This document provides information on prevention of diabetic foot ulcers through a self-care program. It discusses how neuropathy, deformities, and minor trauma can lead to foot ulcers in diabetic patients. Regular foot exams are important to check for common problems like dry skin, calluses, and infections early. Daily foot care including inspection, cleaning, nail trimming, moisturizing, and proper footwear can help prevent ulcers and amputations. Risk factors like smoking, poor control, and peripheral vascular disease increase the risk of ulcers and recurrence.
To learn more about diabetic foot wounds visit my website
www.healmyfootwoundfast.com
Educational power point on foot wounds relating to:
1. Obesity in America
2. The Epidemic of Diabetes
3. Complications of Diabetes
4. Cost Realities of Diabetes
5. Chronic Foot Ulcers
Dr. Donald Pelto
299 Lincoln Street Suite 202
Worcester, MA 01605
To learn more about diabetic foot wounds visit my website
www.healmyfootwoundfast.com
Educational power point on foot wounds relating to:
1. Obesity in America
2. The Epidemic of Diabetes
3. Complications of Diabetes
4. Cost Realities of Diabetes
5. Chronic Foot Ulcers
Dr. Donald Pelto
299 Lincoln Street Suite 202
Worcester, MA 01605
Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. This lack of feeling is called "sensory diabetic neuropathy.
offloading is an important aspect in Diabetic foot ulcer patients.There are two major aspects of offloading. Offloading is immensely useful in helping ulcers heal and secondly in prevention of recurrence of ulcers.
Podiatry & Foot Care - General Tips (Northern Foot Care)Dr. Daniel Reminga
Presentation covering podiatry, general foot care statistics, top foot problems, and basic foot care guidelines. All information via northernfootcare.com and Dr. Reminga.
Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain. This lack of feeling is called "sensory diabetic neuropathy.
offloading is an important aspect in Diabetic foot ulcer patients.There are two major aspects of offloading. Offloading is immensely useful in helping ulcers heal and secondly in prevention of recurrence of ulcers.
Podiatry & Foot Care - General Tips (Northern Foot Care)Dr. Daniel Reminga
Presentation covering podiatry, general foot care statistics, top foot problems, and basic foot care guidelines. All information via northernfootcare.com and Dr. Reminga.
Diabetic ulcer
Diabetes type 2 cure. It's real!
Discover the new and improved diabetes cure that will completely remove diabetes from your life!
This diabetes cure applies for:
- Diabetes type 1
- Diabetes type 2
This is a webpage for St. James Health Care the focus of this website is general education for the newly diagnosed diabetic patient. This site will also provide links to other reliable resources.
Diabetes a known disease to everyone. If you are a diabetic patient & also have a wound then you are the person who know the sufferings. Here, we discussed about the care regarding diabetes. Following these, your sufferings will reduce. Thanks
Diabetes, Peripheral Neuropathy & How to ConductTrevor Perkes
Discussion of the relationship between diabetes and peripheral neuropathy and loss of protective sensation. How to perform a monofilament sensory test to detect a loss of protective sensation
Learn more at ProhealthcareProducts.com
A description of common foot complications in the diabetic foot. Discussion include: Diabetic foot ulcers, callouses, toenail fungus, hammertoes and bunions.
Hari laser clinic is one of the best in advance laser treatment , we are a specialized team in piles treatment , varicose veins , fissures, Pilonidal sinus and Fistula and also we have an highly professional surgeons to provide best in the class service in Laparoscopic Surgeries ( Gallstones, hernia and other forms of laser surgery we also include excellent service in Breast surgeries, thyroid surgeries and Diabetic foot management and many more services are include in our hari laser clinic
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
1. Prevention Of Diabetic Foot Ulcer
Disease A Patient Self Care Program
Dr. Vijay Viswanathan, M.D, Ph.D.,
Joint Director
Diabetes Research Centre
Chennai.
