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Diabetes and Wounds: Caring for Sores

Avoid amputation with the prevention and early treatment of skin sores.

5 Tips for Preventing Foot Sores continued...

Use an antifungal cream if you have evidence of athlete's foot (tinea pedis) or other fungal infection. Athlete's foot can make the skin crack and peel, which increases your risk for an infection. Be on the lookout for fungal nail infections, too (nails will look and feel harder, darker, and thicker). See your podiatrist or your doctor about treatment and care.

  • Avoid fancy footwear. This means no tight socks and, above all, no tight, pointy shoes with high heels.

"Footwear is probably one of the biggest offenders," says Jeffrey Buehrer, MD, a vascular surgeon and wound care specialist at Firelands Regional Medical Center in Sandusky, Ohio. A well-fitted pair of athletic shoes is often a safe bet, or your podiatrist can work with you to have shoes custom-fitted for your needs -- often at no charge through the Medicare therapeutic shoe program. Brem admits that these shoes may not be the most stylish, "But they will likely save your limb."

Diabetes and Wounds: Getting Timely Treatment

What if, despite your best efforts, you develop a foot sore? "Any break in the skin of the foot is an absolute emergency," declares Brem. "There's no such thing as 'just a little cut.'" Brem's recommendations:

  • Put a triple antibiotic cream on the foot sore immediately
  • Cover the wound with a light gauze and keep pressure off the area
  • See a local wound center within seven days at most

And calluses, which are precursors to foot ulcers in many diabetic patients, should be considered -- and treated -- just as seriously.

"Diabetic foot wounds can develop complications rapidly," explains Buehrer. "I'll see patients who tell me that they scratched their foot in the garden and everything seemed fine, and then they woke up two days later to find it horribly swollen. Early intervention is always better."

Once you go in to see the doctor about your foot sore, he or she may do several things:

  • Test that you have a good blood circulation to the area. This is called an ankle brachial index.

If the ankle brachial index is 0.9 or less, you should see a vascular surgeon to determine if intervention is necessary. "An ankle brachial index of 0.9 or below could point to a 50% occlusion of a major artery."

  • Cleaning a foot sore is a process known as debridement. The doctor can culture the area to check the type of bacteria that may be present.

"Looks can be extremely deceiving in a person who has diabetes and a foot ulcer," Brem says.

  • Offload your foot. This means putting it in a special custom-designed support boot -- such as the Cam Walker or Air Calf Boot. "This may be bulky, but it's absolutely necessary until you heal," says Brem. "If everyone did these steps, amputations would decrease by 90%."

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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