Diabetic foot

Trainee nurse: The other day a patient asked me for some advice on footcare as he seems to suffer from diabetes, and I was wondering what important information we should give.

→ Resident nurse: It’s a good thing to always start by reminding patients about the basics, that’s insulin, a hormone made by the pancreas, helps glucose from food get into the body cells to be used for energy. Sometimes the body doesn’t make enough, or any, insulin or doesn’t use insulin well. Glucose then stays in the blood and doesn’t reach body cells. Over time, having too much glucose in the blood can cause major health problems, like blindness, cardiac disorders, veins problems, vision impairment, and what not.

→ Trainee nurse: I mean, since the patient knows what he suffers from, what advice to give?

→ Resident nurse: People who suffer from diabetes must take special care of their feet, as they are at a higher risk of infection and necrosis that can lead to amputation.

Trainee nurse: And how could I justify this information?

Resident nurse: It’s that the increased prevalence of infection among diabetics is due to a lack of sensitivity in the lower extremities, caused by reduced blood flow and nerve damage.

Trainee nurse: So, the best way to care for feet is to prevent these wounds in the first place.

Resident nurse: Exactly. And by the way, what did you tell your patient then?

Trainee nurse: To quit smoking, you know, he told me that he smokes, as this would greatly reduce circulation, which can exacerbate the blood flow problems and sensation.

Resident nurse: And what else?

Trainee nurse: To choose the right footwear, made from fabric that when it rubs against the skin it would not cause foot wounds and ulcers, which would also be loose enough and comfortable, and not tight on the toes.

Resident nurse: The patient might also wear custom-made orthopedic shoes to fit the size, shape and contours of the feet, and thick cotton socks, and maybe use talcum between the toes, to absorb humidity.

Trainee nurse: Yes, but what do we target when we tell patients to check their feet daily?

Resident nurse: That it’s important to inspect one’s feet on a regular basis, keeping an open eye on cuts, cracks, blisters and other signs of the beginning of a wound.

Trainee nurse: And of course, it’s also important to get regular health and blood check-ups at the GP to adapt one’s treatment and anticipate possible complications.

Resident nurse: Exactly, and probably one last thing, to tell patients that regular workouts help to improve the body’s sensitivity to insulin and to manage blood glucose levels, which might help reduce the need for medications.