Posts Tagged ‘diabetes’

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.

Tips for Trimming Those Diabetic Toenails

Monday, December 8th, 2014

Make sure you have the proper tools. A set of toenail nippers, nail file, and orange stick are typically used.  Always follow your facility or healthcare’s settings policy for nail clip blog imagesinfection control. Single use disposable equipment is favorable.
Nails are easiest to trim after they have soaked for 10 minutes in a footbath to soften them. It is important to remember and educate our patients that the soaking of a diabetic patients feet should only be done by a healthcare professional. You can save some time by cleaning under the patient’s toenails with an orange stick wiping on a clean washcloth in between each toe while the feet are soaking.
After soaking and washing of the feet are completed, dry the patient’s feet completely. Wash your hands and put on new gloves to trim the toenails. Use your dominant hand to hold the nipper. Start with the small toe and work your way medial toward the great toe. Squeeze the nipper to make small nips to cut along the curve of the toenail. Be careful not to cut the skin. Use your index finger to block any flying nail fragments. Nippers are used like a pair of scissors – make small cuts, never cut the nail in one clip all the way across the nail. Never use two hands on the nipper. The nail is trimmed in small clips in a systematic manner. The nail should be cut level with the tips of the toes, never cut so short or to break the seal between the nail and the nail bed. The shape of the nail should be cut straight across and an emery board should be used to slightly round the edges. When filing nails always use long strokes in one direction, avoid using a back and forth sawing motion.
When all toes have been trimmed and filed, remove gloves and wash hands. Apply clean gloves and apply lotion to the top of the foot and to the bottom of the feet, rubbing lotion in well, wipe excess lotion off with a towel. Put patients socks and shoes back on as needed. Wash your hands again and smile, you are done!

FREE WEBINAR:  Skin and Nail Changes in the Diabetic Foot.  Click Here and use coupon code: NAILS through 12/31/15.



Don’t Put Your Foot in Your Mouth: What You Must Know About Diabetic Footwear (Advanced)

Tuesday, August 23rd, 2011
Don’t Put Your Foot in Your Mouth: What you Must Know About Diabetic Footwear will be presented by Dr. Alison J. Garten DPM, CPed, Kaiser Permanente at this year’s Wild on Wounds National Conference September 7-10, 2011.
This is a MUST go to presentation designed to educate the wound care professional on how diabetic shoes in the high-risk patient can greatly reduce the likelihood of ulcerations in their feet. We will together identify who are the high-risk patients through patient examples, discuss the anatomy of the high-risk diabetic and the importance of professionally fitted shoes in this population. We will conclude with specific examples of how specific ulcers could have been prevented. We’ll discuss the Diabetic Therapeutic Shoe Bill guidelines under the Medicare law, and explain how diabetic shoes can be a profitable business for your practice.

For more information about the Wound Care Education Institute, please visit

Click Here To Register for the Wild on Wounds National Conference

Diabetic Foot Complications: Time To Take The Shoes Off and Battle

Friday, June 17th, 2011

Diabetic Foot Complications

Diabetic Foot Complications: Time To Take The Shoes Off and Battle will be presented at this year’s Wild On Wounds National Convention in Las Vegas NV at Caesars Palace by David Yeager DPM, FASPS, FACFAS, KSB Foot and Ankle/ Wound Care Center

Diabetic foot complications are an everyday occurrence. Lets talk about what we are up against. Learn how to identify, treat, and prevent diabetic foot complications we are up against. Learn how to identify, treat and prevent diabetic foot complications. We will discuss the significant morbidity that is associated with these infections and the financial impact they have on the delivery of care.

This session will be held on Thursday September 8, 2011 from 2:15-3:15 p.m

For more Information about the Wound care Education Institute and WOW 2011, Check out Wild on Wounds National Convention

Wild On Wounds Conference: Total Contact Cast

Wednesday, June 1st, 2011

Total Contact Casting

Total Contact Cast: Utilizing a Gold Standard, Easy as 1-2-3

One of the sessions being offered at the Upcoming Wild on Wounds National Conference in September is sure to be a popular among the attendees. Jeffrey L. Jensen DPM, FACFAS, Dean and Professor, Barry University School of Podiatric Medicine and Surgery, will present this power packed session.

Attendees will explore the effects of diabetes on tissues and a brief comparison of diabetic wound treatments. The remainder of the session will concentrate on a detailed, hands-on practicum on the technique for proper application of Total Contact Casts. This session will be held September 7, 2011 from 8:00-11:30 a.m.

For more information check out The Wild on Wounds National Conference .

What factors do you face when it comes to ensuring adequate support for your patients?

Monday, November 2nd, 2009

Wound development has many different etiologies. Diabetes, arteriosclerosis, venous insufficiency, trauma and a host of others come to mind. Treatment of these wounds may be similar in approach and others may be completely different. One thing that is common in treatment of wounds is adequate support for the underlying structures near and under the wounds. Sometimes this step and consideration is ignored or overlooked all together.

Roho Cushion

Roho Cushion

There are many different types of support surfaces to consider. There are mattresses and beds as well as support cushions, positioning devices, orthotics and specialty shoes that help offload pressure from areas that experience pressure or friction. Here is a a little refresher article on support surfaces.

The following is quoted from that article. “An important part of the prevention and treatment of pressure ulcers is placing people on an appropriate support surface. Choosing the appropriate support surface is not an easy task as there is no standard criteria to evaluate support surfaces. Therefore, it is important to assess the performance of each type of support surface accurately, identify individual patient needs and then select the most appropriate option based on a well-informed, educated approach.”-WCIN .

Ortho Wedge Cushion

Ortho Wedge Cushion

Although this is true, it lends some discussion as to how we as wound care certified professionals consider this in our approach to relieving pressure. There are so many variables that go into the decision making process that the decision itself is often delayed due to the variables. Costs, availability, compliance, resources are all variables that effect the bottom line, which is to prevent or help heal the wounds!

Aircell XL

Aircell XL

So how do you approach pressure relief in your day to day practice? In long term care, do you have pressure relieving mattresses or alternating pressure mattresses? Are you turning Q2 hrs? Is that the extent of the pressure relief that you afford? How strong is your assessment of the patient’s need for pressure relief when they have an appointment in the outpatient clinics? Are you certain the patient has some sort of support surface? What factors do you face when it comes to ensuring adequate support for your patients?

For more information about becoming Wound Care Certified and our Skin and Wound Management Course, please visit WCEI’s registration page