The following risk factors increase your chances of developing foot problems and  infection in your legs and feet if you are diabetic.

1.      Footwear: Poorly fitting shoes are a common cause of diabetic foot problems

·        If you have red spots, sore spots, blisters, corns, calluses, or consistent pain associated with wearing your shoes, you need to get new, properly fitting footwear as soon as possible.

·        If you have foot abnormalities such as flat feet, bunions, or hammertoes, you may need prescription shoe or shoe inserts.

2.      Nerve damage: People with long-standing or poorly controlled diabetes are at risk for having damage to the nerves in their feet. The medical term for this is peripheral neuropathy.

·        Because of nerve damage, you may be unable to feel your feet.

·        Diabetics may not properly perceive minor injuries (such as cuts, scrapes, blisters), signs of abnormal wear and tear (that turn into calluses and corns) and foot strain.  A diabetic may not be able to perceive a stone in their shoe to remove it immediately.

Constant rubbing can easily create a sore.

3.      Poor circulation: Diabetes, especially when poorly controlled, can

lead to accelerated hardening of the arteries.  When there is not good

blood flow to injured tissue, healing does not occur as well. 

 4.      Trauma to the foot: Any trauma to your foot can increase the risk for

a more serious problem to develop.

When to Seek Medical Care

 Write down your symptoms and be prepared to talk about them on the phone with your doctor.  Following is a list of common reasons to call your doctor if you have a diabetic foot or leg problem.

1.      Any significant trauma to your feet or legs.

2.      Persistent mild-to-moderate pain in your feet or legs.  Constant pain is never normal

3.      Any new blister, wound, or ulcer.

 4.  Any new areas of warmth, redness, or swelling on your feet or legs.

 5.  Drainage of pus from a wound is usually a sign of infection.

 6.  Fever of chills in association with a wound. 

7.      Red streaking away from or redness spreading out from a wound.

Prevention of diabetic foot problems involves a combination of factors.

·        Good diabetes control

·        Regular leg and foot self-examinations

·        Knowledge on how to recognize problems

·        Choosing proper footwear

·        Regular exercise, if able

·        Avoiding injury by keeping footpaths clear

·        Having your doctor examine your feet at least once a year using a monofilament, device made of nylon string that tests sensation

   Nutrition Tips to Help Wound Healing

People who are recovering from wounds whether from traumatic injury, surgical incisions, pressure ulcers (bed sores), poor circulation, diabetes or burns can improve

Their healing and reduce the risk of wound infections by putting extra effort into eating

well throughout the recovery process.

 Unfortunately, pain, immobility, fatigue and loss of appetite may reduce the intake of

important nutrients at a time when your body needs more of them. A well-balanced diet

with adequate calories, plenty of fluids and extra amounts of protein, Vitamin C and Zinc

are essential for improved wound healing.

 The following are some suggestions that we hope you will find useful.

• Take a multivitamin everyday with vitamin C and Zinc unless otherwise ordered by your doctor. 
• Try not to lose weight during the process of wound healing even if you are overweight to begin with.  Unless specifically instructed to lose weight as part of your treatment plan, weight loss during this time can delay healing.
• Work hard to get in at least 2 quarts of fluid each day (unless otherwise ordered by your doctor).  For those with large “weeping wounds” or burn, daily fluid intake may be much higher, ask your doctor about any special needs you might have.
• Concentrate on getting more protein into your diet from foods such as meat, fish, poultry, eggs, beans and dairy products. (Protein creates and repairs tissue) 
• Increase your Vitamin C and Zinc intake by eating more of the foods rich in these nutrients.

Suggested items can be found in the guidelines provided. 

• If you are taking a medication called prednisone, be sure to take a multivitamin with Vitamin A. This will help to counteract the side effects of prednisone on wound healing. Ask your doctor if you should take any additional Vitamin A supplements. 
• If your appetite is poor or you have lost ten or more pounds in the recent past, you may require a nutritional supplement such as Instant Breakfast, Ensure, Boost, orprotein powders. Sugar-free varieties are available for diabetics. Ask your doctor, nurse or dietician for suggestions within your dietary guidelines.

Suggested Nutrient Rich Foods for Wound Healing

Foods rich in Protein

Beef                                         Beans                                  Eggs

Chicken                                  Milk                                       Nuts

Pork                                         Cheese                               Cottage Cheese

Turkey                                     Ice Cream                          Yogurt

Fish                                          Peanut Butter

Foods Rich in Vitamin C

Oranges                                   Lemons                                    Cranberry Juice

Orange Juice                           Cantaloupe                               Kale*

Grapefruit                                 Green Pepper                         Cabbage

Broccoli                                   Strawberries                            Tomatoes

                                                                                                    Turnip Greens*

Foods Rich in Zinc

Shellfish                                  Rice                                         Organ Meats (liver, Gizzard)

Oysters                                    Dried Beans and peas                                                                      

Wheat Germ                            Dark Turkey Meat                Milk

Foods rich in Vitamin A

Liver                                        Greens*                                  Squash

Egg Yolks                           Apricots                                   Whole, Fortified Skim

Broccoli*                                 Cantaloupe                               or Low Fat Milk

Peaches                                   Sweet Potatoes                       Carrots

Tomatoes

Foods Rich in Iron

Liver                                        Peanuts                                    Egg

Beef                                         Dried Peaches                        Oysters

Pork                                         Sardines                                   Enriched Bread / Cereals

Beans                                       Tuna                                         Green Peas

Blackstrap Molasses               Prune Juice                             Clams

Winter Squash

*Foods high in Vitamin K which should be limited if you are taking Coumadin.

Please contact your physician, dietician, or nurse with any questions or concerns.