Diabetic foot health: everything is in your hands. Diabetes mellitus Is it possible to soar feet with diabetic feet?

Salt baths have been used since ancient times to improve the health of the body. Salt baths for diabetes are an integral part of therapy. Thanks to a pleasant procedure, the skin is cleansed, metabolic processes are normalized, and weight loss occurs. Although salt baths are not able to relieve the patient of the underlying ailment, they significantly improve well-being and reduce the risk of complications. But it is important to know what types of baths are useful for diabetes, and how to properly perform the balneological procedure.

The benefits of salt baths for diabetes

Rock salt (sodium chloride, sodium chloride, table, kitchen or table salt) is a source of nutrients needed by patients with diabetes. It contains sodium (Na), bromides, potassium (K), calcium (Ca), chlorine (Cl). Due to these elements, when using baths, table salt has a beneficial effect on the body:

Water with added salt cleanses the body of excess fluid and toxins.
Normalizes metabolism. Thanks to iodine and magnesium, it activates metabolic reactions at the cellular level.
Calms the nervous system.
Increases skin turgor by improving microhemodynamics (circulation) of blood.
Stimulates the regenerating properties of cells.
Reduces pain in the musculoskeletal system.
When salt enters the lesion through the skin pores, it relieves inflammation and relieves pain due to arthritis.
Restores water-salt balance.
Relieves muscle fatigue and swelling of the legs.

Salt baths increase the load on the heart, so you need to take them with caution.

Despite the positive effects of salt baths on the body, there are also negative effects of the procedure. In diabetes mellitus, salt baths enhance hemodynamics and the removal of toxins, which increases the load on the heart muscle. Therefore, you may feel unwell during the procedure. In this case, it is necessary to interrupt bathing for a while.

During breastfeeding, when taking the procedure, harmful substances are removed and distributed throughout the body. The possibility of toxins entering breast milk cannot be ruled out. In addition to the listed contraindications, there are the following situations when diabetes mellitus occurs:

oncology;
feverish conditions;
girls during menstruation;
pathologies of the hematopoietic system.

Effective recipes

The table shows the types of baths used for diabetes:

Name	Recipe	Notes	Effect
Classical	Dilute 0.5 kg of sea salt in 1 liter of water, add to the bath	If there is more, the skin will dry out, and if there is less, there will be no benefit.	Nourishes the skin with minerals and trace elements
			Normalizes metabolism
Coniferous	1 kg salt, 2 tab. dilute pine extract in 1 liter of warm water. Then pour the solution into the bath	-	Helps against cellulite
			Calms
Aroma bath	Dissolve 0.4 kg of sea salt in 1 liter of water, pour into the bath and add 1-2 drops of orange, tangerine, lavender, cypress, bergamot, rosemary oil.	Aroma oils are suitable for monotherapy, but you will need 5-6 drops	Helps in the fight against excess weight
			Normalizes metabolism
Cleansing	Dissolve 0.3 kg of salt and 0.2 kg of baking soda in 1 liter of warm water and add to the bath	Take for up to 10 minutes, but do not drink soda or green tea.	Restores water-electrolyte balance
			Has an anti-inflammatory effect
Anti-inflammatory	Pour 30 g of medicinal marigold flowers (calendula) with boiling water and leave for 20 minutes.	The procedure is especially useful for dry skin	Removes inflammation, skin becomes elastic and smooth
	Pour into the bath. 3 tbsp. l. honey, 0.3 kg of sea salt dissolve in a liter of water, pour into the bath

Before starting a course of healing procedures, patients with diabetes mellitus, both type 1 and type 2, require consultation with an endocrinologist. Allergic reactions to the components included in the bath are possible.
How to take it correctly?

The bath should be hot, not cool, as this will not achieve a state of relaxation.
To get the maximum effect from the procedure, you must follow simple rules for taking baths:
Perform hygiene procedures first.
Fill the bath with water with a temperature no higher than 38 degrees. You can take hot treatments, which will relax you. Cool ones have tonic properties.
Prepare the required volume of sea salt or its mixture. Dissolve the prepared composition in water.
Take a bath for no more than 20 minutes.
After the procedure, without showering, put on a robe or other comfortable home clothes. Within 1-2 hours, the salt mixture in a dry state will actively affect the body.
If desired, after completing the procedure, do self-massage, take a shower and apply a moisturizing or nourishing cream.
It is not advisable to take the procedure every day. A 2-day break is required between procedures. You can get the most benefit from a bath if you take it before bed.
The general course consists of 10-15 sessions. Then a break - 2 months.

Diabetes mellitus affects many organs and systems of the human body. Legs are one of the targets that the disease hits. Due to high sugar levels, irreversible changes occur in the nerves and vessels that supply blood to the feet. That is why proper foot care for diabetics is of great importance.

