November is Diabetes Awareness Month: Don't Let Diabetes Get a Toehold

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"The California Podiatric Medical Association Offers Tips to Help Those Living with Diabetes Take a Step in the Right Direction to Staying on Their Feet with Information on Healthy Foot Care and the Importance of Regularly Having Their Feet Examined by a Podiatric Physician."

California Podiatric Medical Association

California Podiatric Medical Association

Your feet shouldn't hurt

A serious systemic disease, diabetes disrupts the vascular system, affecting the entire body and leading to many complications throughout the body including the eyes, kidneys, legs and especially feet, which is why foot health is vital for those living with diabetes.

"People with diabetes should pay special attention to their feet," says California Podiatric Medical Association President Rebecca Moellmer, DPM. "Diabetes often leads to peripheral vascular disease (PVD). In PVD, there is a narrowing of the blood vessels that frequently leads to significantly decreased circulation in the lower part of the legs and feet, which makes the feet one of the first parts of the body to show signs of peripheral vascular disease.

"Your feet are an early warning system for PVD, especially for those with diabetes," says Dr. Moellmer, a podiatric physician and surgeon on faculty as an Assistant Professor at the College of Podiatric Medicine at Western University of Health Sciences in Pomona, California.

"Poor circulation contributes to diabetic foot problems by reducing the amount of blood, oxygen and nutrition supplied to the skin and other tissue, leading to swelling, dryness and cracks of the foot, causing injuries to heal poorly, which is why podiatric physicians are often the first physicians to spot vascular disease," Dr. Moellmer noted.

Podiatric physicians undergo years of rigorous medical education and training to become specialists in the care and treatment of the human foot and ankle, and are especially trained to treat complicated foot conditions that can be caused by diabetes, like PVD and diabetic neuropathy (loss of sensation in the feet), infection, pressure sores and ulcers.

"Due to the lack of feeling in their feet, diabetics can unknowingly put themselves at risk,” Dr. Moellmer continued. The loss of sensation means the inability to feel pain, heat and cold in the feet, which means that diabetics can develop minor cuts, scrapes and blisters that they might not be aware of due to the loss of sensitivity in their feet. If these minor injuries are left untreated they can quickly lead to infection and ulceration. The leading cause of hospitalization among those with diabetes is foot ulcers and infections. Complications for infection and ulceration can in turn lead to partial or full amputation of the foot and lower leg," reported Dr. Moellmer.

"Diabetes is currently the leading cause of non-traumatic amputations," says Dr. Moellmer. "Regular visits to a doctor of podiatric medicine can help identify potential problems before they become limb threatening. Limb salvage is an integral part of podiatric medicine," Dr. Moellmer concluded.

A study by the American Podiatric Medical Association found that between 45 and 85 percent of amputations can be prevented with regular foot care provided by podiatric physicians, making them an important member of the diabetes health care team. In addition to treatment and care, podiatric physicians can provide vital information to help those with diabetes better manage the effects of diabetes on their feet.

To find a local trained, licensed podiatric physician visit CalPMA.org

The California Podiatric Medical Association offers the following foot care tips for those with diabetes:

"1. Take Care of Your Diabetes: Make healthy lifestyle choices to keep your blood sugar close to normal. Work with your health care team to create a diabetes plan that fits your lifestyle.

2. Check Your Feet Every Day: You may have foot problems that you may not be aware of. Check your feet for cuts, sores, red spots, swelling, or infected toenails. Checking your feet should become part of your daily routine. If you have trouble bending over to see your feet, use a plastic mirror to help. You can also ask a family member to help you. Important Reminder: Be sure to call your podiatric physician immediately if a cut, sore, blister, or bruise on your foot does not heal after one day.

3. Wash Your Feet Every Day: Wash your feet in warm, NOT HOT, water. Do not soak your feet because your skin will get dry. Before bathing or showering, test the water to make sure it is not too hot. You should use a thermometer or your elbow. Dry your feet well. Be sure to dry between your toes.

4. Keep the Skin Soft and Smooth: Rub a thin coat of skin lotion or cream on the tops and bottoms of the feet. Do not put lotion between your toes, because this might cause infection.

5. Wear Shoes and Socks at All Times: Do not walk barefoot - not even indoors. It is extremely easy to step on something and hurt your feet. Always wear seamless socks, stockings, and nylons with your shoes to help avoid the possibility of blisters and sores developing. Be sure to choose seamless socks that are made of materials that wick moisture away from your feet and absorb shock. Socks made of these materials help keep your feet dry. Always check the insides of your shoes before putting them on. Make sure the lining is smooth and there are no foreign objects in the shoe, such as pebbles. Wear shoes that fit well and protect your feet.

6. Protect Your Feet from Hot and Cold: Always wear shoes at the beach or on hot pavement. Put sunscreen on the tops of your feet for protection from the sun. Keep your feet away from radiators or open fires. DO NOT use hot water bottle or heating pads on your feet. If your feet are cold, wear seamless socks at night. Lined boots are good to keep your feet warm in the winter. Choose socks carefully. DO NOT wear socks with seams or bumpy areas. Choose padded socks to protect your feet and make walking more comfortable. In cold weather, check your feet often to keep your feet warm avoid frostbite.

7. Keep the Blood Flowing to Your Feet: Put your feet up when you are sitting. Wiggle your toes for 5 minutes, 2 or 3 times a day. Move your ankles up and down and in and out to improve blood flow in your feet and legs.
DO NOT cross your legs for long periods of time.
DO NOT wear tight socks, elastic, or rubber bands, or garters around your legs.
DO NOT wear restrictive footwear or foot products. Foot products that can cut off circulation to the feet, such as products with elastic, should not be worn by diabetics.
DO NOT smoke. Smoking reduces blood flow to your feet. If you have high blood pressure or high cholesterol, work with your health care team to lower it.

8. Be More Active: Ask your podiatric physician to plan an exercise program that is right for you. Walking, dancing, swimming, and bicycling are good forms of exercise that are easy on the feet. Avoid all activities that are hard on the feet, such as running and jumping. Always include a short warm-up or cool-down period. Wear protective walking or athletic shoes that fit well and offer good support.

9. Communicate With Your Podiatric Physician: Ask your doctor to check the sense of feeling and pulses in your feet at twice a year. Ask your podiatric physician for proper foot care."

Founded in 1912, the California Podiatric Medical Association (CPMA) is the leading and recognized professional organization for California’s podiatric physicians and surgeons. Podiatric physicians and surgeons, also known as doctors of podiatric medicine (DPM) and podiatrists are qualified by their long and rigorous education, training and experience to diagnose and treat conditions affecting the foot, ankle and structures of the leg.

CPMA - Keeping Californians on their Feet – Healthy, Active and Productive

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