Produced by The Alfred Workforce Development Team on behalf of DHS Public Health - Diabetes...

Produced by The Alfred Workforce Development Team on behalf of DHS Public Health -

Diabetes Prevention and Management Initiative June 2005

Best Feet Forward

Footcare for People with Diabetes

Level 3

Module 4.1.2

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

Acknowledgements

The foot diagrams and resources used in this presentation are adapted from

Feet can last a life time. A health professionals guide to preventing

diabetes foot problems. National Diabetes Education Program

www.ndep.nih.gov/resources/health.htm


Workshop purpose – Level 3

Target

Aged care workers, HACC workers, consumers and carers

Objective To provide training to increase skills in:

Why people with diabetes are at risk of foot problems How to care for the feet of people with diabetes to

prevent problems Identifying foot problems Action to take for foot problems


Overview of diabetes

Diabetes means that blood glucose in the body (often called blood sugar) is too high.

Glucose comes from the food we eat

Glucose is transported by the blood stream to all the cells in the body.

G

G

G

G

G

G

GGG

Muscle

Bloodstream



Insulin helps the glucose from food get into your cells.

Insulin is a chemical (a hormone) made in a part of the body called the pancreas.

PancreasPancreas

G

G

GG

insulin

Muscle



If your body doesn't make enough insulin or if the insulin doesn't work the way it should, glucose can't get into cells.

Glucose stays in the blood. Blood glucose levels get

too high, causing

diabetes.

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G

G

G

GG

G

G

Muscle

Bloodstream


Common types of diabetes

Type 1 Type 2Age of onset Usually <40 Usually >40Body weight Lean Usually obeseProne to ketoacidosis

Yes No

Medication Insulin essential

Tablets and /or insulin

Onset of symptoms

Acute Gradual (may be asymptomatic)


Treatment goals

Symptom freePrevent short term complicationsPrevent long term complicationsQuality of life = Lifestyle focus


Complications of diabetes

Diabetes can cause increased risk of: Heart Problems Stroke Eye sight problems Kidney problems Foot problems


Foot problems

The feet can be affected by: Decreased blood supply poor

healing

Nerve damage loss of feeling

High Blood Sugar levels decrease healing


Assessment and awareness

Regular assessment of feet is important to check for: Sense of feeling and pulses

in the feet

Foot problems/deformities or past history of foot ulcer

If foot problems are present feet referral to a podiatrist is recommended.


Assessment and awareness

Always be aware of High Risk Feet Loss of feeling Poor blood supply Past history of foot

ulcerSource: Footcare in

Diabetes Workbook for Health Professionals. Australian Diabetes Educators Association


Caring for the feet

Check feet every day. Individuals may have

serious foot problems, but feel no pain.

Check feet for cuts, sores, red spots, swelling, and infected toenails.

Make checking feet part of your every day routine.


Caring for the feet

Wash feet every day Wash feet in warm, not

hot, water. Do not soak because skin will get dry.

Dry feet well. Be sure to dry between the toes.


Caring for the feet

Keep the skin soft and smoothRub a thin coat of

skin lotion or cream. Do not put lotion or

cream between toes


Caring for the feet

Smooth corns and calluses gently.

Check with the doctor/podiatrist before using a pumice stone.

Use pumice stone after bathing or showering

Don’t cut corns and calluses. Don't use razor blades, corn plasters,

or liquid corn and callus removers - they can damage the skin.


Caring for the feet

Toenails should be trimmed regularly With clippers after

bath/shower. Straight across and smooth

with an emery board or nail file.

don't cut into the corners of the toenail.

If toenails are thick or yellowed, or nails curve and grow into the skin, have a podiatrist trim them.


Preventing foot problems

Protect the feet Wear shoes and socks at all

times. Choose clean, lightly padded

socks that fit well. Socks that have no seams are best

Check the insides of shoes before putting them on to be sure the lining is smooth and that there are no objects in them.



Protect the feet Wear shoes that fit well and

protect the feet. Athletic or walking shoes

are good for daily wear. They support the feet and allow them to "breathe."

Avoid vinyl or plastic shoes, because they don't stretch or "breathe."



Appropriate shoes Pointed toes or high

heels put too much pressure on the toes.

Shoes also need to be deep and wide enough to prevent rubbing.



Protect your feet from hot and cold. Keep your feet away from

radiators and open fires. Do not use hot water bottles on

feet. Lined boots are good in winter

to keep your feet warm and socks at night

Remember to use sunscreen on the top of your feet if outside.



Keep the blood flowing to the feet. Keep feet up when sitting. Exercises for the feet

Wiggle toes for 5 minutes, 2 or 3 times a day Move ankles up and down and in and out.

Don’t Cross legs Wear tight socks, elastic or rubber bands, or

garters around your legs. Don't smoke

Smoking reduces blood flow to feet. Control

Blood glucose, blood pressure and cholesterol.


Healthy Eating

Control blood glucose and blood fats

Body weight Healthy food

Regular carbohydrate High in fibre Low in fat (particularly

saturated fat) Low in added sugar Adequate energy

/protein/fluids/vits and mins


Exercise / Activity

30 minutes moderate intensity on most days preferably all

Helps to: Increased insulin sensitivity Decreased insulin requirements Weight reduction Lipid control Blood pressure control


Identification of a problem

Daily inspection of the feet note: Broken skin Redness Swelling Corns/callus Black/blue areas

Report to nurse/GP or podiatrist for assessment if you detect any of these problems


Prevention is better than cure!

Prevention and early identification of foot problems can prevent foot ulcers and amputation Source: Footcare in Diabetes Workbook for Health

Professionals. Australian Diabetes Educators Association

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Produced by The Alfred Workforce Development Team on behalf of DHS Public Health - Diabetes...

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