During winter, a special attention is needed to the feet for people with diabetes. Diabetic foot is one of the most common complications that occur in people suffering from diabetes. Diabetics often have a lower susceptibility to various changes in the body which is caused by nerve damage. This is why the changes that occur on the feet are sometimes noticed only when they become severe.
So, why exactly are there frequent changes in the feet? Disorders in the production of sweat and fat are detrimental to the skin, especially when walking, and lead to skin rupture and formation of wounds. Disorder in the immune system and damage to the blood vessels complicate the treatment and healing of these wounds which creates conditions for the development of a bacterial infection in the connective tissue, bones and muscles, and in the most severe cases, result in gangrene. Such serious consequences, as well as numerous other effects of diabetes, can be avoided by regular checkups. The following is a list of essential cold weather and winter foot care tips for diabetics that will help you keep your feet safe when the temperature is low.
Just like most people, many diabetics lower the intensity of taking care of their feet during cold weather. Diabetics naturally have cold feet (due to nerve damage), and that’s why some of them avoid washing legs on a daily basis, which is wrong. Daily care and washing your feet is critical. Use water that is heated to body temperature. After washing, wipe your feet thoroughly and apply a moisturiser. Make sure that there is no moisture left between the toes.
Don’t forget the nails
Nails on your feet should always be cut straight to avoid skin injury near the nail, and it would be wise to leave this task to a professional. Since this is not an activity that needs to be performed every day, try to find a day in a week when you will focus on your nails. Just because you are not wearing sandals, this doesn’t mean that you should forget about your nails. It is critical to use utensils and scissors that are yours.
Make sure that you are wearing the right boots
Diabetics, just like anyone else, start wearing boots when the temperatures drop. If you are in a process of buying boots, you should keep in mind that our feet tend to increase their size during the day (if we use our boots for four or more hours). So, make sure that you are wearing the correct size of boots.
Keep your feet warm and dry
It is imperative to keep your feet warm and dry during winter as the dampness can cause fungal and bacterial infection. Keep your feet dry thoroughly after exposure to wetness, especially the area between the toes as this is where the athlete's foot infection commonly develops.
Perform regular checkupsSince this is a period of the year when feet are prone to problems, it is a good idea to check them every day. Find out whether there are any traces of fungus, blisters, cuts, infections and other complications. Examine the feet thoroughly. Consult your doctor if you notice anything unusual.
Did you find these tips useful? Do you have any more to share? We would love to hear your thoughts in comments!
Rwanda is a small ambitious country known as the land of 1000 hills with a population around 12 million and a rapidly growing economy. It has rolling hills for as far as you can see, a rain forest, gorillas and volcanoes, making for quite the site to any visitor. However, it is also known for the 1994 genocide in which over 1 million people were killed in 100 days across the country.
This tragic event has led to some very big health issues, which the country still faces, but thanks to a range of donor funding and strong political leadership, the country is on its way to quickly becoming a middle-income country.
As countries shift from low incomes to middle income economies, health issues become complex, where the country can face a mix of communicable disease (ie. malaria, HIV, TB) and the introduction of non-communicable disease (ie. diabetes, high BP, cholesterol) with changes in lifestyles.
Now you are probably wondering what this has to do with podiatry?
Well, as clinicians we play a role in the overall wellbeing of every patient that walks through our door for treatment and we become advocates for a number public health issues. While our specialist area is focused on the foot and ankle, an understanding of the bodily systems is imperative for understanding the impacts on the lower limb. This allows us to transition from clinical practice to other work streams such as health policy, public health programmes, service management and research.
As a podiatrist with a public health background, the increase of diabetes and chronic conditions in developing nations has become of personal interest. In many of these countries, diabetes is poorly understood and without proper prevention and care, can lead to a large economic burdens on the healthcare system. In 2012, the UK alone spent a whopping £639 million on foot ulcers and £662 on lower limb amputations, so the prevention and monitoring of these conditions is of paramount importance in the developing world.
The quality of life for individuals with diabetes is also drastically affected if not controlled, impacting mobility, footwear and overall lifestyle. Additionally, chronic ulceration and limb amputation, creates an increases risk (approximately 80%) of mortality within the first 5 years post amputation.
How did all this lead me to Africa, I hear you say?
In April of 2016, I (sadly) departed from the Betafeet clinic to implement an mhealth project in Rwanda in partnership with the Ministry of Health. This project, allows patients across the country to speak with a doctor and receive a prescription via SMS through their mobile phone, reducing the travel time, wait time and expense of receiving care from one of the local physical hospitals. The system is also working on monitoring both communicable and non-communicable disease using artificial intelligence, engaging patients to take ownership of their health.
This could be a major milestone for a country with stretched resources. To put things into perspective, over 80% of the population lives in remote areas of the country and works in the ‘in-formal’ sector as subsistence farmers with an average income of 2-3 dollars per day, which is not very much. To receive care, a patient may travel over an hour to reach their nearest hospital where a doctor is present and then wait anywhere from a few hours to a few days to receive the care they need. However almost 80% of the population already has a mobile phone.
Appropriate access to clinical care is a large part of the prevention and management of many conditions and undertaking this project has been a great experience. As a clinician, I have had the opportunity to utilise my knowledge to develop operational pathways and input into the technology development to shape the way patients receive their care.
It is with
this experience I now look to move on to my next adventure focusing on Aboriginals
and the utilisation of technology in the prevention of major non communicable
disease such as diabetes.
Final comment from Reggie Simpson and Betafeet Podiatry
We wish Andre the very best in his future and thank him for this interesting blog account. We look forward to his next blog focused on his work with the Aboriginal population.