How To Care Foot In Diabetes?

How To Care Foot In Diabetes
Tips for Healthy Feet – Get to the bottom of any foot problems by using a mirror or asking for help. Check your feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or any other change to the skin or nails. Use a mirror if you can’t see the bottom of your feet, or ask a family member to help.

  • Wash your feet every day in warm (not hot) water.
  • Don’t soak your feet.
  • Dry your feet completely and apply lotion to the top and bottom—but not between your toes, which could lead to infection.
  • Never go barefoot.
  • Always wear shoes and socks or slippers, even inside, to avoid injury.
  • Check that there aren’t any pebbles or other objects inside your shoes and that the lining is smooth.

Wear shoes that fit well, For the best fit, try on new shoes at the end of the day when your feet tend to be largest. Break in your new shoes slowly—wear them for an hour or two a day at first until they’re completely comfortable. Always wear socks with your shoes.

Trim your toenails straight across and gently smooth any sharp edges with a nail file. Have your foot doctor (podiatrist) trim your toenails if you can’t see or reach your feet. Don’t remove corns or calluses yourself, and especially don’t use over-the-counter products to remove them—they could burn your skin.

Get your feet checked at every health care visit, Also, visit your foot doctor every year (more often if you have nerve damage) for a complete exam, which will include checking for feeling and blood flow in your feet. Keep the blood flowing. Put your feet up when you’re sitting, and wiggle your toes for a few minutes several times throughout the day.

Should you moisturize diabetic feet?

Moisturizing Tips for Diabetic Feet – Using a daily moisturizer on your feet can not only leave them looking great but will also keep them healthy. Moisturizer can soothe the skin, relieve aching feet, and provide hydration to dry areas of the feet. There are several tips to consider when choosing and using a moisturizer for your diabetic feet. These include:

Why is foot care so important for diabetics?

This is because diabetes damages your nerves and reduces blood flow (circulation) to your feet, which can cause serious foot problems. About 1 in 5 people with diabetes who go to the hospital do so for foot problems. But if you inspect and take care of your feet every day, you can prevent many of these problems.

Can you heal diabetic foot?

Wound Care – As your doctor cleans and disinfects the ulcer, he or she also removes any dead tissue surrounding it. After the wound is clean, the doctor applies bandages to keep the area sterile while it heals. Your doctor can show you how to clean and dress the wound at home and may recommend using a topical antibacterial ointment to help speed healing and prevent further infection.

Can a diabetic foot Be Saved?

Arguments against primary amputation –

Natural history of disease

The 5-year mortality in patients with diabetes and critical limb ischaemia is 30% and about 50% of patients with diabetic foot infections who have foot amputations die within five years, The mortality rate is similar to some of the most deadly cancers,

  1. Poor treatment can lead to lower extremity amputations.
  2. About half of these amputations can be prevented by proper care,
  3. It is vital that the diabetic condition in patients with infection is urgently controlled, otherwise the vicious cycle of infection leading to the instability of the diabetes and ketosis allows the spread of infection,

Patients with a severe infection should be hospitalized immediately as these are often imminently limb-threatening and, in some cases life- threatening, When all or part of a foot has dry gangrene, it may be preferable especially for a patient who is a poor surgical candidate to let the necrotic portions auto-amputate.

  • It may also be best to leave adherent eschar in place, especially on the heel, until it softens enough to be more easily removed, provided that there is no underlying focus of infection,
  • Wet gangrene develops if infection supervenes and this spreads rapidly leading to a severely compromised limb, systemic sepsis and death if there is no intervention,

However, the required emergency amputation still carries a high mortality of up to 50% because of severe sepsis and the effects of tissue necrosis,

2. Assessment and treatment

The diabetic patient presenting with a foot wound should be assessed at three levels- the patient as a whole, the affected limb and foot and the infected wound, The affected limb and foot should be assessed for arterial ischaemia, venous insufficiency, presence of protective sensation, and biomechanical problems.There may be an obvious large wound or ulcer associated with erythema and pyrexia.

