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Module 4.1.2. Best Feet Forward. Footcare for People with Diabetes Level 3. Acknowledgements. The foot diagrams and resources used in this presentation are adapted from Feet can last a life time. A health professionals guide to preventing diabetes foot problems.

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best feet forward

Module 4.1.2

Best Feet Forward

Footcare for People with Diabetes

Level 3

Produced by The Alfred Workforce Development Team

on behalf of DHS Public Health -

Diabetes Prevention and Management Initiative

June 2005

acknowledgements
Acknowledgements
  • The foot diagrams and resources used in this presentation are adapted from

Feet can last a life time. A health professionals guide to preventing diabetes foot problems.

National Diabetes Education Program www.ndep.nih.gov/resources/health.htm

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

workshop purpose level 3
Workshop purpose – Level 3

Target

Aged care workers, HACC workers, consumers and carers

Objective

  • To provide training to increase skills in:
    • Why people with diabetes are at risk of foot problems
    • How to care for the feet of people with diabetes to prevent problems
    • Identifying foot problems
    • Action to take for foot problems

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

overview of diabetes

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Overview of diabetes

Bloodstream

  • Diabetes means that blood glucose in the body (often called blood sugar) is too high.
  • Glucose comes from the food we eat
  • Glucose is transported by the blood stream to all the cells in the body.

Muscle

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G

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

overview of diabetes5
Overview of diabetes
  • Insulin helps the glucose from food get into your cells.
  • Insulin is a chemical (a hormone) made in a part of the body called the pancreas.

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G

Muscle

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insulin

Pancreas

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

overview of diabetes6
Overview of diabetes
  • If your body doesn\'t make enough insulin or if the insulin doesn\'t work the way it should, glucose can\'t get into cells.
  • Glucose stays in the blood.
  • Blood glucose levels get too high, causing diabetes.

Muscle

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G

G

G

G

Bloodstream

G

G

G

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

common types of diabetes
Common types of diabetes

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

treatment goals
Treatment goals
  • Symptom free
  • Prevent short term complications
  • Prevent long term complications
  • Quality of life =

Lifestyle focus

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

complications of diabetes
Complications of diabetes
  • Diabetes can cause increased risk of:
    • Heart Problems
    • Stroke
    • Eye sight problems
    • Kidney problems
    • Foot problems

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

foot problems
Foot problems
  • The feet can be affected by:
    • Decreased blood supply poor healing
    • Nerve damage loss of feeling
    • High Blood Sugar levels decrease healing

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

assessment and awareness
Assessment and awareness
  • Regular assessment of feet is important to check for:
    • Sense of feeling and pulses in the feet
    • Foot problems/deformities or past history of foot ulcer
    • If foot problems are present feet referral to a podiatrist is recommended.

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

assessment and awareness12
Assessment and awareness
  • Always be aware of High Risk Feet
    • Loss of feeling
    • Poor blood supply
    • Past history of foot ulcer

Source: Footcare in Diabetes Workbook for Health Professionals. Australian Diabetes Educators Association

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

caring for the feet
Caring for the feet
  • Check feet every day.
  • Individuals may have serious foot problems, but feel no pain.
  • Check feet for cuts, sores, red spots, swelling, and infected toenails.
  • Make checking feet part of your every day routine.

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

caring for the feet14
Caring for the feet
  • Wash feet every day
    • Wash feet in warm, not hot, water. Do not soak because skin will get dry.
    • Dry feet well. Be sure to dry between the toes.

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

caring for the feet15
Caring for the feet
  • Keep the skin soft and smooth
    • Rub a thin coat of skin lotion or cream.
    • Do not put lotion or cream between toes

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

caring for the feet16
Caring for the feet
  • Smooth corns and calluses

gently.

    • Check with the doctor/podiatrist before using a pumice stone.
    • Use pumice stone after bathing or showering
    • Don’t cut corns and calluses.
    • Don\'t use razor blades, corn plasters, or liquid corn and callus removers - they can damage the skin.

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

caring for the feet17
Caring for the feet
  • Toenails should be trimmed regularly
    • With clippers after bath/shower.
    • Straight across and smooth with an emery board or nail file.
    • don\'t cut into the corners of the toenail.
    • If toenails are thick or yellowed, or nails curve and grow into the skin, have a podiatrist trim them.

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

preventing foot problems
Preventing foot problems
  • Protect the feet
    • Wear shoes and socks at all times.
    • Choose clean, lightly padded socks that fit well. Socks that have no seams are best
    • Check the insides of shoes

before putting them on to be

sure the lining is smooth and

that there are no objects in them.

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

preventing foot problems19
Preventing foot problems
  • Protect the feet
    • Wear shoes that fit well and protect the feet.
    • Athletic or walking shoes are good for daily wear. They support the feet and allow them to "breathe."
    • Avoid vinyl or plastic shoes, because they don\'t stretch or "breathe."

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

preventing foot problems20
Preventing foot problems
  • Appropriate shoes
    • Pointed toes or high heels put too much pressure on the toes.
    • Shoes also need to be deep and wide enough to prevent rubbing.

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

preventing foot problems21
Preventing foot problems
  • Protect your feet from hot and cold.
    • Keep your feet away from radiators and open fires.
    • Do not use hot water bottles on feet.
    • Lined boots are good in winter to keep your feet warm and socks at night
    • Remember to use sunscreen on the top of your feet if outside.

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

preventing foot problems22
Preventing foot problems
  • Keep the blood flowing to the feet.
    • Keep feet up when sitting.
    • Exercises for the feet
      • Wiggle toes for 5 minutes, 2 or 3 times a day
      • Move ankles up and down and in and out.
    • Don’t
      • Cross legs
      • Wear tight socks, elastic or rubber bands, or garters around your legs.
    • Don\'t smoke
      • Smoking reduces blood flow to feet.
    • Control
      • Blood glucose, blood pressure and cholesterol.

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

healthy eating
Healthy Eating
  • Control blood glucose and blood fats
  • Body weight
  • Healthy food
      • Regular carbohydrate
      • High in fibre
      • Low in fat (particularly saturated fat)
      • Low in added sugar
      • Adequate energy /protein/fluids/vits and mins

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

exercise activity
Exercise / Activity
  • 30 minutes moderate intensity on most days preferably all
  • Helps to:
    • Increased insulin sensitivity
    • Decreased insulin requirements
    • Weight reduction
    • Lipid control
    • Blood pressure control

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

identification of a problem
Identification of a problem
  • Daily inspection of the feet note:
    • Broken skin
    • Redness
    • Swelling
    • Corns/callus
    • Black/blue areas

Report to nurse/GP or podiatrist for assessment if you detect any of these problems

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

prevention is better than cure
Prevention is better than cure!
  • Prevention and early identification of foot problems can prevent foot ulcers and amputation

Source: Footcare in Diabetes Workbook for Health Professionals. Australian Diabetes Educators Association

DPMI Workforce Development – The Alfred Workforce Development Team June 2005

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