How you look after your feet

No matter which type of diabetes you have, you should take extra good care of your feet, if you experience the onset of nerve damage (neuropathy). Sensible foot care and protection, along with well-controlled blood sugar, can reduce your risk of more serious foot problems.

Foot care

We recommend that, on a daily basis, you keep an eye on your feet and care for them in a sensible way. Here, we provide you with a few pieces of good advice:

• Wash your feet under running water on a daily basis, a shower is perfect.
• Avoid foot baths, as this will dry out your skin and, also, there is a risk of burns in case the water is too hot.
• Use neutral soap
• Dry thoroughly, particularly between the toes.
• Apply moisturising cream to keep the skin soft, supple and resistant. Do not apply between the toes.
• Check your feet on a daily basis, and act if you detect changes such as e.g. red spots or wounds you must act upon it. It is a good idea to use a mirror, if you find it difficult to get a look of the soles of your feet. You could also ask another person to look for you.
• Always empty your shoes for pebbles and the similar before putting them on.
• Always cut your nails straight across. If there is a sharp corner, you can use a nail file to round it. If you find it difficult to deal with this on your own, you can have an authorised podiatrist help you.
• Leave the treatment of ingrown toenails, corns and calloused skin to your podiatrist, as this may be the beginning of an ulcer.
• Use good socks without hard seams or edges. You could perhaps turn the inside of the sock out. It is preferable to wear socks made of natural materials, such as e.g. cotton or wool.
• Stimulate your blood circulation by walks and foot exercises.

Chiropody and insoles or arch support

At SDCC we refer you to a state authorised podiatrist, thus providing you with access to regular chiropody.

To avoid pressure and reduce the risk of foot ulcers, a podiatrist can also create insoles for your shoes if it is necessary to relieve sensitive areas or correct foot deformities.

Treatment by the state-authorized podiatrist is eligible for subsidies according to the current rules, but there is always a co-payment.

Nerve damage (neuropati)

Nerve damage may lead to impaired sense of touch in your feet. The risk of developing neuropathy depends on how long you have had diabetes, how well your blood sugar has been - or is currently being - controlled, and of your age.

Very often, the nerve damage will creep up on you, and many will not detect the gradually disappearing sense of touch in their feet. If you suffer from neuropathy, there will thus be an increased risk of the occurrence of ulcers or fractures in connection with your feet, without your noticing anything.

It can also manifest itself as numbness or burning or very painful sensations, extremely dry skin on your feet and problems with your balance, which tells you that the nerves in your feet have been affected as a consequence of your diabetes.

The symptoms of nerve damage may often be relieved by a better regulation of your blood sugar. Talk with your therapist about the possibilities for this.

Annual examination

 At SDCC, we annually examine the sensation in your feet, including measuring your vibration sense with a biothesiometer. If your perception of vibration is above 25 volts, you are at risk from damage, without noticing it.

Our check-up of your feet will also include a check of your pulse and, hence, the blood supply to your feet.

If you have reduced blood supply to your feet, the tissue will get less oxygen and nourishment and, thus, there will be an increased risk of ulcers having difficulties in healing up. In such cases, it will be assessed whether you shall be referred to the vascular surgeons.

Reduce the risk of further development of complications in your feet by:

• keeping your blood sugar levels as well regulated as possible.
• quitting smoking if you are a smoker.
• choosing footwear and stockings that fits your feet. You can, for instance, search www.sdcc.dk. for the leaflet, entitled 'Good advice for buying footwear'.
• on a daily basis, making it a habit to check whether your feet are OK.
• having a good foot hygiene.

NB: If your feet are injured, you must immediately contact SDCC.

Contact

If you have questions or are in doubt, you are welcome to contact the Nursing Advisory Service from 8:00 AM to 4:00 PM on weekdays, or the Foot Clinic from 8:30 AM to 9:00 AM at phone: 39 68 08 00.