  • The presence of any exposed bone and ulcer larger than 2 cm increase the likelihood of osteomyelitis,
  • It is suspected in a patient with an adequate blood supply to the affected foot that has a deep ulcer which would not heal after 6 weeks of appropriate wound care and off-loading,
  • Some diabetic patients who develop neuropathies or osteomyelitis but with little arterial disease may often benefit from surgical debridement or excision and/or prolonged antibiotic therapy for at least 4 weeks, based on the culture and sensitivity of biopsied bone tissue or the curettage of deep tissues,

Swab specimens, especially of incompletely debrided wounds provide less accurate results, It is important to distinguish between the ischaemic and the neuropathic foot with respect to management although these factors may co-exist, The neuropathic foot is characterized by warm, dry, bounding pulses as a result of peripheral vasodilatation, callosities, painless penetrating ulcers at pressure points and sites of minor injury, painless necrosis of toes, spreading infection along plantar spaces, general loss of pain and thermal sensation, decrease ankle jerk reflex, tone and power,

3. Diabetic foot infection

Diabetic foot infections typically begin in a neuropathic ulceration. An infected diabetic foot with good blood supply would respond to debridement, In neuropathic foot, severe infection is treated with intra-venous antibiotics in hospital and, antiseptics and dressings for ulcers.

Necrotic tissue is removed and conservative digital amputations or filleting is sufficient.The surgical approach would optimize the likelihood for healing while attempting to preserve the integrity of the walking surface of the foot, Specialised footwear is used to reduce weight bearing, In ischaemic foot infection is treated by debridement (cleaning the wound, removing pus, dead necrotic tissue and infected bone),

While all wounds are colonized with microorganisms, the presence of infection is defined by findings of inflammation or purulence, There are usually complex polymicrobial infections, but aerobic gram positive cocci is a vital part of diabetic foot infection.

A broad-spectrum intra- venous antibiotic and metronidazole for anaerobes are recommended. Antibiotics can usually be discontinued once the clinical signs and symptoms of infection have resolved usually 1–2 weeks for mild infection and 2–3 weeks for moderate to severe infection, and not until the wound has healed.

This is to avoid resistance, If the wound is not easily debrided varidase dressing is used, and inadine or granuflex dressing would promote granulation, The use of topical antimicrobials for most clinically uninfected wounds is not advocated for lack of evidence substantiating the benefit over conventional wound care therapy,

  1. Several recent systematic reviews have suggested that silver-containing dressings and topical silver were neither better nor worse than control dressings in preventing wound infection and prolong healing,
  2. New techniques for wound debridement include low frequency ultrasound therapy, hydrosurgery, monofilament polyester fibre pad and plasma-mediated bipolar radiofrequency ablation,
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Skin grafting when no infection is present may be required, The diabetic foot infection classification system (Table 2 ), along with a vascular assessment, would help determine which patients should be hospitalized, which may require special imaging procedures or surgical interventions including amputation,

4. Revascularisation

As diabetes is chronic and progressive, it makes sense to have a conservative surgical approach that include surgical revascularization, A successful surgical bypass of larger vessel disease may enable more conservative treatment of the diabetic foot. Revascularisation is, however, considered inappropriate in bedridden patients, in a functionally useless limb, in patients with life threatening sepsis, extensive muscle necrosis and where it is technically impossible. Primary amputation is better in these cases, A percutaneous transluminal angioplasty (PTA) and luminal stenting or arterial reconstruction to improve blood flow would aid healing, Because in most cases ischaemia is secondary to larger vessel artherosclerosis rather than to ‘small vessel disease’, vessels above the knee and below the ankle tend to be relatively spared. Thus lower extremity artherosclerosis can be amenable to angioplasty or vascular bypass, The indications for a PTA in diabetic peripheral arterial disease are classically for disabling claudication and critical limb ischaemia, Patients with non-critical ischaemia (ankle/brachial pressure index (ABPI- 0.4-0.9) can in some cases be successfully treated without a vascular procedure, Although the prevalence of ABI <0.9 in individuals with normal glucose tolerance was 7% and increased to 20.9% with diabetes, care should be taken when interpreting ABPI in diabetics, Arterial calcification of the vessel media renders the vessels incompressible and causes false ‘high' readings. Toe pressure measurements may be of value. Revascularization by percutaneous transluminal angioplasty (PTA) of short segment disease was feasible in more than 96% of diabetics with critical limb ischaemia (ankle systolic pressure of less than 50 mmHg or the toe pressure of less than 30 mmHg), Many centres have reported successful use of both aggressive endovascular interventions and distal bypass procedures for more severe vascular disease of the foot. The short-term effects are satisfactory with healing of the foot ulcers and thus diminishing the risk of amputation. However, follow-up is required to ascertain the long-term effects, The feasibility with bypass prosthetic grafting (BPG) is lower but consistent, Studies strongly suggest that early recognition and aggressive surgical drainage of pedal sepsis followed by surgical revascularization is critical to achieving maximal limb salvage of 74% at 5 years in the high risk population, The risks of unsuccessful revascularization leading to limb loss must be weighed against the benefits and the patient informed. However, careful debridement of necrotic, infected diabetic foot wound should not be delayed while awaiting revascularization, Aggressive attempts at foot salvage are justified in diabetic patients with advanced forefoot tissue loss/infection. After procuring adequate arterial tissue perfusion, a less conservative transtarsal (mid-foot) amputations salvaged over half of non-healing transmetatarsal amputations with excellent functional results,

