Definition:

Diabetes is a serious disease that can develop from lack of insulin production in the body or due to the inability of the body's insulin to perform its normal everyday functions. Insulin is a substance produced by the pancreas gland that helps process the food we eat and turn it into energy.

The prevalence of Diabetes Mellitus is growing in epidemic proportions all over the world, particularly in India. It is now known that India has the highest number of diabetic subjects in the world, even higher than China and USA. India has the highest prevalence rates of diabetes, about 20% of the total diabetic population in the world.

Diabetes is classified into 2 different types: Type 1 and Type 2. Type 1 is usually associated with juvenile diabetes and is often linked to hereditary. Type 2, commonly referred to as adult onset diabetes, is characterized by elevated blood sugars, often in people who are overweight or have not attended to their diet properly.

Many complications can be associated with diabetes. Diabetes disrupts the vascular system, affecting many areas of the body such as the eyes, kidneys, legs, and feet. People with diabetes should pay special attention to their feet.

Of the sixteen million Americans with diabetes, 25% develop foot problems related to the disease. Diabetic foot conditions develop from a combination of causes including poor circulation and neuropathy. Diabetic Neuropathy can cause insensitivity or a loss of ability to feel pain, heat, and cold. Diabetics suffering from neuropathy can develop minor cuts, scrapes, blisters, or pressure sores that they may not be aware of due to the insensitivity. If these minor injuries are left untreated, complications may result and lead to ulceration and possibly even amputation. Neuropathy can also cause deformities such as Bunions, Hammer Toes, and Charcot Feet.

It is very important for diabetics to take the necessary precautions to prevent all foot related injuries. Due to the consequences of neuropathy, daily observation of the feet is critical. When a diabetic patient takes the necessary preventative footcare measures, he or she reduces the risks of serious foot conditions.

Poor Circulation

Diabetes often leads to peripheral vascular disease that inhibits a person's blood circulation. With this condition, there is a narrowing of the arteries that frequently leads to significantly decreased circulation in the lower part of the legs and the feet. Poor circulation contributes to diabetic foot problems by reducing the amount of oxygen and nutrition supplied to the skin and other tissue, causing injuries to heal poorly. Poor circulation can also lead to swelling and dryness of the foot. Preventing foot complications is more critical for the diabetic patient because poor circulation impairs the healing process and can lead to ulcers,
infection, and other serious foot conditions.

Proper footcare is especially critical for diabetics because they are prone to foot problems such as:

. Loss of feeling in their feet
. Changes in the shape of their feet
. Foot ulcers or sores that do not heal

Simple daily footcare can prevent serious problems. According to the National Institute of Health, the following simple everyday steps will help prevent serious complications from diabetes:

1. Take Care of Your Diabetes

Make healthy lifestyle choices to keep your blood sugar close to normal. Work with your health care team to create a diabetes plan that fits your lifestyle characteristics.

2. Check Your Feet Every Day

You may have foot problems that you may not be aware of. Check your feet for cuts, sores, red spots, swelling, or infected toenails. Checking your feet should become part of your daily routine. If you have trouble bending over to see your feet, use a plastic mirror to help. You can also ask a family member to help you. Be sure to call on your doctor immediately if a cut, sore, blister, or bruise on your foot does not heal after one day.

3. Wash Your Feet Every Day

Wash your feet in warm, NOT HOT, water. Do not soak your feet because your skin will get dry. Dry your feet well. Be sure to dry between your toes. Use talcum powder to keep the skin dry between the toes.

4. Keep the Skin Soft and Smooth

Rub a thin coat of skin lotion or cream on the tops and bottoms of the feet. Do not put lotion between your toes, because this might cause infection.

5. Trim your Toe nails Each Week or When Needed

Trim your toenails with clippers after you wash and dry your feet. Trim the toenails straight across and smooth them with an emery board or nail file. DO NOT cut into the corners of the nail or rip off hangnails.

