1. Keeping Your Feet Healthy
How poorly controlled diabetes
mellitus can affect the lower
extremities:
The good, the bad and the ugly

2. Keeping Your Feet Healthy
Neurologic and Vascular Compromise Predisposes Diabetics to
Foot Ulcers
Changes are caused by poor blood glucose control
aldose reductase sorbitol (sugar alcohol)
NAD NADPH (oxidative stress on tissue)
Result is a change in tissue quality and small vessel disease

3. Keeping Your Feet Healthy
• 4 changes seen: • Importance:
– neuropathy – if you can’t feel your feet, you
can’t feel if they’re injured
– angiopathy
– if you injure your feet, it will
– immunopathy take less force to cause ulcers
– dermopathy – if you ulcerate the skin, it will
be harder to heal
• 3 types of neuropathy:
– if the ulceration reaches bone,
– autonomic it may mean amputation
– motor – the amputation level may be
proximal to injury to heal site
– sensory
– it is unusual to have one
amputation not lead to others

4. Keeping Your Feet Healthy
• Never ignore a red mark, a
bruise or blister
• Never ignore an ingrown nail or
local trauma
• Never let color changes to the
feet or legs go untreated. A
‘little’ thing can become a big
thing--with unfortunate results--

5. Keeping Your Feet Healthy
arterial
Don’t ignore
changes or injuries blister
to the foot or legs
cellulitis
high pressure points

6. Keeping Your Feet Healthy
Feet should be checked daily
Shoes should be worn at all times
Shake out shoes before wearing
Wear proper fitting shoes
Never use hot water to bathe
Check glucose levels and keep a log
Visit primary care doctor on a
regular basis--bring log with you
Visit foot care specialist at least
once a year--sooner if there is a
problem
Attend diabetic classes and learn
about what you can do to stay
controlled and well
Avoid complications by living right,
eating right, exercising and staying
under control