1 | 2

The American Diabetes Association reports that 15% of all people with diabetes will eventually develop ulcers, and that these ulcers frequently become infected. These ulcers, which may start out as a blister or callous, or simply a reddened area, are because of a gradual loss of nerve function in the feet - also known as a neuropathy . Frequently seen in diabetes, this neuropathy comes on slowly, and is therefore hard to recognize early. People with this neuropathy may experience tingling, numbness, shooting pains, burning sensations, "pins and needles", a combination of these, or, most worrisome, few symptoms at all except the gradual loss of protective sensation (the ability to feel things that may cause blisters, ulcers, etc.). With neuropathy you may be able to feel touch, but not pain.

The following suggestions should help minimize the possibility of developing ulcers in people with diabetes:

• Inspect feet daily, watching for blisters, cracks, calluses, inflammed areas, fungus infection, signs of shoe pressure, signs of injury such as cuts and bruises, and skin breakdown between the toes.
• Calluses are signs of increased pressure. They occur about bony prominences. If they occur, consult your doctor so that ulcers do not develop.
• Have your doctor examine your feet at each visit. Be sure that anyone caring for your feet knows that you are a diabetic. (This includes the shoe salesman).
• Wash feet daily with mild soap in tepid water. Dry carefully, expecially between the toes. Blot to dry, do not rub.
• Do not use chemical agents for removal of corns and calluses. Check with your doctor. Use pumice stone and other simple techniques for reducing calluses.
• File the toenails straight across. Do not curve into the nail grooves. Do not dig into the corners or along the grooves.
• Do not use scissors. If nails are too thick for a straight pocket clipper, consult your doctor. Do not use a knife or razor blade.
• Do not use adhesive tape on your feet.
• Do not walk barefoot on hot surfaces like hot sandy beaches or cement around swimming pools.
• Do not wear shoes without stockings.

1 | 2