Causes of leg damage in diabetics

Diabetic nerve damage - neuropathy. Over time, under the influence of high sugar, the nerve endings of the feet are damaged. This leads to a disruption of sensitivity in them. A diabetic loses the ability to feel pain, pressure, temperature. The ability to feel pain is very important for a person, since pain warns of illness and danger. When this ability is lost, it is very easy to miss wounds or even ulcers on the legs. This is why diabetics’ legs do not hurt due to neuropathy, and they come to them late for treatment;
Diabetic vascular damage - angiopathy. With diabetes, the function of blood vessels throughout the body deteriorates. The small (peripheral) vessels of the legs are especially affected, this leads to impaired microcirculation and cell hypoxia. As a result, the skin of the legs of diabetics is very dry and inelastic. This pathological dryness is not relieved by moisturizing cream and causes cracks to appear, which can become infected. Wounds develop, which take a very long time to heal due to lack of microcirculation;
Diabetic joint damage is arthropathy. Impaired protein glucose metabolism leads to disruption of cartilage tissue and the development of hyperostosis. Therefore, diabetics often experience pain in the joints of their lower extremities, especially when walking. Arthropathy begins with swelling and redness of the foot. Over the years, deformation of the fingers appears, and pronounced swelling of the foot is observed. In severe cases, dislocations, subluxations, and fractures occur, as a result of which the foot shortens and widens.

In modern medicine, the entire variety of diabetic lesions is usually referred to by a single term – “diabetic foot”.

Manifestation of symptoms

There are many manifestations of diabetic foot damage. The patient may not attribute some of them to complications of diabetes, or even notice them. In view of this, every diabetic should know the symptoms of diabetic foot damage.

They are as follows:

dry skin that cannot be overcome with cream;
peeling and itching of the skin of the legs;
hyperpigmentation and depigmentation of the skin of the lower leg;
excessive callus formation (hyperkeratosis);
hair loss on the lower legs in men;
change in shape and thickening of nails;
swelling of the ankles;
the skin of the legs is pale and cold to the touch (rarely, on the contrary, bluish and warm);
fungal infection of the skin of the feet and nails;
numbness of the lower extremities;
leg pain;
violation of thermal, tactile and other types of sensitivity.

If you do not pay attention to the symptoms listed above in time, then severe consequences of diabetic foot damage occur.

Namely:

non-healing painless ulcers and wounds;
abscesses, phlegmons;
arthropathy;
osteomyelitis (bone suppuration);
gengrene.

Characteristics of leg pain due to neuropathy

Legs with diabetes mellitus hurt both when walking and at rest, especially bothering the patient at night. As a rule, they are of medium intensity, but over time they intensify and prevent the diabetic from leading his usual lifestyle. Pain is localized in the feet and legs, less often large joints hurt (with diabetic arthropathy). With this disease, in addition to the fact that the diabetic’s legs hurt, symptoms are also observed: cramps, tingling, numbness, weakness in the legs, decreased sensitivity, swelling of the legs.

The reasons for the symptoms described above can be different and are not always caused by the development of diabetes - this includes joint pathology, damage to nerves or blood vessels, venous disease, and osteochondrosis. To make a correct diagnosis and identify the true cause, the doctor necessarily recommends undergoing an examination.

Treatment for leg pain varies and depends on the primary disease. For example, drugs that are used to treat joint disease do not help relieve pain in the legs in diabetes.

Swelling of the legs in diabetes also has different causes. Diabetics often have concomitant heart disease, and, as is known, with heart failure, swelling of the feet and legs appears in the evening. Swelling can also be due to varicose veins of the lower extremities. Diabetic kidney damage is characterized by morning swelling of the legs.

Foot examinations for diabetes

It is very important to see a doctor on time to diagnose complications of diabetes. The patient can specifically examine the lower extremities in the “Diabetic Foot Room”. Where specially trained endocrinologists, vascular surgeons and nurses work.

Doctors diagnose the extent of damage to the legs, adjust diabetes treatment, and also prescribe specific treatment for neuro- and angiopathy. The nurses in this office teach patients proper foot care, perform hygienic treatment of the feet (cut off calluses, apply medicinal creams, etc.).

Be examined in the “Diabetic Foot Office” upon initial diagnosis of diabetes mellitus, then at least once a year if you feel normal.

Research carried out in the office:

examination, with mandatory checking of the pulse in the lower extremities;
checking neurological reflexes;
ultrasound examination of leg vessels;
testing pain, tactile, temperature and vibration sensitivity;
electroneuromyography.

Even a slight change in condition (the appearance of new symptoms) or slight inflammation on the skin of the legs is a reason to consult a doctor within 24 hours.

Attention and care

Caring for your feet with diabetes involves following a few simple but very important rules:

