Produced by The Alfred Workforce Development Team on behalf of DHS Public Health - Diabetes Prevention and Management Initiative June 2005 Best Feet Forward.
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Produced by The Alfred Workforce Development Team on behalf of DHS Public Health -
Diabetes Prevention and Management Initiative June 2005
Best Feet Forward
Footcare for People with Diabetes
Level 3
Module 4.1.2
DPMI Workforce Development – The Alfred Workforce Development Team June 2005
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
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
Overview of diabetes
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.
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Bloodstream
DPMI Workforce Development – The Alfred Workforce Development Team June 2005
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.
PancreasPancreas
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insulin
Muscle
DPMI Workforce Development – The Alfred Workforce Development Team June 2005
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.
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Bloodstream
DPMI Workforce Development – The Alfred Workforce Development Team June 2005
Common types of diabetes
Type 1 Type 2Age of onset Usually <40 Usually >40Body weight Lean Usually obeseProne to ketoacidosis
Yes No
Medication Insulin essential
Tablets and /or insulin
Onset of symptoms
Acute Gradual (may be asymptomatic)
DPMI Workforce Development – The Alfred Workforce Development Team June 2005
Treatment goals
Symptom freePrevent short term complicationsPrevent long term complicationsQuality of life = Lifestyle focus
DPMI Workforce Development – The Alfred Workforce Development Team June 2005
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
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
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
Assessment and awareness
Always be aware of High Risk Feet Loss of feeling Poor blood supply Past history of foot
ulcerSource: Footcare in
Diabetes Workbook for Health Professionals. Australian Diabetes Educators Association
DPMI Workforce Development – The Alfred Workforce Development Team June 2005
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
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
Caring for the feet
Keep the skin soft and smoothRub 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
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
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
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
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
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
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
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
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
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
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
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
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