5. Postoperative sepsis

Smokers, older patients with longer history of uncontrolled diabetes, and those with gangrenous infections and large ulcers have poorer outcome with amputations, Many patients are elderly with impaired continence and poor hygiene and as a number carry Clostridium perfringens in their stools post operative mortality from gas gangrene is high,

6. Postoperative amputation pain and rehabilitation

Post- operative amputation pain is mostly due to phantom limb pain (54%) and phantom limb sensation (90-98%), Phantom limb pain usually continues for more than six months whereas phantom limb sensation (except pain) usually disappears or decreases with time.

The true mechanism is not known but many theories overlap a peripheral, spinal and central mechanism. The successful treatment of phantom limb pain is thus difficult and treatment is usually combined and multiple based on the person’s level of pain. These include biofeedback to relieve muscle tension, physical therapy, surgery to remove scar tissue entangling a nerve, transcutaneous electrical nerve stimulation (TENS) of the stump, neurostimulation techniques, medications such as analgesics, neuroleptics, anticonvulsants, antidepressants, beta -blockers and sodium channel blockers,

The patient must therefore be properly prepared for surgery psychologically with time being spent on assessment by the physiotherapist and reassurance and encouragement being provided by the surgeons, ward nurses or a successful amputee. The patient should be encouraged to spend periods lying prone to help keep the knee straight post-operatively and avoid fixed flexion deformity.

  • The level of amputation may have to be high enough to ensure adequate healing of the stump,
  • Above Knee amputation (AKA) or ‘transfemoral amputation’ is associated with a much poorer outcome because these patients are more often unwell than those needing a below knee or ‘transtibial amputation’ (BKA).

Although AKA is more likely to heal, rehabilitation is less successful, Most elderly patients are not psychologically prepared and rehabilitation is an up-hill task.

Can Vaseline be used on diabetic feet?

Everyday DOs and DON’Ts to protect your feet – Even if you don’t have foot problems now, you still need to care for your feet. Daily foot care is the best way to prevent problems — or to catch problems early, before they become serious.

DO wash your feet every day. Use warm water, not hot water, and dry your feet carefully afterwards. Make sure the skin between your toes is dry. but DON’T soak or scrub your feet. People with diabetes have fragile skin, and soaking and scrubbing can cause the skin to break down. DO check your feet carefully every day. If you need to, use a hand mirror to look at the bottom of your feet — or ask a family member to help check. Remember to look between your toes, too. Look for any of these problems:

cuts or scratches blisters or irritated skin cracks or very dry skin calluses or corns puffy, cold, or red feet

DO prevent and treat dry skin. Use unscented lotion or petroleum jelly (Vaseline) on your feet, though not between your toes. Diabetes can cause very dry skin, which in turn can cause cracking and other problems. but remember, DON’T put lotion or Vaseline between your toes. Extra moisture there can lead to infection. DO gently care for your feet and toenails. The best time for this is after you wash your feet. Use a pumice stone to keep calluses under control. Keep your toenails trimmed straight across and use an emery board to smooth the edges. but DON’T use razors, scissors, or harsh chemicals on your feet. To get rid of corns, warts, or stubborn calluses, see a doctor or other professional. DO always wear shoes or slippers with good soles that support and protect your feet. Remember, even a small foot injury can become serious for a person with diabetes. Wearing shoes is smart prevention. and DON’T go barefoot, even indoors. Headed to the bathroom in the middle of the night? Wear slippers. DO choose comfortable, close-toed shoes. Make sure that new shoes are roomy enough to wiggle your toes. Avoid shoes that rub, pinch, or slip — and break in new shoes gradually. You don’t want to get blisters. and DON’T wear plastic shoes, flip-flops, high heels, or point-toed shoes. DO inspect your shoes for rough, worn, or sharp internal parts. Your foot may not feel a problem with your shoe. DO wear clean, thick-soled socks that fit smoothly and are made of a “breathable” material. Wearing shoes without socks can invite blisters. but DON’T wear socks with holes in them, or socks that have been mended. These may have rough areas that will irritate your skin.