Every day, a diabetic needs to carefully examine his feet, especially the feet, soles, and spaces between the toes, using a mirror installed on the floor or with the help of loved ones. During the examination, it is necessary to identify even minor scratches, cuts, blisters, cracks and other skin defects that can become gateways for infection.
A diabetic should wash his feet daily with warm water and neutral soap, paying special attention to the spaces between the toes. They should be wiped with blotting movements of a soft towel.
When the first symptoms of fungal diseases appear, especially between the fingers, such as peeling, white plaque, redness, itching. You need to contact a dermatologist, he will prescribe treatment, usually in the form of an antifungal cream.
A patient with diabetes mellitus needs to inspect his shoes daily for foreign objects, ruptures in the insole and other defects that can rub or injure the skin of the feet. Any insoles with protrusions are strictly contraindicated for diabetes, as they can quietly contribute to the formation of calluses, bedsores, and ulcers.
Treat your toenails with great care; it is better to use a nail file rather than scissors. File your nails straight, it is better to round the corners and do not leave sharp edges, as they can injure other fingers. If the nails become thicker, use a file to file them down from above, leaving only 2-3 mm of thickness. A nail that is too thick when walking will put pressure on the delicate nail bed and cause a bedsore.
To warm your feet, it is better to use warm socks, but not a hot bath or heating pad. Diabetics have reduced thermal sensitivity, so they do not feel the temperature of the water, which can lead to a burn. For the same reason, diabetics should not steam their feet. When washing your feet, also gently avoid very low or very high temperatures. First, check the water in the bath with your hand and only after you are sure that it is not hot, immerse your feet.
If you find an injury, remember that due to the tanning properties of diabetic feet, alcohol solutions of brilliant green, iodine, as well as alcohol and potassium permanganate are contraindicated. Therefore, all damage must be treated with special medicinal creams, a 3% hydrogen peroxide solution, chlorhexidine, betadine, miramistin, and a loose sterile bandage applied.
Typically, diabetics have very dry skin on their feet. After washing, it must be lubricated with a nourishing fatty foot cream. Creams based on vegetable oils are also suitable for these purposes. It is also useful to apply preventive creams with urea to the skin of your feet every day.
When keratinized skin appears, it must be treated with pumice. In this case, this is the best remedy. However, pumice needs to be changed frequently, as fungus may appear in it. You cannot use scissors or a blade for this procedure. After treatment, the skin must be lubricated with a nourishing cream.
Do not use Salipod-type patches, callus removers, or cutting tools to remove rough skin.
Wear only comfortable shoes. Forget about buying shoes that need to be broken in. Avoid sandals with a strap between the toes. If your feet are deformed, wear orthopedic shoes. Never wear shoes with bare feet, darned or dirty socks or stockings, or walk barefoot.
Walk every day in comfortable shoes for at least 30 minutes. Do massage and exercises for your legs and feet. Stop smoking.

To effectively treat and prevent diabetic foot, maintain normal blood sugar levels and follow proper foot care. This will help avoid such dangerous complications as phlegmon and gangrene.

FOOT CARE FOR DIABETES

Feet with diabetes require special attention. With decompensated diabetes mellitus, small vessels and nerves are affected in the legs, as in other parts of the body. If the vessels are damaged, the normal blood supply to the limbs is disrupted. As a result of the wound

The legs heal poorly, fester, and trophic ulcers can form. Since when nerves are damaged, sensitivity decreases, a person does not feel pain and does not notice minor injuries, abrasions, or diaper rash, so he can easily get an infection that causes serious complications.

Conventionally, there are “large” and “small” foot lesions that occur with this disease.

“Small problems” include:

Hyperkeratosis (excessive callus formation);

Thickening and change in the shape of nails;

Fungal infection of nails and skin (especially interdigital spaces);

Numbness of the feet and other sensory disturbances;

Pain in the legs, which can be caused by various reasons: damage to nerve endings and blood vessels, joint diseases, venous diseases. To find out the cause of the pain, a special examination is desirable.

The "big problems" include:

Non-healing wounds and ulcers on the legs;

A special form of joint damage is diabetic osteoarthropathy;

Infectious processes: abscess and phlegmon (suppuration of the subcutaneous tissue), osteomyelitis (infectious process in the bone).

These complications can be prevented if you at least know minimum rules for foot care:

1. Wash your feet daily, dry them with a towel, thoroughly drying the skin between the toes.

2. Examine your feet daily to notice scratches, abrasions and wounds in time.

3. Don't cut your nails too short.

4. Don't walk barefoot.

5. Keep your feet warm and protect them from dampness.

6. Do not warm your feet with hot baths, electrical appliances, heating pads, etc. - with reduced sensitivity it is easy to get burns.

Don't soar your feet!!

7. If your feet change color, swelling or damage appears on them, seek medical help immediately.

8. Do leg exercises every day.

Let's talk about these rules in more detail.

The soles of the feet can be easily examined using a mirror. If you are unable to do this yourself, have a family member examine your feet.

Avoid exposing your feet to very hot or very cold temperatures. Test the water in the bathroom first with your hand to make sure it is not too hot. If your feet get cold at night, wear warm socks, but do not use heating pads or other hot objects!

Inspect your shoes daily to see if foreign objects have gotten into them or if the lining is torn. All this can injure or chafe the skin of your feet. “Magnetic insoles” (with protrusions) are strictly contraindicated for diabetes: there are often cases when they lead to the formation of ulcers. Buy only shoes that fit comfortably on your feet from the very beginning; and not one that needs to be worn in (or stretched). Avoid wearing shoes with narrow toes or ones that squeeze your toes. If the feet are significantly deformed, special orthopedic shoes are required. Never wear shoes on bare feet. It is very important to choose stockings or socks that fit exactly and change them daily. You should not wear darned socks or socks with a tight elastic band.

For injuries, iodine, potassium permanganate, alcohol and brilliant green are contraindicated. Never use chemicals or preparations to soften calluses (such as Salipod patch) and do not remove calluses with cutting tools (razor, scalpel, etc.). For this purpose, use pumice and similar special devices.

If the skin of your feet is dry, lubricate them (but not the spaces between the toes) with a rich cream (containing peach, sea buckthorn and similar oils) or any baby cream

There is a special set of exercises for legs, which help keep them “in shape”.

The best exercise, of course, is considered daily walking at an accelerated pace - lasting from 30 minutes to 1 hour. It's good if you increase the distance every day, and when returning from a walk, quickly climb a flight of stairs, using only the ball of your foot. But if for some reason you can’t walk a lot, at least don’t forget to do the exercises.

