Diabetes Care: Information for Clinical Providers
Useful Web Sites
- American Association of Diabetes Educators - Diabetes education resources, continuing education courses
- American Association of Clinical Endocrinologists - Good clinical and patient information
- Centers for Disease Control Home Page
- Children with Diabetes - Extensive resources on insulin-dependent/Type I diabetes
- Clinical Practice Recommendations - Standards of Care for Type 1 and Type 2 diabetes, from the ADA
- Diabetes Research - from American Diabetes Association
- Diabetes Statistics - from the CDC's National Diabetes Surveillance System
- Doctor's Guide to Diabetes Information and Resources - News, discussion groups, links
- National Institute of Diabetes and Digestive and Kidney Diseases - At the National Institutes of Health
- Search for other Diabetes-related Web sites using MedGuide
- Gestational Diabetes Mellitus (GDM) - Diabetes diagnosed during pregnancy
Nine Steps to Better Foot Care
- Keep your feet absolutely clean and dry.
- Check both feet daily (including between your toes) or have someone help you. You can use a mirror to see the bottoms of your feet. If your vision is impaired, have a family member do the examination. Be on the lookout for swollen or red areas, breaks, cuts or scratches, patches of dry skin, very cold areas (which indicate circulation problems), or very warm areas (which could indicate an infection).
- Wash your feet in warm (not hot!) soapy water every day. Then dry them thoroughly, especially between your toes.
- Check your shoes twice a day and shake them out to make sure there are no small objects in them that could cause injury.
- Wear shoes and socks that fit well. Never go barefoot; use aqua socks for ocean and pool.
- Be careful when you trim your toenails. Cut your nails straight across. If they are very thick and curved, or if your sight is not adequate, you may need professional help to cut them properly.
- Be very careful to avoid burns from hot water, pavement, sand, hot-water bottles, and heating pads. Remember, you may not feel a burn.
- Never perform "bathroom surgery" on corns or calluses -- let your podiatrist see and treat any problems.
- Call your diabetes doctor or podiatrist immediately if you discover an ulcer or open sore, an infection in a cut or blister, a red, tender toe (possibly an ingrown toenail), change in feeling, such as pain, tingling, numbness or burning, any change in the way your foot looks, and any puncture wound. Have your feet checked every time you visit the doctor.
Patient Instructions for Care of the Diabetic Foot
- Do not smoke.
- Inspect toes and between toes daily for blisters, cuts and scratches. The use of a mirror can aid in seeing the bottoms of the feet.
- Wash feet daily, dry carefully, especially between the toes.
- Avoid extremes of temperatures. Test water before bathing.
- If feet feel cold at night, wear socks; do not apply hot water bottles or heating pads.
- Do not use chemical agents for the removal of corns and calluses.
- Inspect insides of shoes daily for foreign objects, nail points and torn linings.
- Wear properly fitted stockings, do not wear mended stockings, avoid stockings with seams, change stockings daily.
- Do not wear garters.
- Shoes should be comfortable at the time of purchase. Do not depend on them to "stretch out."
- Do not wear shoes without stockings.
- Do not wear sandals with thongs between the toes.
- Do not walk barefooted, and never on hot surfaces such as sandy beaches or around swimming pools.
- Cut nails straight across.
- Do not cut corns and calluses; follow special instructions from your physician or podiatrist.
- See your physician regularly and be sure that your feet are examined at each visit.
- If your vision is impaired, have a family member inspect feet daily and trim nails and buff down calluses.
- Be sure to inform your podiatrist that you have diabetes.