6. Wear Shoes and Socks At All Times

Wear shoes and socks at all times. Do not walk barefoot, not even indoors. It is extremely easy to step on something and hurt your feet. Always check the insides of your shoes before putting them on. Make sure the lining is smooth and there are no foreign objects in the shoe, such as pebbles. Wear shoes that fit well and protect your feet.

7. Protect Your Feet From Hot and Cold

Always wear shoes at the beach or on hot pavement. Keep your feet away from radiators or open fires. DO NOT use hot water bottle or heating pads on your feet. If your feet are cold, wear seamless socks at night. Lined boots are good to keep your feet warm in the winter. Choose socks carefully. DO NOT wear socks with seams or bumpy areas. Choose padded socks to protect your feet and make walking more comfortable.

8. Keep the Blood Flowing to Your Feet

Put your feet up when you are sitting. Wiggle your toes for 5 minutes, 2 or 3 times a day. Move your ankles up and down and in and out to improve blood flow in your feet and legs.

1. DO NOT cross your legs for long periods of time.
2. DO NOT wear tight socks, elastic, or rubber bands, or garters around your legs.
3. DO NOT wear restrictive footwear or foot products. Foot products that can cut off     circulation to the feet, such as products with elastic, should not be worn by diabetics.
4. DO NOT smoke. Smoking reduces blood flow to your feet.

9. Be More Active

Ask your doctor to plan an exercise program that is right for you. Walking, dancing, swimming, and bicycling are good forms of exercise that are easy on the feet. Avoid all activities that are hard on the feet, such as running and jumping. Always include a short warm-up or cool-down period. Wear protective walking or athletic shoes that fit well and offer good support.

10. Communicate With Your Doctor

Ask your doctor to check the sense of feeling and pulses in your feet at least once a year. Ask your doctor to tell you immediately if you have serious foot problems. Ask your doctor for proper footcare tips.

Foot Facts

. The foot contains 26 bones, 33 joints, 107 ligaments and 19 muscles.

. 1/4 of all the bones in the human body are down in your feet. When these bones are out of alignment, so is the rest of the body.

. Only a small percentage of the population is born with foot problems.

. It's neglect and a lack of awareness of proper care - including ill fitting shoes - that bring on problems.

. Women have about four times as many foot problems as men. High heels are partly to blame.

. Walking is the best exercise for your feet. It also contributes to your general health by improving circulation, contributing to weight control, and promoting all-around well being.

. Your feet mirror your general health. Conditions such as arthritis, diabetes, nerve and circulatory disorders can show their initial symptoms in the feet - so foot ailments can be your first sign of more serious medical problems.

. Arthritis is the number one cause of disability. It limits everyday dressing, climbing stairs, getting in and out of bed or walking.

. About 60-70% of people with diabetes have mild to severe forms of diabetic nerve damage, which in severe forms can lead to lower limb amputations. Approximately 56,000 people a year lose their foot or leg to diabetes.

. There are 250,000 sweat glands in a pair of feet. Sweat glands in the feet excrete as much as a half-pint of moisture a day.

. Walking barefoot can cause plantar warts. The virus enters through a cut.

. The two feet may be different sizes. Buy shoes for the larger one.

Footwear and orthotics play an important role in diabetic footcare. Orthotics designed with Plastazote" foam, the #1 material for protecting the insensitive diabetic foot, are usually recommended. Plastazote is a material designed to accommodate pressure "hot spots" by conforming to heat and pressure. By customizing to the foot, Plastazote provides the comfort and protection needed in diabetic footcare. Footwear constructed with Plastazote is also recommended frequently for the diabetic patient. Diabetic footwear should also provide the following protective benefits:

. High, wide toe box (high and wide space in the toe area)

. Removable insoles for fitting flexibility and the option to insert orthotics if necessary.

. Rocker Soles designed to reduce pressure in the areas of the foot most susceptible to    pain, most notably the ball-of-the-foot.

. Firm Heel Counters for support and stability.

If you are a diabetic, you should be particularly alert to any problems you may be having with your feet. It is very important for diabetics with neuropathy to take necessary precautions to prevent injury and keep their feet healthy. If you have diabetes and are experiencing a foot problem, immediately consult your foot doctor.