$Unique_ID{BRK00955}
$Pretitle{Endocrine Glands and Metabolism, Skin and Subcutaneous Tissue}
$Title{How Can Ulcers of the Feet in Diabetics Be Prevented?}
$Subject{diabetes ulcers foot}
$Volume{C-20, L-20}
$Log{
Figure 1*0009801.scf
Figure 2*0009802.scf
Figure 3*0009803.scf}

Copyright (c) 1991   Tribune Media Services, Inc.


How Can Ulcers of the Feet in Diabetics Be Prevented?


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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?

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ANSWER:  Several, and I hope they fit in with the advise 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 Dads, 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.  Lets 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.
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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.
