The Importance of Diabetic Foot Care

• Rates of diabetes have been on the rise, making complications such as diabetic foot care more common.
• Overview of symptoms and complications that may arise from diabetic foot.
• Learn the basics of diabetic foot care for patients who may be unable to perform it themselves.

Diabetes is a common disease affecting the population.  The incidence rate of diabetes has been on the rise for an extended period of time and the complications of diabetes have also increased.

Diabetic foot is considered one of the most common complications of diabetes. Nurses play an important role in the education of diabetes and assisting patients in managing the disease.

Nurses also play an important role in preventing diabetic foot, providing regular foot care, and in the prevention of foot injury in those with diabetes. Nurses are responsible for early detection of any changes in skin and foot sensation, foot care, and dressing.

Nurses are also encouraged to stay up to date on the latest diabetic foot care instructions to ensure they are providing the highest quality of nursing care to diabetic patients. Ensuring that the highest quality of care is provided will assist in achieving positive health outcomes for the patients.

Like many other diseases, the elderly population is at an increased risk for developing complications from diabetes, especially those of the foot. The increased risks could be due to many factors such as the aging process and reduced skin integrity.

Due to the increased risk for diabetic foot, many nursing homes have initiated foot care clinics where one day each week is dedicated to the foot care of diabetic patients. On this day, nurses thoroughly inspect and wash the diabetic patient’s feet.  They also provide nail trimming.

Symptoms/Complications of Diabetes

Peripheral Neuropathy Symptom

Peripheral neuropathy is the most common type of diabetic neuropathy, and it affects the feet and legs first. Signs of peripheral neuropathy are worse at night and include the following:

• Numbness or decreased ability to feel pain or temperature changes
• Tingling or burning feeling
• Sharp pains or cramps
• Sensitivity to touch
• Serious foot problems such as ulcers, infection, bone, and joint damage

Peripheral Artery Disease Symptom

• Coldness in the lower leg or foot, especially when compared to the other side
• Leg numbness or weakness
• No pulse or weak pulse in legs or feet
• Painful cramping in one or both hips, thighs, and calf muscles

Risk Factors that can lead to Diabetic Foot Complications

• Nerve damage from peripheral neuropathy
• Foot deformities in the toes, arches, or bottoms of the feet
• Poor circulation as a result of poorly managed blood sugar – this can damage the blood vessels resulting in decreased blood flow to the feet. The skin can become weakened and contribute to the formation of foot ulcers.
• Past foot ulcer – once a patient has a foot ulcer even if it heals completely, he/she is at risk of developing another one.
• Diabetic foot condition left untreated – affected lower limb may be at risk for amputation.

Basic Diabetic Foot Care

For the patient who is unable to complete the following steps on his/her own, they will need a nurse to provide the care for them. For the patient who can provide the care independently, it is important to provide nursing education on the following steps:

• Examine feet daily for discoloration, swelling, cracks, pain, or numbness
• Provide daily washing of the feet followed by thorough drying, especially between the toes
• Controlling water temperature when washing the feet
• Educating the patient on the importance of avoiding going barefoot or wearing shoes without socks
• Trimming all nails (give nursing education on proper nail trimming)
• Avoiding manipulation of existing foot lesions such as corns
• Ensuring proper dressings and medications are applied to any foot lesions

The Bottom Line

In conclusion, the combination of close monitoring one’s blood sugar and the administration of diabetic medication(s) as ordered, nurses must ensure they are making foot care an important aspect of the diabetic patient’s care plan to avoid the possible serious foot complications that can occur with this disease.

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