Pedicure for diabetics

Diabetes is a serious illness which affects the life of individuals and society throughout the world. At present there are 415 million sufferers in the world.

Diabetes mellitus is a part of the group of chronic metabolic disorders and the hormone insulin plays a major role in the control of the level of sugar in the blood (hyperglycaemia). Chronic raised blood sugar levels are the cause of various organ failures; the eyes, veins, nerves, heart and brain being the most affected. There are several types of diabetes:

• Diabetes type 1
• Diabetes type 2
• Pregnancy or gestation diabetes
• Other types of diabetes

The worst complication of diabetes is diabetic legs, gangrene and amputation. The biggest risk factor starts with ulcers on the feet caused by damage, infection and a condition of the nerve endings (neuropathy). Usually, complications set in due to a combination of factors. Other risk factors are poor control of the condition, poor quality footwear, previous ulcers on the feet, age, obesity, unhealthy diet and incorrect pedicures.

Due to the illness, diabetics can have a variety of problems with the skin and nails on the feet which can lead to several deformations:

• Calluses
• Corns
• Hallux valgus
• Hammer and claw toes
• Nail deformations
• In-growing toe nails
• Fungus infections of the skin and nails
• Atrophy

Prevention plays an important part in safeguarding against worst case complications of the feet. Well informed patients, close relatives and medical personnel, regular and professional medical pedicures and proper footwear play an essential part in this.

• It is very important to check your feet every day, after a shower is an ideal time. If it is difficult to bend ask a close relative to help or use a mirror.
• Wash your feet in warm (37°C) running water every day using a mild soap, Check the temperature with your elbow or a thermometer to avoid scalds. If there are no wounds you can soak your feet but for no longer than 5 minutes using water without additives to soften the skin such as salt or vinegar.
• It is important to pay attention to any change in skin colour, corns or calluses, hard and thickened skin, blisters and cuts or other injuries. Check nails and the skin between the toes.
• The skin is very often dry so it is important to use a cream or lotion to moisturize on a daily basis. If the skin between the toes is damp to the touch use powder to keep dry.
• Feet need to be protected in appropriate footwear which needs to be roomy, comfortable and made of natural material. There should be no rough stitches, enough room for the toes, a thick sole and the shoes should fasten either with ties or Velcro. Check the inside of the shoe before putting them on to make sure there are no foreign objects. Socks should be made of natural fibres (cotton or wool) without rough edges. Elastic stockings should not be too tight and should be replaced if there are holes as darned socks have rough edges.
• Diabetics can carry out their own pedicure if they have good eye sight and no problems with their feet. Instruments should not be shared with other family members.
• Nails need to be trimmed straight across and the corners slightly rounded. Nails should neither be too short or too long.
• Do not use any rough files or trim the skin around the toes.