1. 1 Diabetes and The Importance of Foot Care Dr. Mercy Popoola Presented At The: 9 th Annual Healthy Aging Summit, Augusta Georgia June, 2006

2. 2 The Diabetes Epidemic 21 million people with Diabetes 21 million people with Diabetes > $132 billion annually (ADA 2002) > $132 billion annually (ADA 2002) $10 Billion annual cost – Lower Extremities amputations $10 Billion annual cost – Lower Extremities amputations Diabetes has increased by 50% over the last 10 years Diabetes has increased by 50% over the last 10 years 50% Can Be PREVENTED (ADA) 50% Can Be PREVENTED (ADA) OBESITY Epidemic is a Factor OBESITY Epidemic is a Factor 15% will develop a foot ulcer 15% will develop a foot ulcer

3. 3 The Effects of Diabetes on Foot Health Most Diabetic foot ulcers are due to neuropathy (Loss of sensation). Most Diabetic foot ulcers are due to neuropathy (Loss of sensation). Neuropathy is Often Ignored. But… Neuropathy is Often Ignored. But… Once it rears it’s head, it presents a life long challenge or problem. Once it rears it’s head, it presents a life long challenge or problem. Leading to ulcers and amputation Without Preventative Measures. Leading to ulcers and amputation Without Preventative Measures.

4. 4 Other Foot Health Problems Age and Self Care Limitations Age and Self Care Limitations Arthritis - Osteoarthritis Arthritis - Osteoarthritis Fear of Bone Fractures Fear of Bone Fractures Breathing Problems Breathing Problems Economics: Lack of Reimbursement Economics: Lack of Reimbursement Access to Care: Limited Access to Care: Limited Mobility: Transportation Issues Mobility: Transportation Issues Heart Disease, Post Stroke… Heart Disease, Post Stroke…

5. 5 Study Outcome: Transportation a Big Issues!

6. 6 The Importance of Regular Foot Screening To Prevent and Reduce Complications Nerve: Lack of Sensation- Neuropathy Nerve: Lack of Sensation- Neuropathy Vision: Poor Vision and Blindness Vision: Poor Vision and Blindness Circulation: Poor and Insufficient Circulation: Poor and Insufficient Blood Sugar: High and Unstable Blood Sugar: High and Unstable Foot Structure: Collapse Foot, Bunion Foot Structure: Collapse Foot, Bunion Nail Abnormalities: Ingrown Toenail, Fungus Nail Abnormalities: Ingrown Toenail, Fungus Prone to Infections and Ulcers… Prone to Infections and Ulcers… Leading to Amputation! Leading to Amputation!

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8. 8 Prevention and Management: Ideas For Foot Care At Home Meticulous Foot and Nail Care Meticulous Foot and Nail Care Appropriate Foot Wear - KEY Appropriate Foot Wear - KEY Stop Smoking Stop Smoking Leg Exercises & Manage Obesity Leg Exercises & Manage Obesity Manage Cholesterol Manage Cholesterol Maintain Diabetes control Maintain Diabetes control Alternative & Complementary Therapy: Proper Nutrition, Yoga, Massage, Aroma Therapy, Relaxation, Meditation, … Alternative & Complementary Therapy: Proper Nutrition, Yoga, Massage, Aroma Therapy, Relaxation, Meditation, …

9. 9 Patient Education By Providers Patient Education By Providers Daily Foot Assessment with a Mirror if Necessary Daily Foot Assessment with a Mirror if Necessary Protection & Prevention of Injury Protection & Prevention of Injury Appropriate Foot Wear Appropriate Foot Wear Regular Vision Check Regular Vision Check Early Intervention & Follow Up Early Intervention & Follow Up Checking for Circulation (Doppler) and Neuropathy (Monofilament) Checking for Circulation (Doppler) and Neuropathy (Monofilament)

10. 10 Neurological Assessment: Monofilament For Neuropathy!

11. 11 Prevention: Shoe Strategies Poor Shoes Can Lead to Foot Pain & Foot Ulcers Diabetes Must Never Go Without Proper Shoes, Even at Home Diabetes Must Never Go Without Proper Shoes, Even at Home Shoes With Extra Depth Shoes With Extra Depth Do not Buy Shoes In the Morning Do not Buy Shoes In the Morning Use Seamless Socks Use Seamless Socks Poor Shoes and Socks Can Lead to Corns, Calluses, Ingrown Toe Nails… Poor Shoes and Socks Can Lead to Corns, Calluses, Ingrown Toe Nails… Be Careful with OTC Foot Care Product Be Careful with OTC Foot Care Product

12. 12 Shoe Education Does Your Shoe Fit? Check Out Ellen Degeneres Feet!

13. 13 Coastal Georgia Regional Development Centers Program County Locations & Centers: Five County Locations & Centers: Five Numbers Served Per Site: 15-40 Numbers Served Per Site: 15-40 Common Foot & Nail Problems Common Foot & Nail Problems Corn and CALLUSCorn and CALLUS FUNGAL NAIL INFECTION & Long NailsFUNGAL NAIL INFECTION & Long Nails Dirty, Coated, & Dry FeetDirty, Coated, & Dry Feet PAINFUL FEET & Swollen FeetPAINFUL FEET & Swollen Feet Lack of Information or MisinformationLack of Information or Misinformation

14. 14 Foot Care Program Includes More Than Toenail “cutting” More Than Toenail “cutting” Filing and Shaping Filing and Shaping Foot Assessment & Survey Foot Assessment & Survey Foot Bath and Massage Foot Bath and Massage Referral and Follow Up Referral and Follow Up Foot Care Education Foot Care Education Shoe Assessment and Education Shoe Assessment and Education FUTURE: COLLABORATION! FUTURE: COLLABORATION!

15. 15 Future Possible Collaboration And Opportunities Grant Writing Grant Writing Epidemiological Study Epidemiological Study Hands on Foot & Nail Care Hands on Foot & Nail Care Opportunities: Faculty & Students Opportunities: Faculty & Students Interest: Prevention Focus Interest: Prevention Focus Vision For Training and Follow Up Vision For Training and Follow Up Mobile Foot Clinic – Please Join Us to Get the Fund For the VAN! Mobile Foot Clinic – Please Join Us to Get the Fund For the VAN!

16. 16 What About Our Foot Mobile? What About Alternative Therapy For Foot Pain? Any Questions?

17. 17 Some Foot Care Resources Foot Care Product Foot Care Product www.universalfootcare.com 1-800-323-5110www.universalfootcare.com 1-800-323-5110www.universalfootcare.com www.feelgoodstore.com 1-800-926-0880www.feelgoodstore.com 1-800-926-0880www.feelgoodstore.com Best Shoes Best Shoes SAS (770)953-8118 or (210) 921-7415SAS (770)953-8118 or (210) 921-7415 Foot Support Foot Support www.supportplus.comwww.supportplus.comwww.supportplus.com 1-800.229-29101-800.229-2910 Stores – Wal-Mart and Bath & Body Works… Stores – Wal-Mart and Bath & Body Works… Good Foot Lotions: www.Amerigel.com Good Foot Lotions: www.Amerigel.comwww.Amerigel.com Providers: www.google.com Foot Search Providers: www.google.com Foot Searchwww.google.com To Get Monofilament: 1-800-543-9055 or To Get Monofilament: 1-800-543-9055 or 1-888-289-92931-888-289-9293