1. Holding the back of a chair, squat as deeply as possible 10 times. The back should be straight.

2. While standing, place your palms against the wall. Place your legs so that your torso is slightly tilted forward. The feet should be in full contact with the floor surface. Bend your arms 10 times while keeping your back and legs straight. Exercise helps prevent leg muscle cramps.

3. Rise up onto your toes and back down onto your heels 20 times. At the same time, try to shift your center of gravity from one leg to the other.

Now sit down, raise your legs to an accessible height

Stretch your toes forward as far as you can (20 times) and with force towards you (20 times)

Now circular movements of the legs to the right and left (20 times)

Place your feet on the edge, spread your knees to the sides, make several movements, as when walking.

Throw the crumpled newspaper on the floor and use your toes to tear it as small as possible, then collect it in a bucket

4. Sit on a chair and stand up. Repeat this 10 times. Your arms should be crossed on your stomach.

5. Holding the back of the chair, alternately rise to the tips of your right and left toes.

6. Stand with one foot on a raised surface, such as a large book. While holding onto a chair or table, swing your other leg back and forth 10 times. Change the position of your legs and repeat the exercise.

7. Sit on the floor, lean back a little and place your hands on the floor behind you. Shake your feet several times until you feel warm and relaxed.

If you do gymnastics every day for a month, blood circulation in the legs is restored, the legs become “warm”

In case of persistent skin itching, hangnails, microcracks, furunculosis, pustules, dry calluses, hyperkeratosis, prevention should be taken. A good way is general baths with medicinal herbs. One bath requires an average of 150-200 g of dry plant material.

Bath collection

Three parts of elderberry flowers, 2 parts of currant leaf, 2 parts of nettle leaf, 2 parts of tansy flowers, 4 parts of horsetail grass, 5 parts of string grass. Two hundred grams of the collection are brewed with 3-5 liters of hot water and boiled for 10 minutes over low heat, filtered and poured into the bath. The bath should not be hot (26-38 °C), duration - 10-15 minutes. Take baths 3 times a week, the course is 10-12 procedures.

Baths with marsh dried grass

For trophic changes in the feet (brittle nails, cracks, hyperkeratosis), characteristic of diabetes mellitus, foot baths are recommended: 50 g of crushed herbs are added to a bucket of boiling water, left to cool for 1-1.5 hours.

Chinese baths

For diabetes, you can make foot baths with warm water (up to 40 ° C) with the addition of copper sulfate - about 1 teaspoon per 3 liters of water. Take baths for 10-15 minutes, at least once a week. Vitriol baths are a very strong antiseptic, and the feet are the most painful place in diabetes.

In addition to baths, you can also do baths and compresses with medicinal herbs.

Strawberry leaves have an excellent wound healing effect. Therefore, fresh and dry steamed leaves applied to purulent wounds and old ulcers are good at clearing pus and promoting healing.

Infuse one teaspoon of crushed strawberry leaves in 1 glass of boiling water for 4 hours, strain. Apply a compress 1-2 times a day.

Berry juice and crushed berries are also a good external remedy for eczema, rashes and small wounds.

Infuse two teaspoons of dried bearberry leaves for 2-3 hours in 2 glasses of cold boiled water. Take 1/2 cup 2-4 times a day, and also apply a compress to the affected area.

Boil two teaspoons of bearberry for 15 minutes in 0.5 liters of water, leave for 1 hour, strain. Take 1 tbsp. spoon after 3-4 hours, while simultaneously applying warm compresses for 30-40 minutes.

Plantain leaves have antiseptic, anti-inflammatory, analgesic, and wound-healing effects. An infusion of leaves is drunk for skin diseases (rashes, acne, lichen). It has an antimicrobial effect and serves as a good means for washing purulent wounds and ulcers, promoting their rapid healing. Infuse one tablespoon of dry plantain leaves in 1 glass of boiling water for 2 hours, strain. Take 1 tbsp. spoon 20 minutes before meals 4 times a day. Wrap two tablespoons of washed fresh crushed leaves in cheesecloth. Apply to the affected area for inflammatory skin processes.

And may your feet never hurt!!

All patients with diabetes know that the lower extremities are among those organs whose health is threatened by high blood sugar.

Non-healing wounds, trophic ulcers and even gangrene are the most severe manifestations of “diabetic foot syndrome”. Many patients are bothered by pain and other unpleasant sensations (tingling, burning, numbness) in their legs. So-called “minor foot problems” are also common: nail diseases, foot deformities (usually due to joint diseases), dry skin, etc. These problems also require timely treatment.

It is widely believed that lower extremity damage in diabetes is caused by vascular complications. This is not entirely true.

The main causes leading to the development of diabetic foot syndrome are diabetic neuropathy (damage to nerve endings in the extremities) and diabetic angiopathy (impaired vascular patency). Diabetic neuropathy occurs 2–3 times more often than angiopathy.

Basic measures to protect your feet.

! Constantly maintaining blood sugar at a level as close to normal as possible. Discuss the optimal sugar level for you with your doctor.

! In addition to sugar levels, patients with diabetes should remember that narrowing of blood vessels (atherosclerosis) is caused by: smoking, high blood pressure, high blood cholesterol and excess weight. All these problems require timely identification and elimination.

! Neuropathy can be a consequence not only of diabetes, but also of regular consumption of alcohol in large quantities. Therefore, excessive alcohol consumption should be avoided.

! Compliance with foot care rules that were developed specifically for patients with diabetes.

Medical studies have shown that, despite their apparent simplicity, these measures reduce the risk of diabetic ulcers, gangrene and amputation by 3-4 times!