What ointment is good for diabetic feet?

Clotrimazole –

Clotrimazole is one of the most effective ointments for preventing and treating infections in diabetic foot ulcers. It belongs to a class of medicines called Imidazoles. This is an antifungal ointment that works by stopping the growth of infection-causing fungi. Clotrimazole is available under brand names like Fungoid, Lotrimin, etc.

    What are signs of diabetic feet?

    Signs of Diabetic Foot Problems Swelling in the foot or ankle. Pain in the legs. Open sores on the feet that are slow to heal or are draining. Ingrown toenails or toenails infected with fungus.

    What can I soak my diabetic feet in?

    You can make an Epsom foot bath by adding one cup of Epsom salts to a tub of warm water. Soak your feet in this mixture for around twenty minutes for relief.

    What can diabetics not do?

    Don’t –

      Patients who are on insulin or oral hypoglycemic agents should not fast, because it may result in hypoglycemia (low blood sugar levels). They should not skip a meal assuming that it can be made up by consuming extra food at the next meal. This may result in low blood sugar and also blood glucose fluctuations which leads to microvascular complications. Do not eat white bread, chips, and pastries, which quickly increase blood sugar. Avoid processed foods and meats as they will be rich in salt and oil. Restrict fried and fatty foods. Do not take full fat dairy products. Alcohol increases blood pressure and triglycerides and heavy drinking weakens the heart muscle (cardiomyopathy). In excess, it affects the liver and peripheral nerves. Do not use artificial sweeteners beyond the recommended quantity. If possible get used to tea/coffee without sugar gradually. Do not exercise on empty or full stomach. Do not watch TV while eating food. Do not smoke. Do not miss your medication.

    Is diabetic foot serious?

    How does diabetes cause foot problems? – Foot problems are common in people with diabetes. They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called, can cause numbness, tingling, pain, or a loss of feeling in your feet.

    1. If you can’t feel pain, you may not know when you have a cut,, or ulcer (open sore) on your foot.
    2. A wound like that could get infected.
    3. The infection may not heal well because the damaged blood vessels can cause poor blood flow in your feet.
    4. Having an infection and poor blood flow can lead to,
    5. That means the muscle, skin, and other tissues start to die.

    If you have gangrene or a foot ulcer that does not get better with treatment, you may need an, This is a surgery to cut off your damaged toe, foot, or part of your leg. It may prevent a bad infection from spreading and could save your life. But there’s a lot you can do to prevent a foot wound from becoming a major health problem.

    Is walking good for diabetic foot pain?

    Introduction – Peripheral neuropathy is a common complication of diabetes 1, The prevalence of diabetic neuropathy is approximately 50% in patients with longstanding disease 2, 3, Hyperglycemia is a key factor underlying diabetic neuropathy because it leads to the accumulation of advanced glycation end products (AGEs), which damages intra-epidermal nerve fibers (IENF) and provokes pain 4, 5, 6,

    In diabetic condition, aerobic exercise such as walking is commonly recommended to improve glucose control and reduce microvascular and macrovascular complications 7, 8, Walking exercise can decrease both hyperglycemia-induced damage to nerve cells and neuronal ischemia caused by impaired neurovascular flow in diabetes 9, 10,

    However, the effects of walking exercise on diabetic neuropathic symptoms are known to vary according to intensity 11, Moreover, in diabetes, microvascular reactivity in response to extrinsic mechanical stress is impaired, and land-based endurance exercise can harm peripheral nerves 9,

    • Therefore, it is clinically important to understand the effect of mechanical loading on the development of diabetic neuropathic symptoms.
    • Diabetic neuropathic symptoms appear in the distal portions of the extremities, most commonly beginning in the feet before the fingers become involved 3, 12,
    • A length-dependent dying back process and fiber-dependent axonopathy (longer fibers are more vulnerable to injury) might be related to this phenomenon 12,

    Diabetic nerves also have increased susceptibility to extrinsic stress and are more vulnerable to ischemic damage than non-diabetic nerves 13, 14, However, why diabetic neuropathy occurs most commonly in the feet remains unclear. We hypothesized that mechanical overloading on feet during excessive walking could precipitate neuropathic foot pain, especially in diabetic conditions.

