Best Feet Forward

1. 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

2. 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

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

4. G G G G G 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 G G G G DPMI Workforce Development – The Alfred Workforce Development Team June 2005

5. 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. G G Muscle G G insulin Pancreas DPMI Workforce Development – The Alfred Workforce Development Team June 2005

6. 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 G G G G G Bloodstream G G G DPMI Workforce Development – The Alfred Workforce Development Team June 2005

7. Common types of diabetes DPMI Workforce Development – The Alfred Workforce Development Team June 2005

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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