This is much greater than the effect of any of the medications that can be used to prevent diabetic foot syndrome.

Foot care rules

! The slightest inflammation in the legs with diabetes can develop into a big problem. Even with minor inflammation, you should consult a doctor.

! Wash your feet daily and dry them gently (without rubbing). Don't forget to rinse and dry the interdigital areas thoroughly! After showering or swimming, your feet should be thoroughly dried.

! Check your feet daily to look for blisters, cuts, scrapes, or other lesions that could lead to infection. Don't forget to check the skin between your toes! The soles of the feet can be easily examined using a mirror. If you are unable to do this yourself, have a family member examine your feet.

! Avoid exposing your feet to very hot or very cold temperatures. Test the water in the bathroom first with your hand to make sure it is not too hot. If your feet get cold at night, wear warm socks. Do not use heating pads or other hot objects!

! Inspect your shoes daily to see if foreign objects have gotten into them or if the lining is torn. All this can injure or chafe the skin of your feet.

! It is very important to change your socks or stockings daily. Wear only stockings or socks that fit properly. You should not wear darned socks or socks with a tight elastic band.

! Buy only shoes that fit comfortably on your feet from the very beginning; Don't buy shoes that need to be broken in (or stretched). Avoid wearing shoes with narrow toes or ones that squeeze your toes. If the feet are significantly deformed, special orthopedic shoes are required.

! Never wear shoes on bare feet. Never wear sandals or sandals with a strap that goes between your toes.

! Never walk barefoot and, especially, on a hot surface (for example, on sand in summer). Walking without shoes is dangerous due to the significant increase in pressure on the soles of the feet.

! For injuries, iodine, potassium permanganate, alcohol and brilliant green are contraindicated due to their tanning effect. Abrasions, cuts, etc. treat with hydrogen peroxide (3% solution) or special agents (dioxidine, miramistin, chlorhexidine) and apply a sterile bandage.

! Never use chemicals or callus softeners (such as Salipod patch). Never remove calluses with cutting tools (razor, scalpel, etc.). For this purpose, use pumice and similar special devices.

! Toenails should be cut straight without rounding the corners (the corners can be filed).

! You shouldn't smoke! Smoking with diabetes increases the risk of amputation by 16 times. If the skin of your feet is dry, lubricate them (but not the interdigital areas) with a rich cream containing peach, sea buckthorn and similar oils, and lanolin.

Foot examination and care

How to examine the soles in old age when there is not enough flexibility?

The easiest way is to place your foot on the knee of the other leg while sitting. If necessary, you can examine the entire skin of the soles by holding a small mirror to the foot. You can also place a mirror on the floor to inspect the skin of your soles. If your vision does not allow you to examine the skin of your feet, ask your relatives for help.

How to properly dry your feet?

Firstly, do not rub it, but get it wet (otherwise you can damage the skin). Secondly, thoroughly dry the interdigital areas (if there is high humidity, fungus may appear there). To reduce foot sweating, sprinkle with talcum powder.

When should you use foot cream?

Foot cream is necessary if the skin of the feet is too dry, if it has cracks. If there is no dry skin, there is no need to lubricate your feet with cream.

What specific cream is suitable for the skin of the feet?

The cream should be thick. Such creams are called nourishing (as opposed to moisturizing, that is, non-greasy). Creams with vegetable oils (sea buckthorn, peach, etc.) and lanolin are suitable. For fungal skin infections, a non-greasy cream is preferable.

Calluses

Is it necessary to remove calluses?

Yes, a callus creates increased pressure on the skin and can turn into a trophic ulcer. To prevent them from forming again, you need comfortable shoes and soft insoles (at least 10 mm thick and made of a special porous material).

What if a callus forms on the back (top) side of the finger?

You need to choose shoes with a soft top and greater fullness, constantly wear a bandage of gauze or a special orthopedic device on your finger (a bursoprotector for small joints in the form of a “cuff”).

What if calluses turn black?

This means that a hemorrhage (hematoma) has formed under the callus. If there is pain when pressing, consult a doctor immediately! If not, the callus should be removed with a pumice stone in several sessions. If suddenly, after treatment with pumice, there is pus or liquid under the callus, you need to properly treat the wound and urgently consult a doctor.

Should I open water calluses (blisters)?

You need to carefully puncture the bubble with a sterile needle and release the liquid, and then apply a sterile bandage. Do not cut off the “cover” of the bubble. Until healing, walk as little as possible (stay at home and do not go outside). Do not wear shoes that have rubbed your feet!

What to do if the bubble bursts open and its bottom is exposed?

Wash this wound, as well as all abrasions (with dioxidine, chlorhexidine, miramistine) and apply a sterile bandage or a Koletex-type napkin.

What to do if one finger rubs the other?

If a thickened nail rubs, it should be filed down with a nail file to normal thickness. If your nails are in order, you should always wear a pad between your fingers. You can buy it (this is the so-called “finger separator”) or use a pad made of eight or more layers of gauze for this purpose (cotton wool is not suitable, because the pad must have a uniform thickness). It is also important to change to looser shoes that don't press your toes too tightly together.

Nails

Can my nails be cut or do they just need to be filed?

Nail trimming can be done for those who still have sensitivity in their feet and good vision. But don’t cut them too short and try to round the corners (the corners can be filed). If your vision is reduced, the sensitivity of your feet is impaired, or your nails are thickened, you can no longer trim your nails: you just need to file them down or ask your relatives for help!