    How can I treat diabetic feet at home?

    Tips for Healthy Feet – Get to the bottom of any foot problems by using a mirror or asking for help. Check your feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or any other change to the skin or nails. Use a mirror if you can’t see the bottom of your feet, or ask a family member to help.

    Wash your feet every day in warm (not hot) water. Don’t soak your feet. Dry your feet completely and apply lotion to the top and bottom—but not between your toes, which could lead to infection. Never go barefoot. Always wear shoes and socks or slippers, even inside, to avoid injury. Check that there aren’t any pebbles or other objects inside your shoes and that the lining is smooth.

    Wear shoes that fit well, For the best fit, try on new shoes at the end of the day when your feet tend to be largest. Break in your new shoes slowly—wear them for an hour or two a day at first until they’re completely comfortable. Always wear socks with your shoes.

    • Trim your toenails straight across and gently smooth any sharp edges with a nail file.
    • Have your foot doctor (podiatrist) trim your toenails if you can’t see or reach your feet.
    • Don’t remove corns or calluses yourself, and especially don’t use over-the-counter products to remove them—they could burn your skin.

    Get your feet checked at every health care visit, Also, visit your foot doctor every year (more often if you have nerve damage) for a complete exam, which will include checking for feeling and blood flow in your feet. Keep the blood flowing. Put your feet up when you’re sitting, and wiggle your toes for a few minutes several times throughout the day.

    Is hot water good for diabetic feet?

    What things should I avoid to care for my feet? –

    Don’t use any instruments on your feet (except nail clippers) without your doctor’s advice. Don’t cut calluses or corns, or use medicine to remove them, unless your doctor tells you it’s okay. Don’t soak your feet. Don’t use hot water, a heating pad or a massager on your feet. Don’t go barefoot. Don’t use adhesive tape or chemicals on the skin of your feet. Don’t put inserts or pads in your shoes without your doctor’s advice. Don’t walk in wet shoes. Don’t place your feet on cold or hot surfaces. Don’t use any tobacco products—they affect blood flow in ways that are especially dangerous to people with diabetes.

    Why can’t diabetics soak their feet?

    Take care of your feet. – When you have diabetes, caring for your feet is very important in avoiding serious foot complications. Take care of your feet by doing the following:

    Wash your feet thoroughly everyday Dry them thoroughly, and don’t forget to dry between your toes Moisturize your feet, but avoid moisturizing between your toes Keep your toenails trim, and use an emery board to file down sharp edges Check your feet for sores, cuts, blisters, corns, or redness daily. Let your doctor know if you find any of these. Wear moisture-wicking socks Before putting your shoes on, check for sharp objects (i.e. small rocks) Wear shoes that fit well and don’t rub your feet

    While you’re at it, avoid these:

    Don’t walk around barefoot Don’t soak your feet

    Although it can hurt, diabetic nerve damage can also lessen your ability to feel pain, heat, and cold. Loss of feeling often means you may not feel a foot injury. You could have a tack or stone in your shoe and walk on it all day without knowing. You could get a blister and not feel it.

    1. You might not notice a foot injury until the skin breaks down and becomes infected.
    2. Nerve damage can also lead to changes in the shape of your feet and toes.
    3. If your foot doesn’t fit comfortably in regular shoes, ask your doctor about special therapeutic shoes or inserts, rather than forcing your feet and toes into shoes that don’t fit and can cause more damage.

    Diabetes can cause changes in the skin of your foot. At times your foot may become very dry. The skin may peel and crack. This problem is caused by nerve damage that affects your body’s ability to control the oil and moisture in your foot. After bathing, dry your feet and seal in the remaining moisture with a thin coat of plain petroleum jelly, an unscented hand cream, or other such products.

    Do not put oils or creams between your toes. The extra moisture can lead to infection. Also, don’t soak your feet—that can dry your skin. Calluses occur more often and build up faster on the feet of people with diabetes. This is because there are high-pressure areas under the foot. Too much callus may mean that you will need therapeutic shoes and inserts.

    Calluses, if not trimmed, get very thick, break down, and turn into ulcers (open sores). Never try to cut calluses or corns yourself—this can lead to ulcers and infection. Let a health care professional on your diabetes care team cut your calluses. Also, do not try to remove calluses and corns with chemical agents.

