1. UNIT FOUR LESSON 11 Foot Care

2. Objectives At the end of the lesson, participants should be able to: 1. Explain the importance of taking care of their feet 2. Explain the daily, weekly, and yearly care of their feet 3. Set a goal that relates to foot care 4. Describe feelings and experiences of living with diabetes 5. Identify ways to modify everyday snacks to fit into the diabetes meal plan

3. L-esson

4. How High Glucose Damages The Feet Neuropathy (noo-ROP-uh-thee) Nerve damage in the legs and feet Lack of feeling of pain, heat, or cold Sores, blisters, or cuts, on the feet may be present without the person realizing Skin may break down and become infected

5. How High Glucose Damages The Feet Peripheral Vascular Disease Circulation problems or poor blood flow in the legs and feet Tissues and skin affected by poor blood flow may die, which is known as gangrene (GANG-green) To keep gangrene from spreading to other tissues of the body, the doctor may amputate the infected area

6. How High Glucose Damages The Feet Dry itchy skin High blood glucose causes the body to lose fluids This is because the nerves that control the oil and moisture in the feet no longer work This makes skin dry, itchy, and prone to cracks and infections

7. Common Foot Problems

15. Daily Foot Care Check for cuts, sores, red spots, swelling, and infected toenails Set a specific time each day to check your feet Use a mirror if you cannot bend over or pull your feet up to check them See a doctor right away if a cut, sore, blister, or bruise on the foot does not begin to heal after a day or two

16. Daily Foot Care Wash both feet in warm water every day Use a thermometer or your elbow to make sure the temperature of the water is not too hot Avoid soaking feet Dry your feet well after washing and pat your skin dry instead of rubbing

17. Daily Foot Care Pay attention to the area between your toes and use talcum powder to keep it dry Use lotion to keep the skin at the top and bottom of the feet soft Do not put cream or lotion between your toes

18. Weekly Foot Care Trim your toenails: After washing your feet when they are soft Straight across and avoid cutting into the corners Use a nail file or emery board to smooth nail after trimming

19. Yearly Foot Care Have a doctor check your feet Take off your socks and shoes before the doctor comes in Tell the doctor if there is pain in the feet or other serious foot problems

20. Questions to Ask Your Doctor Are the nerves in my feet healthy? How is the blood flow to my legs and feet? What exercises should I do? How should I trim my toenails? What lotions or creams should I use?

21. How to Protect Your Feet Wear shoes and socks at all times, even when you are indoors, to prevent blisters and sores Avoid wearing socks that are too tight below the knees, as these may reduce blood flow to the legs and feet Use socks without seams to prevent blisters

22. Protect Your Feet From: Heat Radiators Open fires The sun Hot pavements Hot water bottles and heating pads Cold weather

23. How to Keep Blood Flowing to the Legs and Feet Put your feet up when sitting Wiggle your toes and move your ankles up and down for five minutes, two or three times a day Avoid crossing your legs for long periods or wearing tight socks, elastic or rubber bands, or garters around the legs Avoid smoking, which reduces blood flow to the feet

24. How to Choose Proper Shoes Have feet measured each time before buying shoes because the size and shape of the feet change over time Buy shoes that are comfortable and that fit the length and width of the feet with plenty of room for the toes Shoes should not be too big as this can also cause foot ulcers

25. How to Choose Proper Shoes New shoes should be comfortable when purchased and should not need a “break-in” period Avoid wearing new shoes for more than an hour at a time It is best to try on shoes with the type of socks you will wear with them

26. How to Choose Proper Shoes Avoid shoes with high heels and pointed toes Avoid shoes such as sandals that expose your toes and heels

27. How to Identify Foot Problems ProblemSigns and Symptoms Foot changesShape, color or temperature Nerve or sensation changes Burning, tingling, or hurting of the feet Skin changesDrying and cracking Poor circulationBlisters, sores, and ulcers

28. E-mpowerment Diabetes Education Series: Foot Care

29. Diabetes Education Series Describe your experiences and feelings living with diabetes and caring for your feet. What was most difficult for you? What are ways that you could overcome some of these difficulties?

30. A-ction Did you accomplish the goal you set last week? Your goal is to follow daily, weekly, and yearly care of your feet. This is a goal on your Diabetes Checklist.

31. R-eal-Life Problem Solving Keith’s Story

33. Questions about Keith’s Story What is Keith’s problem? Why is this problem for Keith? What are some things that Keith needs to do to solve this problem? List as many solutions as possible. What do you think is the best solution and why?

34. Questions about Keith’s Story Please find the Real-Life Problem Solving handout for this lesson in your folder These questions will help with your understanding of Keith’s story

35. N-utrition Menu Spicy Snack Mix Chili Bean Dip with Wrap

36. See you next week! Topic for the next week: Your Health Care Team

37. Date: References: Margaret E. Cook-Newell, Ph.D., R.D., L.D., CDE Irene Hong-McAtee, MD, MCR Adrienne Glodt, B.S., Graduate Student Laura Hieronymus, MSEd, APRN, BC-ADM, CDE Cheryl Case, M.S., Harrison County Ann Hollon, M.A., Wolfe County Hazel Forsythe, Ph.D., R.D., L.D., CFCS Stephen D. Perry, M.S., R.D., L.D. Pam Sigler, M.S. Lynn Blankenship, M.S., Metcalfe County Theresa Scott, M.A., Floyd County Tamara Thomas, M.S., Franklin County Rusty Manseau, B.A., Graphic Artist Author: Ingrid Adams, Ph.D., Assistant Professor, Nutrition and Food Science, University of Kentucky Other Contributors