or are losing feeling then you will be able to reduce the risk of problems occurring, by taking daily inspections of your feet and by taking sensible precautions like not walking bare footed or sitting too close to fires.

Diabetes also affects the blood supply to your feet, and this can delay healing and increase your risks of infection and amputation.

Osteoarthritis

Osteoarthritis (OA) is often called the 'wear and tear' arthritis. It occurs when the cartilage of a joint) becomes damaged. As the cartilage deteriorates, the bone underneath can thicken, causing pain, stiffness and swelling.

OA can affect any of your joints in the feet but most likely to affect the joint at the base of the big toes. This joint is more prone to wear and tear from the pressures of walking, especially if you roll your foot in excessively as you walk. Wear and tear at the ends of the bone cause the cartilage to erode and the bone ends may begin to join together. Eventually your big toe may become rigid (a condition called hallux rigidus) which makes walking difficult. Or your big toe may drift towards your other toes (hallux valgus) which may cause bunions.

Rheumatoid arthritis

Rheumatoid arthritis (RA) is a condition that causes inflammation in many joints of the body. Unlike osteoarthritis which is caused by wear and tear, rheumatoid arthritis is a chronic inflammatory disease where a faulty immune system attacks the tissue that lines and cushions the joints, leaving them swollen, painful and stiff.

RA affects the smaller joints such as the fingers and toes first, so feet are often one of the first places to be affected. The joints may enlarge and become rigid, so they can no longer be fully extended. See: Arthritis Research Campaign

Deformities

Bunions

The proper name for a bunion is "Hallux valgus". Hallux valgus refers to the condition in which the big toe is angled excessively towards the second toe rulsting in a bunion. Posh Spice is famous for her bunions. A bunion is the the bony prominence on the side of the big toe. It may also have a large sac of fluid, known as a bursa, which can then become inflamed and sore. Unfortunately this condition can also encourage corns and calluses to develop. You may have a genetic tendency to having bunions if your parents or grandparents suffered from bunions. Women are also more likely to get them than men due to the hormones that tend to cause looser ligaments and more restrictive footwear styles, such as stilettos.

Hammer toes

This is where the becomes bent up in an inverted "V" shape and can't straighten out during walking. Corns develop where it rubs against the shoe. Wearing  too-tight shoes and socks make the condition worse.

Corns

When we walk or stand, our body weight is carried first on the heel and then on the ball of the foot, where the skin is thicker, and more able to withstand the pressure. When this pressure becomes intense, growths, in the form of corns and callus, may appear. Hard  corns always occur over a bony prominence, such as a joint, whereas soft corns form between the toes. You should never attempt to cut them out yourself. Many of the over the counter corn remedies will be ineffective and proper treatment should be sort from a registered Chiropodist

Verrucae

A verruca is simply a wart that is usually found on the soles of your feet, though they can also appear around the toes. A verruca can grow to half an inch in diameter and may spread into a cluster of small warts. It is caused by a virus known as human papiloma virus (HPV) and is highly contagious. You can buy effective self treatments from a pharmasist but do not self-treat if you have diabetes or blood circulation problems If you do however, or find that the verruca appears to be getting bigger, consult your podiatrist.

---