> In Remission
Diabetes is a lifelong condition which can cause foot problems. Some of these problems can occur because the nerves and blood vessels supplying your feet are damaged. This can affect:
These changes can be very gradual and you may not notice them. This is why it is essential that every year you have your feet screened and assessed by a podiatrist. You can then agree a treatment plan to suit your needs.
Your screening and assessment have shown that you are in the ‘In Remission’ category as you have had a previous ulcer, amputation or have a consolidated Charcot. Being in the ‘In Remission’ category means that there is a very high risk that you will develop further foot ulcers, have a further amputation or a recurrence of, or a new episode of, Charcot foot. Your podiatrist will tick which of the following you are ‘In Remission’ from
Keeping good control of your diabetes, cholesterol and blood pressure will help to keep you ‘In Remission’.
As your feet are in the ‘In Remission’ category you will need to take extra care of them. You will need regular treatment by a podiatrist experienced in the diabetic foot.
If you smoke, you are strongly advised to stop. Smoking affects your circulation and can lead to amputation.
If you follow the advice and information in this leaflet it will help you to take care of your feet between visits to your podiatrist. Hopefully this will help to keep you in the ‘In Remission’ category and reduce the chance of further problems in the future.
Advice on keeping your feet healthy
Check your feet every day
You should check your feet every day for any blisters, breaks in the skin, pain or any signs of infection such as swelling, heat or redness. If you cannot do this yourself, ask your partner or carer to help you.
Wash your feet every day
You should wash your feet every day in warm water and with a mild soap. Rinse your feet thoroughly and dry them carefully, especially between the toes. Do not soak your feet as this may damage your skin. Because of your diabetes, you may not be able to feel hot or cold very well. You should test the temperature of the water with your elbow, or ask someone else to test the temperature for you.
Moisturise your feet every day
If your skin is dry, apply a moisturising cream every day, avoiding the areas between your toes.
Do not cut your toenails unless your podiatrist advises you to.
Socks, stocking and tights
You should change your socks, stockings or tights every day. They should not have bulky seams and the tops should not be elasticated.
Avoid walking barefoot
If you walk barefoot you risk injuring your feet by stubbing your toes and standing on sharp objects which can damage the skin.Check your shoes
Check the bottom of your shoes before you put them on to make sure that nothing sharp such as a pin, nail or glass has pierced the outer sole. Also run your hand inside each shoe to check that no small objects such as small stones have fallen in.
Badly fitting shoes
Badly fitting shoes are a common cause of irritation or damage to feet. The podiatrist experienced in the diabetic foot who assessed your feet may give you advice about the shoes you already own and on buying new shoes. They may suggest that you are measured for prescription shoes which will be supplied to you.
If you have been supplied with shoes, they will have been made to a prescription. You should follow the instructions your orthotist (the person who makes the shoes) or podiatrist gives you. These should be the only shoes you wear. Shoes will normally be prescribed with insoles. These are an important part of your shoes and you should only remove them if your orthotist or podiatrist advises you to. Whoever provided your shoes will carry out all repairs or alterations to make sure that they will match your prescription.
These shoes have been provided to you to give you the best possible chance of staying ‘In Remission’ and avoiding any future problems.
Minor cuts and blisters
If you check your feet and discover any breaks in the skin, minor cuts or blisters, cover the area with a sterile dressing. Do not burst blisters. Contact your podiatry department or GP immediately (contact numbers are over the page). If these people are not available and there is no sign of healing after one day, go to your local accident and emergency department.
Hard skin and corns
Do not attempt to remove hard skin or corns yourself. Your podiatrist experienced in the diabetic foot will provide treatment and advice where necessary. Over-the-counter corn remedies Do not use over-the-counter corn remedies. They are not recommended for anyone with diabetes as they can damage the skin and create ulcers.
Avoid high or low temperatures
If your feet are cold, wear socks. Never sit with your feet in front of the fi re to warm them up. Always remove hot water bottles or heating pads from your bed before getting in.
If you have had an ulcer before, an amputation or a Charcot foot, you are at High Risk of developing further problems. If you follow the advice in this leaflet and look after your feet carefully, with the help of a podiatrist, you will reduce the risk of further problems.
If you discover any problems with your feet, contact your podiatry department or GP immediately. If they are not available, go to your nearest accident and emergencydepartment. Remember, any delay in getting advice or treatment when you have a problem can lead to serious problems.
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