If the nails thicken (or “grow up”)?

This usually happens with fungal nail infections. The fungus can be cured, but it is quite difficult. Regardless of whether the fungal infection is treated, the nail needs to be returned to its normal shape as soon as possible. Using a nail file, you need to grind it off from above, leaving only 1–2 mm of thickness. Otherwise, when walking, the nail will put pressure on the finger and cause an ulcer.

What if the nail “grows in”?

The only way to deal with this problem, oddly enough, is to let the corner of the nail grow. To prevent it from injuring the skin, as soon as it grows a little, you need to place a thin cotton wool flagellum under it. Then the corner of the nail will gradually rise and lie on top of the edge of the nail bed. But this method requires a lot of patience and avoidance of long hikes during the entire course of treatment.

How to recognize a fungus?

Fungal infection of nails is manifested by their thickening, loosening and separation. Fungal infection of the interdigital spaces is often not noticed, although it is more dangerous and easier to cure. Manifestations: a weeping white coating on purple-pink skin, sometimes with cracks. May be accompanied by itching. If the interdigital spaces are affected, conventional antifungal agents in the form of creams are contraindicated. Antifungal solutions only! (eg clotrimazole 1%).

What to do if your nail turns black? What it is?

This is a subungual hemorrhage. If the finger turns red and hurts, it means that the hemorrhage has festered. You need to see a doctor urgently! If there is no suppuration, treatment will consist of choosing soft and spacious shoes, filing the nail with a file if it is too long or thick. The hemorrhage will resolve on its own within a few months. If you continue to wear the same (poorly fitted) shoes, the condition of the toe may worsen.

Shoes

How to check if the shoes are the right size?

This is especially important for those who have reduced sensitivity in their feet. You need to place your foot on a sheet of thick paper, trace along the contour and cut out the insole - “sole imprint”. Then put this insole into your shoes. If it is bent somewhere, it means that the shoes will put a lot of pressure there and cause the formation of calluses or abrasions.

If a woman wants to be taller, but the endocrinologist does not recommend wearing high-heeled shoes?

You can choose high platform shoes. They are beautiful and fashionable, but safer for your feet.

Can shoes rub if they are 1-2 sizes too big?

Maybe. For shoes, not only size is important, but also fullness. Shoes can also chafe if they are too big and loose on the foot, if the insole is bent, or if the socks are too large and bunch up. All this is very important.

Leg injuries

What to do if you have cuts, abrasions or abrasions on your legs?

Wash the wound with a solution of hydrogen peroxide, furacillin or dioxidine (the latter is sold in ampoules at the pharmacy). Apply a sterile bandage or a special napkin (but not a plaster!) such as Koletex to the wound. Secure the bandage with a bandage. Do not use: alcohol, iodine, potassium permanganate and brilliant green, which tan the skin and slow down healing.

Can I use a bactericidal patch?

Only as a last resort and not for long (less than a day), because The skin gets wet under the patch. It is better to secure the bandage with a bandage. The bandage on the lower leg can be secured with a gauze pad glued to the skin with an adhesive plaster around the perimeter. Until healing, walk as little as possible (stay at home and do not go outside).

Which ointment is best for wound healing?

Ointments are not the best remedy, because... they impede the outflow of discharge and create a good environment for the growth of bacteria. Most often, for non-healing wounds, modern dressings are used - napkins with increased absorbency, antimicrobial and other effects, as well as special sponges for filling the wound. Only the doctor decides which bandage to choose.

If the wound does not heal, who should I contact: an endocrinologist or a surgeon?

The endocrinologist must be notified. But it’s best to go to the specialized office “Diabetic foot”.

What to do for leg burns and sunburn?

Rinse as you would other wounds (but not with hydrogen peroxide - it will increase skin damage, but with dioxidin or furacillin) and apply a sterile bandage. Special products for the treatment of burns (synthomycin emulsion, Olazol, Panthenol, etc.) help. For severe burns, consult a doctor.

What to do with cracked heels?

Treat the skin with pumice so that it is not thickened, and lubricate it with a rich cream (so that it does not become dry). Cracks form because the skin is thick and dry. To reduce the load on the skin, you need to reduce weight (if you are overweight) and wear soft insoles in your shoes. House slippers must have a back. If a crack bleeds, you can only lightly treat it with pumice, but then rinse it and apply a bandage according to the same rules as for wounds.

Treatment methods for diabetic foot syndrome

Are leg surgeries contraindicated in diabetes (correction of deformities, removal of dilated veins, arterial bypass surgery)?

There are cases when a timely operation (for example, on blood vessels) saves from deterioration of the condition of the legs. Whether the operation will have an effect, whether it is too early or too late to do it, can only be determined by a surgeon. But before any operation, it is necessary to achieve stable normalization of sugar levels. This is a prerequisite for the operation.

What is “physical education for feet”?

Exercises that are good for your legs:

· flexion and extension of toes;

spreading the toes;

· flexion and extension at the ankle joint;

· circular movements in the ankle joint.

You need to perform it daily or 2 times a day for 10–15 minutes.

Is it possible to massage your feet yourself, how and with what?

You can use your hands or a roller massager. You can’t use various massagers with spikes (such as the “Kuznetsov applicator”) due to the risk of damaging your legs. For the same reason, when massaging with your hands, the movements should be “kneading” and not “rubbing”. Contraindications for shin massage are varicose veins, atherosclerosis of leg vessels. The feet can be massaged almost always (only if there is no inflammation, damage, etc.).

