May 14, 2010

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

Have you heard Trevor on the radio? Listen to 730 CKDM Tuesday Mornings at 8:35 am! We now have most of the articles published in the Parkland Shopper on our Website www.dcp.ca

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

So is there any such thing as a diabetic shoe? My parents are snowbirds. Every winter they go down to Texas. They got back recently, and we were catching up on the phone. While down south my dad was out walking, and saw an ad for diabetic shoes in a pharmacy window. It sounded like a scam to him, but I told him foot care was actually very important for diabetics.

I often talk about the big 4 problems in diabetes. The big 4 are: heart attack and stroke, blindness, kidney disease and amputation. I call these the big 4 because diabetics sometimes ask, Why do I have to test my blood sugar, take my medications, watch my diet and exercise. I feel fine. The answer is although a diabetic may feel okay, if they keep their blood sugar down and look after themselves, hopefully they can avoid these big 4 problems.

Diabetes is considered the leading, non-traumatic cause of amputation. The part of the body most likely to be amputated in diabetics are the feet. Unfortunately, over the years in the pharmacy I have seen many diabetics that I've known get their feet amputated. Some people with an extra dose of misfortune had more and more of their foot and leg amputated in several consectutive operations. So, not to scare you, but foot care in diabetics is deadly serious.

Why are diabetics so prone to foot problems? Well diabetes works against the feet in a couple of ways. Over time diabetes can damage nerves. If those are sensory nerves from the feet, a diabetic can't feel things that poke, scrape, or pinch their feet. We call that diabetic neuropathy. This lack of feeling in the feet makes it more likely that a diabetic wont feel small injuries like blisters or scrapes. So these small injuries can go unnoticed and thus untreated. Which brings us to the second problem working against the diabetic foot. Many diabetics have poor circulation due to the damage diabetes has done to their blood vessels. Less blood to the foot makes it less able to heal after an injury and less able to fight off an infection if one occurs. So diabetics are less likely to notice an injury to their feet and so they are more likely to leave it untreated. That untreated injury is less likely to heal than in a non-diabetic foot and is more likely to get infected. So diabetics are more prone to foot problems.

What can diabetics do to help protect their feet? Start by looking at you feet everyday. Get into the routine of inspecting your feet everyday to make sure there are no cuts, cracks, ingrown toenails or other problems. Get a small mirror to look at the bottom of your feet. When possible, wear white socks. Any blood or other drainage from sores you may not have noticed will show up well on a white sock. Cut your toenails straight across, not too short and file the sharp corners. Do not do home surgery on corns, calluses, slivers or warts. Talk to your doctor about anything you want cut off your foot. The doctor may do it themselves or refer you to a diabetic foot care nurse. And speaking of your doctor, may sure they look at your feet at least once a year. I have even heard it suggested that you take off your shoes and socks on every visit to your doctor to encourage them to look at your diabetic feet as routinely as they would check your blood pressure and sugar.

So what about that diabetic shoe my dad saw advertised in Texas? Do they exist? Rather than just one diabetic shoe, it is more that there are certain characteristics that diabetics should look for in a pair of shoes. Shoes for diabetics should be supportive, and have low heels. Diabetics should not wear pointed toe shoes or shoes like sandals with open toes or heels. Diabetics should never go barefoot. It is recommended they have a pair of shoes to change into for walking around the house. And diabetics should make sure their shoes are fitted properly in a store where the staff are trained to professionally fit their feet.

Canadian Diabetes Association www.diabetes.ca

Canadian Footwear www.canadianfootwear.com

As always if you have any questions or concerns about these or other products, ask your pharmacist.


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