Posts Tagged ‘Diabetic Shoes’

Diabetic Patient Education

Monday, December 29th, 2014

Patient education plays a vital role in positive outcomes for our diabetic patient. Diabetic patients need to understand the importance of proper foot care and importance of good blood glucose control to maintain the integrity of their feet.

So what do our patients need to know? They need to work closely with their physician and the dietician to be sure their blood glucose levels are properly controlled. foot_mirror_between_toesThe ADA recommends an A1c below 7%.  They need to know how important it is to check their feet daily to catch any problems early. We as clinicians need to teach them how to do this and what to look for. Teach your diabetic patients to inspect their feet everyday. They can do this by having family members or caregivers check their feet, or they can use a mirror and do it themselves.

Explain to your patients what exactly they are looking for; cuts, sores, red spots, swelling, infected toenails, blisters, calluses, cracks, excessive dryness or any other abnormality. They should check all surfaces of the feet and toes carefully, at the same time each and every day. Explain to your patients to call their physician right away if they notice any abnormalities or any open areas. Other problems the diabetic patient should be aware of with their feet and report to their physician include tingling or burning sensation, pain in the feet, cracks in the skin, a change in the shape of their foot, or lack of sensation – they might not feel warm, cold, or touch. The patient should be aware that any of the above could potentially lead to diabetic foot ulcers.

Instruct your patients to wash their feet every day, but not soak their feet. Use warm, NOT hot water – be sure they check the water temperature with a thermometer or shoe_fittheir elbow. Dry feet well, especially between toes. Apply lotion on the tops and bottoms of their feet but not between toes. Trim toenails each week and as needed after bath / shower, trim nails straight across with clippers, smooth edges with emery board.

Wear socks and shoes at all times, the diabetic patient should never be barefoot, even indoors. Have them check their shoes prior to wearing, be sure there are no objects inside and the lining is smooth.  Instruct them to wear shoes that protect their feet; athletic shoes or walking shoes that are leather are best, be sure they fit their feet appropriately and accommodate the foot width and any foot deformities.

For our diabetic patients, glucose control is a key factor in keeping them healthy, but patient education and understanding of proper foot inspection and what findings to report to their physician are just as important for the well being of our diabetic patient.

Free Webinar “How-To: Diabetic Foot Exam Made Easy”. Use Promo Code: DFOOT  through 12/31/15.

“Footnotes on Selecting Diabetic Footwear”

Monday, January 28th, 2013

There are a lot of shoes out there, but not all of them would be appropriate selections for our diabetic patients.  In fact, selecting improper footwear could actually harm our diabetic patients and lead to diabetic foot ulcers and possible amputations.  Statistics show that 50% of amputations of our diabetic patients are directly related to improper footwear!amputation

Diabetic Wound Certified clinicians need to know how to check the footwear of our patients as well as the staff caring for our patients.  What are we looking for in a shoe for our diabetic patient?  The shoe should offer a firm snug fit.  The heel should be less than 1 inch, the greater the heel the greater the pressure on the ball of the foot and this could lead to callus formation and ulcerations.  The shoe should have laces, buckles or elastic to hold it in place.  When the diabetic is wearing slip on shoes the toes must curl to hold the shoe on and this can lead to calluses on the top of the toes and potential ulceration.  The shoe should have 1cm between the longest toe and the end of the shoe when the patient stands, we don’t want added pressure to the tips of the toes or on the toenails.  The sole of the shoe should be smooth without seams and cushioned to absorb shock and reduce pressure on the feet.  The shoe should be made from a material that “breathes”, avoid plastic and vinyl as they can encourage fungal infections.  The shoe should have a protective function; a closed toe shoe is imperative for our diabetic patient.  Look closely at the patients foot and the shoe – they should be the same shape, pointed toe shoes cause corns, calluses and ulcerations! Be sure the shoe width is appropriate, has a wide toe box that allow toes to move and accommodates any foot deformity.  The heel of the shoe should also be firm, you can check this by holding the sides of the heel of the shoe between your thumb and forefinger, try to push them together, if the heel compresses, its to soft and won’t give the patient good enough support when walking.

We also need to teach our patients and their family members instructions on checking for proper fit of their shoes and how to shop for new shoes.  They should be re-measured each time, shop late in the day, try on both shoes and walk around in them to ensure they are comfortable, be sure there is a thumbs width of space at the end of the longest toe, try the shoe on with the socks they will be wearing, be sure the heel is less than an inch, and be sure the shoe has laces or velcro closures.  If the patient has serious foot problems or deformities they should be referred for specially molded inserts and or shoes.

Following the above recommendations may just prevent a patient from developing a diabetic foot ulcer and an amputation!  Patient and caregiver education is a key factor in preventing diabetic foot ulcers!

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