by Shelley Francis, BN RN, CDE - Aboriginal Diabetes Initiative, UNBI

When an individual is diagnosed with Diabetes, there is what seems like a hundred things to do right away to gain control. That doctor’s office visit should come with a checklist of things to do so that no important information is forgotten! Two very important things one often forgets with the diabetes diagnosis are the two feet. Let’s face it, who really looks after their feet anyways?

It is very surprising how many people living with diabetes are still unaware of the extremely important role that regular foot care plays in diabetes self management. The long term survival and quality of life issues that face people living with diabetes are profound enough without mentioning what an amputation would mean to the person, family and community. Prevention of this devastating diabetes complication is key to ensuring the reduction of amputations among Aboriginal People in Canada.

So many First Nation Community members are unaware of the critically important task of foot care and do not know how to take care of their feet. It is fairly common that Our People are too shy to attend foot care clinics, especially if they are located outside the community. It is noteworthy that foot clinics that are held within the community health center are far more reaching and successful to the community members in need. It is important for all of us to spread the word about the importance of foot care and encourage our loved ones and neighbours to get the help they need in managing their feet.

Regular foot care is important for all of us to do, but it is especially important for those people living with diabetes. Diabetes is a lifelong disease that will damage the body’s blood vessels if not managed properly over time. Because our feet require adequate blood supply and nerve stimulation, they are prone to conditions that can potentially impair good blood flow and nerve supply. If there is reduced oxygenation and lack of feeling in the feet, unwanted symptoms may appear: swelling, decreased or complete lack of sensation, burning, tingling, pain, irritation or infection on skin or nail structures (fungal toenails), and dry itchy feet among others. Each person has their own unique experience with the affects of diabetes on their feet.

Meet Your Feet

Did you know that each of your feet has 56 bones, 62 tendons, 76 muscles, 112 ligaments and thousands of blood vessels and nerves? One must wonder how on Earth our poor feet can even last our lifetimes! Can you imagine how many miles they have carried us? Can you believe that they are as complex as this? They truly are amazing structures and they demand our attention each and every day!

Daily Tips to Foot Care

People living with diabetes must make the time to care properly for their feet each day. Daily foot care responsibilities include:

  • Daily wash with mild soapy water, taking time to wash between toes and at heels and soles;
  • Dry thoroughly, even between the toes! Leaving moisture can cause unwanted bacterial growth and possible subsequent infection;
  • Daily moisturize with a urea-based product such as Dermal Therapy, Flexitol or Sween Cream. These products are very concentrated and only require a small amount to be used each day (preferably at night). Other moisturizers such as Vaseline Intensive Care and Keri Lotion can have the opposite affect by drying out the skin, so they should be avoided on the diabetic foot – don’t put any lotion between the toes as this can lead to bacterial infections;
  • Daily inspection of the feet. Are there any reddened or sore areas? Is the skin dry? Are there any cracks, calluses or abrasions present? Are the nails healthy? Do they need trimming?;
  • Be careful with your feet… going barefoot can cause injury, walking on hot pavement or beach sand can burn foot soles, foreign objects in footwear can cause injury, heating pads and electric blankets can cause burns;
  • Wearing proper footwear every day. This includes wearing properly fitting shoes, clean white cotton or wool socks to absorb moisture, comfortably fitting shoes and socks – avoid tight fitting footwear as elastics can slow circulation and cause problems. Some people have to seek help for specialized orthotic footwear due to structural foot problems. If you have a difficult time fitting regular store bought shoes, please ask your doctor for a referral to an orthotics specialist who custom makes shoes for special foot types. NIHB will cover specialized orthotic footwear as part of their program. Please contact your CHN or CHR for assistance with access to this service. It is widely recognized that New Balance footwear is available in several different shapes and sizes and is often worn by people with foot challenges; and
  • If you notice any abnormalities with your foot, it is advised to seek medical attention immediately! Prevention and treatment of minor foot problems can save a foot or a leg!

Warning Signs to the Diabetic Foot:

The following warning signs are cause for concern in people living with diabetes and should be taken seriously:

  • Changes in skin color of the foot;
  • Elevation in skin temperature of the foot;
  • Swelling of the foot or ankle;
  • Pain in the legs;
  • Open sores on the feet that are slow to heal;
  • Ingrown and fungal toenails;
  • Toenails that are difficult to trim (thick, crumbly nails);
  • Corns, calluses, especially cracked and bleeding areas; and
  • Dry and cracked heels/soles of the feet.

It is strongly encouraged that anyone who is experiencing foot difficulties seeks medical attention as soon as possible. Not enough attention is paid to our feet, and if we don’t look after our feet properly, we can expect problems to occur in the future. The good news is that diabetes foot complications are preventable with the proper daily care. Most First Nation community health centers have foot care services available to their members who are having difficulty. Please ask your community health staff for more information on how they provide this service to their members. Even if you are capable of caring for your own feet, it might be a good idea to make a foot care appointment for a professional opinion to ensure you are on the right track.

Recipe of the Month:

Hearty Family Fall Casserole

Ingredients:

1 Large head of cauliflower – about 8 cups
1 Large Portobello mushroom diced
9 Boneless loin pork chops
1 26 oz can of fat free Cream of Mushroom Soup
1 cup of Skim or low fat milk

Directions:

Pre- heat oven to 375 F. Place the 8 cups of cauliflower florets in a bowl with the diced mushroom, pre cook in the microwave for 4 min. Drain water. Place veggies in the bottom of an ungreased 9X13 casserole dish, dice and add the mushroom, toss gently. In another bowl mix together the soup and milk pour about 1 cup over the veggies, layer your pork chops over the top and cover with soup mixture. Spread the soup mixture over the chops and into veggies. Bake at 375 degrees for 40 minutes turn over chops and cook for another 40 minutes. For added taste you can top it with shredded cheese or French fried onions.

Servings per Recipe: 9
Calories: 314.6
Total Fat: 7.8 g
Cholesterol: 92.2 mg
Sodium: 684.1 mg
Total Carbs: 12.5 g
Dietary Fiber: 3.1 g
Protein: 47.6 g

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