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For a person with diabetes, proper foot care is the best defense against foot wounds that are difficult to heal.

With diabetics, even minor wounds cannot be ignored and should be treated immediately. Possible nerve damage, a weakened immune system and restricted blood flow can make it difficult for wounds to heal. Here are a few precautions to keep feet healthy:

• The feet should be washed daily (using a mild soap and lukewarm water) and dried very carefully, especially between the toes.
• It often helps to use talcum powder to dust the foot to further reduce moisture; however, it is necessary to remove all the powder after dusting, as it should not leave a residue between the toes.
• If the skin is dry, a good emollient should be used, but not between the toes.
• The feet should also be inspected daily (check sores, cuts, bruises, changes to the toenails; if self‑checking, a mirror can be used to look under the foot if it cannot be seen).
• Toenails should be cut straight across and never cut into the corners; an emery board can be used to file sharp corners. NOTE: Toenails should only be cut by a professional and never by a home care aide.
• Going barefoot should be avoided, even in the home (this lessens the chance of accidental damage).
• Only podiatrists should remove corns and calluses. Commercial corn cures should never be used. They can too easily damage the skin.
• Footwear should fit properly. Poorly fitted shoes are a common cause of diabetes foot complications.
• Feet should be measured each time a new pair of shoes is purchased (foot size and shape change over time) and new shoes should be comfortable when purchased. They should not need a “break-in” period— fitting both the length and width of the foot, with plenty of room for the toes.
• Shoes with high heels, pointed toes, and tightness around the toes should be avoided (these put too much pressure on parts of the foot and can contribute to ulcers).
• See a podiatrist annually.
• Foot ulcers are a common complication for people with diabetes. Ulcers are caused by too much pressure on an area and the skin “breaks down”. It is imperative that pressure is removed from the area and good wound dressings are used.

A well trained in-home caregiver such as those at CareWorks Health Services can recognize early symptoms of potential diabetic wound complications, bringing them to the attention of a physician before the issues become a serious problem. Contact CareWorks Health Services for more information on private duty diabetic care and customized options for varying client needs.

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