    1. These products can burn your skin.
    2. Using a pumice stone every day will help keep calluses under control.
    3. It is best to use the pumice stone on wet skin.
    4. Put on lotion right after you use the pumice stone.
    5. Poor circulation (blood flow) can make your foot less able to fight infection and to heal.
    6. Diabetes causes blood vessels of the foot and leg to narrow and harden.

    You can control some of the things that cause poor blood flow. Don’t smoke; smoking makes arteries harden faster. Also, follow your diabetes care team’s advice for keeping your blood pressure and cholesterol under control. If your feet are cold, you may want to warm them.

    • Eep aware that, unfortunately, if you have nerve damage, your feet may not be able feel heat properly and it is easy for you to burn them with hot water, hot water bottles, or heating pads.
    • The best way to warm cold feet is to wear warm socks.
    • Some people feel pain in their calves when walking fast, up a hill, or on a hard surface.

    This condition is called intermittent claudication. Stopping to rest for a few moments should end the pain. If you have these symptoms, you must stop smoking. Work with your diabetes care team to get started on a walking program. Some people can also be helped with medication to improve circulation.

    • Exercise is good for poor circulation.
    • It stimulates blood flow in the legs and feet.
    • Walk in sturdy, comfortable shoes that fit comfortably, but don’t walk when you have open sores on your feet.
    • Ulcers occur most often on the ball of the foot or on the bottom of the big toe.
    • Ulcers on the sides of the foot are usually due to poorly fitting shoes.

    Remember, even though some ulcers do not hurt, every ulcer should be seen by your doctor right away. Neglecting ulcers can result in infections, which in turn can lead to loss of a limb. What your doctor will do varies with your ulcer. Your doctor may need to take x-rays of your foot to make sure the bone is not infected.

    The ulcer may also need to have any dead and infected tissue cleaned out. You may need to go into the hospital for this cleaning. Also, a culture of the wound may be used to find out what type of infection you have and which antibiotic will work best. Keeping off your feet is very important. Walking on an ulcer can enlarge it and force the infection deeper into your foot.

    Your doctor may put a special shoe, brace, or cast on your foot to protect it. If your ulcer is not healing and your circulation is poor, you may be referred to a vascular surgeon. Managing diabetes is important since high blood glucose (blood sugar) levels make it hard to fight infection.

    After a foot ulcer heals, treat your foot carefully. Scar tissue from the wound will break down easily. You may need to wear special shoes after the ulcer is healed to protect this area and to prevent the ulcer from returning. People with diabetes are far more likely to have a foot or leg amputated than other people.

    The problem? Many people with diabetes have peripheral artery disease (PAD), which reduces blood flow to the feet. Also, many people with diabetes have neuropathy, causing you to not feel your feet. Together, these problems make it easy to get ulcers and infections that may lead to amputation.

    Most amputations are preventable by checking your feet daily, go to regular visits with your doctor, and wear proper footwear. For these reasons, take good care of your feet and see your doctor right away if you see any signs of foot problems. Ask about prescription shoes that are covered by Medicare and other insurance.

    Always follow your doctor’s advice when caring for ulcers or other foot problems. One of the biggest threats to your feet is smoking. Smoking affects small blood vessels. It can cause decreased blood flow to the feet and make wounds heal slowly. A lot of people with diabetes who need amputations are smokers.

    Why can’t diabetics use foot spas?

    Pedicure Risks for Diabetic Patients –

    Poor circulation, Diabetes can cause a lack of or reduced blood flow, resulting in poor circulation. If you suffer a wound from a sharp tool during a pedicure, poor circulation can make it slow to heal. Diabetic neuropathy, Diabetes can cause diabetic neuropathy or nerve damage, resulting in reduced sensation. When you can’t feel sensation in your feet, you may not be aware of a cut or other injury until it becomes infected. Fungal infection, If a salon uses tools that aren’t sterile or the environment isn’t properly sanitized, you are at risk for a fungal infection. Having diabetes can make it difficult to treat fungal infections, leading to more severe problems. Ingrown toenails, If a toenail is cut too short during a pedicure or is not trimmed straight across, it can become ingrown. For those with diabetes, ingrown toenails can easily lead to an infection. When infection occurs, surgery will be necessary (like in the video below) to help rectify the concern.

    If you are diabetic and develop an infection, it can spread to surrounding tissue or bone. If the infection cannot be controlled, it can lead to gangrene or require amputation to save your life.

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