Health care professionals and many lay people can give vivid examples of amputation following major/minor injury to diabetic individuals. Inadequate or dangerous home remedies often precede physician visits and delay treatment. The diabetic must establish daily inspection and care of the feet. Establishing this routine is a major goal in educating the diabetic. A good practice for all people is keeping the feet clean, dry, and free from lesions; keeping the skin turgor supple and hydrated. The diabetic individual may have vascularly deprived tissue that is less resistant to infection, and many have diminished ability to perceive injury or infection. Foot care should be taught early to all diabetics so that it becomes routine.
Instruction about foot care should focus on hazards in the daily life of the individual and provide management for incorporating foot care in the home, work, and play environment. Habitual inspection of the feet, change of socks and shoes, and use of protectant footwear can be indicated where patients report that their feet are often cold and wet, or moist and warm; they go barefoot; they frequently suffer injuries. When indicated, patients may have to revise priorities about spending money to purchase shoes that give support and fit well. Frequent changes of shoes may be indicated.
Annual visits with a Podiatrist are recommended. Due to the development of vascular and neuropathic complications, podiatry services are often effective in minimizing and delaying disability.
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