Diabetes

Diabetic clients need extra attention. The initial anamnesis is followed by a screening:
Color, skin condition, mycoses, eczema; condition of the toes; temperature, foot positioning and more. The Chiropodist will examine the client’s feet with a tuning fork; the so- called Tip- Therm and the Monofilament.

Type I or II diabetes

Duration
Poor healing of wounds
Medication: pills, tablets, injections
Mobility of the foot joints
History of earlier foot problems
Poor eye -sight
Feeling and sensation: Does the client still have a sense of feeling? Is he or she aware of the fact that they have ulcers?
Examination:
Foot type: does the foot sag?
Position of the foot: hammer or claw toes?
Standing on the front of the foot – Valgus-or Varus stand?
Mobility
Ankle mobility
Skin: is the skin red, white or pink?
Is there localized red and swollen skin?
Mycose between the toes, eczema
How does the heel stand?

The Chiropodist or Podiatrist will check if there are ingrown toe-nails.
onychomycoses, are the nail plates loose – or partially loose?
Are there any infections, paronychia, etc.?
Hygiene is an important issue for the diabetic.
Seamless cotton socks are often helpful!
Removal of hard and rough skin needs special attention for the diabetic’s sensitive condition.
For a diabetic foot baths are not recommended as it may make the skin too soft.
The Chiropodist will ask clients how frequently they go to their specialist, or nurse, or dietician for a check-up.

Recommended life style for the diabetic:

1) Wash feet every day and make sure the temperature of the water is suitable – it should not be too hot.
2) Dry feet thoroughly, especially between the toes.
3) Check your feet every day and look for blisters, red skin, cracks, small wounds or scratches, cuts, swelling, mycoses or eczema between toes.
4) Apply a light foot cream every day after washing your feet.
5) Visit your doctor, diabetes nurse and dietitian on regular basis.
6) Go for a walk, or ride your bicycle and do foot exercises on a regular basis. Ask your Chiropodist about proper exercises for your condition.
7) Visit a Podiatrist or Chiropodist every 6-8 weeks.

For more information on diabetes and the diabetic foot
consult with or visit the website of the Israeli Association for Diabetes:
www.sukeret.co.il