Can I wear magnetic healing insoles with massage lugs?

It’s not possible, because in diabetes, protrusions due to point pressure on the skin cause bedsores and trophic ulcers.

If “protruding bones” appear near the 1st finger, will lubricating them with iodine help?

It won't help at all. This is a bony protrusion. No ointment can “dissolve” the bone. Sometimes this foot deformity is corrected surgically. In other cases, they select soft, wide shoes with low heels so that they do not rub the foot, and wear special “protectors” (a pad made of a special material that protects the protrusion from pressure). When deformation begins, insoles-instep supports (used for flat feet) and special pads between the 1st and 2nd toes help slow down its development.

Is it healthy to walk barefoot on the ground?

No, because it's dangerous. The risk of foot injury is too high, not only when walking barefoot, but even in socks without shoes.

Miscellaneous

What's wrong with slippers?

Their soles “slap” when walking and increase the load on the heel. As a result, the skin in this area thickens and cracks form.

How long should you walk?

In general, walking is beneficial, but there are some exceptions. Firstly, the shoes must be chosen correctly. Secondly, with swelling in the legs, rapid formation of calluses, and especially fresh abrasions and wounds, walking worsens the condition of the legs. In these cases, walking should be limited.

What to do if the soles of your feet hurt when walking?

You need to see if there are calluses or cracks there (in this case, follow the rules described above). If the skin is not damaged, reduce the load on the foot using a soft insole (specially made orthopedic insole), and reduce the height of the heel.

Why is it dangerous to go to the bathhouse?

Firstly, it is easy to get a fungal infection in a bathhouse. Secondly, with diabetes, the sensitivity of the legs, including temperature, often decreases. So you can easily burn your feet (on a hot floor, heater, etc.) and not even feel it.

What to do if the elastic band of socks “cuts” into the skin?

This compression of the leg causes great harm. You need to cut the elastic or take small scissors and cut part of the elastic threads. Then the socks will not squeeze the leg, and at the same time they will not fall off.

Necessary studies to monitor the condition of a patient with type 2 diabetes mellitus

* it is advisable to conduct a glycated hemoglobin test once every 6 months; measurement of blood pressure, cholesterol levels in the blood, determination of protein in the urine, examination by an ophthalmologist and a medical examination of the legs must be carried out annually.

Diabetes mellitus is characterized by insulin deficiency and impaired carbohydrate metabolism. The disease leads to damage to all body systems, primarily the nervous and cardiovascular systems. Diabetic foot syndrome occurs as a complication in 5% of patients with this disease. It can not only poison life, but lead to disability.

What is neuropathy and diabetic foot?

Diabetic foot syndrome involves ulcerative-necrotic damage to the tissues of the lower extremities and the condition that precedes it. It affects the functioning of the peripheral nervous system, blood vessels, soft tissues, bones and joints.

There are two known forms of the syndrome: neuropathic and ischemic diabetic foot. In the first case, necrosis of the nervous tissue occurs, which is why the feet gradually lose sensitivity.

Microtraumas occur in those areas that experience increased stress when walking with diabetes. Due to weakened immunity and changes in blood composition, they heal poorly and turn into festering ulcers. But the patient does not feel discomfort in the foot and does not immediately discover that measures need to be taken.

Foot care for diabetes

It is important that it is comprehensive and regular. The patient must:

maintain daily foot hygiene;
learn to choose the right, comfortable and practical shoes and change them in a timely manner;
take medications prescribed by a doctor;
it is important to do it periodically, preferably not trimmed;
consult a specialist from time to time.

Daily hygiene rules

The main goal of foot care measures for diabetes is to monitor possible changes for the worse and maintain a stable condition of the feet, preventing microtraumas from turning into ulcers.

Attention! If there is anything alarming about the appearance or condition of your legs, consult a doctor as soon as possible! Remember that diabetic foot is fraught with tissue necrosis and even the need for surgical intervention.

Rules of foot hygiene for diabetes:

Carefully check whether new lesions have appeared on the skin of your feet or whether the condition of old ones has worsened.
Wash and dry your feet after each time you go outside or before going to bed.
In the evening, take a moisturizing foot bath, if possible with the addition of a natural antiseptic (for example, chamomile), for 10 minutes.
After the procedure, treat ulcers and cracks on the feet.
Apply an antifungal ointment or cream containing urea to your feet to soften the skin and remove dead cells.
Change your socks as often as possible.
Trim your nails promptly.
Don't forget about exercise.
Before going to bed, do a light massage.
If you have diabetes, regularly check the sensitivity of your feet using feathers.

How to cut your nails

It is not advisable to do this every day, but you need to constantly ensure that the edges of the plates do not grow too long.

Contrary to popular belief, if you have diabetes, and especially diabetic foot, you should not cut your nails immediately after taking a bath. When in contact with water, the nail swells, and after treatment, the fresh cut becomes a favorable environment for the development of bacteria. In addition, after drying it turns out to be uneven.

Trimming rules:

Nails should be cut not too short, in a straight line, without rounding the corners to prevent them from growing into the skin.
Along with scissors or instead of them, it is recommended to use a glass file. Careful grinding of the surface and edge of the nail prevents possible microtraumas, including those of neighboring fingers. If the plate is thickened, it is convenient to remove its top layer using a nail file. And finally, you can lightly treat the sharp corners of the nail with it.
After each use, instruments must be wiped with an antiseptic.

