According to figures from the International Diabetes Federation, this disease has been responsible for 7 million deaths in the world during 2021. More than those registered by Covid-19 in the same period. Those who suffer from this disease are at risk of partial or total amputations of their feet, due to poor care or lack of access to professional health care.
“Diabetic foot occurs when there are altered levels of glucose in the blood, as a result of poorly controlled diabetes, which is why a progressive disorder is generated that causes complications in the arteries that supply the foot, leading to sensitivity problems, atrophy in skin and plantar ulcers, among other ailments”comments Yasica Doy, Director of Limablue, a comprehensive foot care center, with treatments in podiatry, orthopedics and baropodometry.
Something that further aggravates this scenario is that, according to the WHO (2013), 44% of people with diabetes in the world do not know it. In Peru, according to data from the INEI Demographic and Family Health Survey (Endes), by 2020, 4.5% of Peruvians aged 15 or older have diagnosed diabetes.
In this sense, from Limablue, the first center specialized in foot care in Peru, they share 4 recommendations for proper diabetic foot care.
1.- CARRY OUT A DAILY INSPECTION: It is important that every person diagnosed with diabetes or pre-diabetes carry out a daily visual inspection of their feet, using a mirror on the floor, to detect any observable abnormality, such as a change in color, textures, blisters, etc. Especially in neuropathic patients (without sensitivity). Likewise, biomechanical evaluations should be carried out to find out if there are possible foot injuries (bunions, claw toes, flat feet or pes cavus, etc.)
In this way, they will be able to seek professional help to avoid any aggravation of the problem and maintain healthy feet.
2.- HAVE PERMANENT PROFESSIONAL ATTENTION: Attention with ingrown nails, foot ulcers are the most common complications in people suffering from diabetes. 70% of foot problems could be solved with the Primary Care of a Podiatry professional, without going to the hospital, and 80% of amputations could be avoided, according to figures from the Official College of Podiatry of the Community of Madrid – Spain.
3.- MAINTAIN DAILY HYGIENE: Feet should be kept clean by washing them daily with warm soapy water. You should not soak your feet, much less with hot water. For drying the feet it is better to use a paper towel. Carry out a thorough drying, making an effort to eliminate moisture from the interdigital area. It is recommended to do it by contact, avoiding friction as much as possible and paying special attention to the interdigital areas.
4.- ATTENTION TO STOCKINGS AND SHOES: It is recommended to use cotton, thread or wool stockings (in no case synthetic material) without sewing and in white, to be able to see if the person has any wound and should visit the specialist. Use a comfortable and wide shoe according to your type of foot, where the fingers have slack and are well protected. Before putting on the footwear, check that the inside of the shoe does not have any object that could cause an injury or chafing.
5.- IT IS IMPORTANT TO REMEMBER: Anyone diagnosed with diabetes should have the following tests done by a podiatrist:
* Monofilament: Sensitivity test to determine neuropathy.
* Thermosensitive Test: Test to determine sensitivity by temperature.
* Tuning Fork Test: Test to evaluate vibration sensitivity
* Pathophysiological evaluation of the foot: Examination of exploration of diseases that contribute to the appearance of a wound such as toenails, calluses, chicken eyes, bunions, among others.
* Baropodometry Test: Footstep test, with this test the overloads or excess pressure in some part of the foot that can generate the appearance of a wound will be evaluated. In addition, with this test you can see if any part of the foot is at risk of generating one.