$Unique_ID{BRK00955} $Pretitle{} $Title{How Can Ulcers of the Feet in Diabetics Be Prevented?} $Subject{diabetes mellitus ulcers foot Endocrine Glands metabolism sugar blood flow Skin feet arterial disease nerve nerves ulcer} $Volume{C-7, G-20} $Log{ Structure of the Pancreas*0009801.scf Diabetes Mellitus*0009802.scf The Functions of Insulin*0009803.scf} Copyright (c) 1991-92,1993 Tribune Media Services, Inc. How Can Ulcers of the Feet in Diabetics Be Prevented? ------------------------------------------------------------------------------ QUESTION: My Dad lives alone, now that Mother is dead, and tends house for himself. He is a diabetic, but seems to manage his insulin injections without any problems. However, during our most recent visit we were horrified to find he had developed several ulcers on his feet. He is under good medical care now, but we want to prevent this in the future. Any suggestions? ------------------------------------------------------------------------------ ANSWER: Several, and I hope they fit in with the advice you are sure to receive about this from your own (or Dad's) doctor. Ulcers of the feet in diabetics are a frequent occurrence, and special attention to a few details are necessary to prevent recurrence. Diabetics suffer from two complications of their disease, arterial disease which interrupts the flow of blood to the feet, and nerve disease which reduces their feeling of minor blows and cuts to their feet. They can't sense the discomfort of a tight or poorly fitting shoe, for example, and ulcers frequently get a foothold (no pun intended) before they are discovered. Once established they require treatment that will combat the infection, help return the blood flow to a maximum, and eliminate any pressure to the susceptible skin of the feet. Since many diabetics try to reduce their blood sugar through restriction in diet, their nutrition may be faulty and must also be corrected. Once ulcers are eliminated, prevention is the order of the day. Patients must be educated to carefully inspect their feet each day and promptly report any signs of redness or cuts to their physician. In fact, in cases like your Dad's, a physician should examine the feet every three to six months for signs of injury. Feet should always be kept dry, and properly fitting shoes are a must, even if it means custom made insoles. Your Dad must never walk about the house barefooted, as this puts him at risk for cuts and bruises he may not feel. Let's hope your Dad is not a smoker, as this is a particular no-no for diabetics with arterial disease. Last but not least, strict control of blood sugar will help prevent the further occurrence of a nasty situation, diabetic foot ulcers. ---------------- The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician. Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.