Treatment of wounds

With diabetic foot, even the smallest injury to the skin can develop into a non-healing ulcer over time. Therefore, all wounds need urgent treatment with an antiseptic.

You can use: Furacilin, potassium permanganate, Miramistin, Chlorhexidine.
Do not use: alcohol, hydrogen peroxide, brilliant green, iodine.
Often, traditional medicine is used to treat minor injuries and ulcers on diabetic feet: celandine, burdock (roots), cucumber pulp, calendula, camphor, tea tree oil and sea buckthorn. All of them are natural antiseptics.

Attention! If the edges of the wound on the foot are swollen and inflamed, it is necessary to use antibacterial agents (Levosin, Levomekol).

To speed up the process, the doctor often prescribes to the patient medications containing vitamins B, C, E and alpha-lipoic acid, antibiotics for oral administration.

When healing has already begun, the skin needs increased nutrition and hydration. Therefore, at this stage, creams with urea (Alpresan, Balzamed and others, especially intended for diabetics), as well as Solcoseryl and Methyluracil ointments, are used.

During the treatment period, it is important to reduce stress on the feet and wear comfortable, roomy shoes.

Which pedicure is suitable for a diabetic?

There is an opinion that if you have this disease you should not use the services of a beauty salon. This is understandable: diabetic foot is easily infected and difficult to treat. Therefore, you should really refuse a classic pedicure in a salon.

But in some cases, it is professional care that helps maintain healthy skin in diabetes. This applies to hardware pedicure.

Grinding with attachments helps to get rid of calluses and keratinized tissue without pain and injury, even when treating the most delicate and hard-to-reach areas of the foot;
Predominantly disposable or sterilizable attachments are used.
Instead of warm water, a chemical softener is used.

Important point! If you prefer a classic pedicure, make sure that the cosmetics are intended specifically for diabetic feet.

Useful video

Gymnastics for feet with diabetes

This measure is necessary because it helps improve blood circulation in the area of the foot and lower leg, normalize carbohydrate metabolism, and strengthen tendons and muscles. Exercising is not difficult, but you need to do it for at least 15 minutes, several times a day. Each movement should be repeated 10-15 times (with one leg).

Lying on your back, lift your legs and stretch them upward if possible. Support yourself behind your knees if necessary. Make circular movements with your feet in both directions.
Sitting on a chair, place your feet on the floor. Alternately lift your heel and then your toe, as if making a roll.
In the same position, straighten your legs parallel to the floor, and, keeping them suspended, bend at the ankle joint.
While sitting, roll a ball from a newspaper thrown on the floor with your toes, then smooth it out, tear it and collect the scraps into a pile.

Gymnastics is one of the most accessible ways to stabilize the body's condition with diabetes.

In what cases should you consult a doctor?

The formation of diabetic foot occurs gradually. If you have several symptoms, it’s time to sound the alarm.

Signs of development of VDS:

decreased sensitivity of the feet;
swelling of the legs;
foot temperature is too high or low;
night pain in the calf muscles, as well as when walking;
“goosebumps”, numbness, chills, twitching and other unusual sensations;
hair loss on the ankles and legs and discoloration of the feet;
nail deformations, fungus, hematomas under the nails, ;
hyperkeratosis, blisters, ingrown nails;
curvature of fingers;
prolonged (over several months) healing of minor abrasions and injuries on the foot, the appearance of dark marks at the site of healed wounds;
ulcers surrounded by dry, thin skin;
deepening of ulcers and formation of cracks, release of fluid from them.

Prevention of diabetic foot

Like many other diseases, complications of diabetes are much easier to prevent than to treat. In addition to daily hygiene procedures, a diabetic needs to follow many rules, lead a healthy lifestyle and pay special attention to his shoes.

In winter, avoid hypothermia. Keep your feet warm and avoid being outside for too long if possible.
Avoid taking hot baths, visiting baths and saunas. This contributes to the deterioration of blood flow and infection of wounds.
Do not walk barefoot or in open shoes.
Choose socks made from natural materials, with soft, wide elastic.
Wear appropriately sized shoes with low heels, not too narrow or tight, as comfortable as possible, without rough internal seams, made of breathable materials - but at the same time keeping their shape.
Buy shoes in the afternoon. It would be good if an orthopedic insole could be inserted into it later. The sole should be hard and not slippery. The foot should fit inside without effort or compression.
If you have diabetes or diabetic feet, avoid rubber shoes, tight tights, and uncomfortable socks.
Before putting on your shoes, smooth out the insoles, pull up your socks, and shake out any debris from your shoes.
Do not remove calluses yourself or use cutting tools for pedicures.
To treat wounds on the feet, do not use aggressive agents (iodine, alcohol).
Strengthen your immune system, give up bad habits (drinking alcohol, smoking).
Maintain a constant blood sugar level and do not allow it to spike.
Watch your blood pressure.
Follow a cholesterol-lowering diet.
See a specialist.

Watch the video in which the doctor explains how to protect yourself from developing diabetic foot syndrome.

Conclusion

The rescue of drowning people is the work of the drowning people themselves. No doctor is able to track all the changes occurring in your body, especially since diabetic foot syndrome often develops rapidly. To avoid complications, you need to accustom yourself to regularly care for your feet. This helps improve the quality of life of a person suffering from diabetes.