Diabetes Foot Screening

When you were first diagnosed with diabetes, were you given instruction on how to take care of your feet on a daily basis? Chances are that you were given limited information in this very important area. The most common reason is because you and your health care professional were mainly focused on getting your blood sugar down to an acceptable range. I am a health care professional working in the diabetes education field and foot care is one area that I really stress when I talk to my clients with diabetes.

Why?

Because I have seen the damaging effects of poor foot care. These damaging effects include chronic foot ulcers that can lead to disability and in some cases, amputation. My goal is to educate as many people as I can about how to care for your feet. The more you know about foot care, the less chance you will have in developing foot ulcers now and in the future. This article is part of a series of information articles for people living with diabetes.

All persons with diabetes should examine their feet and practice daily care to prevent any problems. Those people that do screen and care for their feet on a daily basis greatly reduce their risk of foot complications.
What do you do when examining your feet?
- Look for cuts or sores
- Check for warning signs such as redness, swelling, warmth, pain, slow healing, dry cracks, bleeding corns or calluses, tenderness or loss of sensation
If you notice any cuts, sores or notice warning signs, contact your health care professional as soon as possible for advice as to how to treat the problem. This cannot be stressed enough. Not tending to a foot wound can quickly develop into a bad infection that sometimes can lead to a toe or foot amputation in a person with diabetes.

Screening for foot problems ensures that early warning signs of trouble are dealt with in a timely manner. The person with diabetes should be examining his or her feet on a daily basis. If a person has vision problems, is morbidly obese or is otherwise unable to personally inspect his or her feet daily because of disability, he or she should have a family member/significant other check their feet for them.

Daily care of your feet include:

- Washing your feet daily and drying them carefully, especially between the toes.
- If your feet perspire, use a slight sprinkle of talcum powder between the toes.
- Do not cut corns or calluses. Have a foot care specialist do this for you.
- Keep toenails trimmed and smooth.
- Promptly treat dry skin with lotion being careful not to get the lotion between the toes.
- Keep your blood sugar levels under control

It is important to have a comprehensive foot inspection done by a health care professional. This foot inspection should be performed at least annually in all people with diabetes, starting at puberty and more frequently for those at high risk. Examination of the feet includes assessment of structural abnormalities (i.e. hammertoes), neuropathy (loss of protective sensation), vascular disease, ulcerations and evidence of infection. A 10 gram monofilament may be used to assess sensation changes. The 10 gram monofilament test is otherwise known as a Semmes-Weinstein test.

The 10 gram Semmes-Weinstein monofilament test measures the sensitivity of the nerves in your feet. It is used to assess loss of sensory function when a nerve is damaged or injured. A monofilament is a thin piece of wire much like fishing line. It is touched to the patients toes until it bends. Without looking, the patient is asked to say when he or she feels the pressure. Monofilament testing can be used to find a loss of protective sensation and loss of deep pressure. With someone with no feeling in their toes and feet, he or she will not feel the pressure of the monofilament.
I hope that this article has been informative and has provided you with good guidelines to take care of your feet. If you take these guidelines and use them on a daily basis, my goal will have been accomplished and you will have been given the opportunity to live your life to the fullest.