2. The diabetic patient is often divorced from
his feet, unable to see them because of poor
eyesight and unable to feel them.
[Bloom A. Clin. Endocrinal. Metab 1977].
3. Upto 50% of all non-traumatic lower
limb amputations are performed on
diabetic patients.
Most & Sinnock “Diabetes Care” 1983.
4. DIABETIC FOOT PROBLEMS
ARE A MAJOR CAUSE OF
HOSPITALISATION IN INDIA.
Sathe S.R. : Int. J. Diab. Dev. Countries 1994
Pendsey S : IDF bulletin 1993
V. Vijay et al IDF bulletin 1997
6. Neuropathy Deformity Minor trauma
Baseline Pathophysiologic Environmental Time Ulceration
pathology involvement event
Accumulation of component causes
to form a sufficient cause
Completed
causal chain to
ulcer
The commonest causal pathway to incident diabetic foot ulcers.
7. Risk factors for development and progression of neuropathy and development of
neuropathic foot ulceration.
Risk factors for the development Risk factors for the development of
and progression of neuropathy of neuropathic foot ulceration
* Poor glycaemic control * Loss of pain sensation
* Undiscovered Type 2 diabetes * Undiscovered Type 2 diabetes
* Smoking * Smoking
* High alcohol intake * High alcohol intake
* Low socio-economic status * Low socio-economic status
* Renal failure. * Patient lives alone
* Lack of flexibility / suppleness
* Ill-fitting footwear
* Poor foot hygiene / footcare
* Denial of condition
* Lack of diabetes education
* History of previous ulceration or amputation
* Poor glycaemic control
* Peripheral vascular disease
* Decreased vibration sensitivity.
8. Staging of diabetic neuropathy
• Stage 0 :
No neuropathy (no symptoms and fewer than two
abnormalities on formal testing).
• Stage 1 :
Asymptomatic neuropathy (two or more abnormalities on
formal testing with no symptoms)
• Stage 2 :
Symptomatic neuropathy (two or more abnormalities on
formal testing with minor symptoms).
• Stage 3 :
Disabling neuropathy (two or more abnormalities on formal
testing with severe symptoms).
9. The Risk of Foot Ulceration in Diabetic Patients
with High Foot Pressure : A Prospective Study.
[A. Veves, H.J.Murray, M.J. Young and A.J.M.Boulton
Diabetologia, 1992.]
The Association Between Callus Formation, High
Pressures and Neuropathy in Diabetic Foot
Ulceration.
[ H.J.Murray, M.J. Young, S. Hollis, A.J.M.Boulton
Diabetic Med. 1996]
11. Peak Plantar Pressure in the study groups
Group 1 Group 2 Group 3 Group 4
n=40 n=123 n=118 n=26
Plantar Pressure 207 260* 347* 638*
K Pa (median) (100-441) (53-3274) (101-2942) (354-4484)
% with values above
median of controls - 63.4 79.7** 100
* P<0.02 Vs Group 1 by median test;
** P<0.008 Vs Group 2 by χ2 test.
12. Predictive factors for Recurrent Diabetic Foot
infection in South India.
Follow-up study of 374 patients who had undergone
surgery for foot infection during January 1994 and
December 1997.
[M:F 227:147; Mean age 54.9 + 9.4 yrs; Diabetes
duration 10.9 + 7.7 yrs].
Vijay Viswanathan, D.V.L Narasimham,
R.Seena, C. Snehalatha, A. Ramachandran,
Diabetic Medicine [2000]
13. Comparison of predisposing factors in relapsers and
non-relapsers.
Relapsers Non relapsers P value
n =198 n = 176
Age years 54.5 + 8.9 55.3 + 9.8
Smoking 33 (16.67 %) 31 (17.6 %)
Diabetes duration yrs 11.5 + 8.14 10.2 + 7.1
Mean base line
HbA1 % 10.3 + 1.1 10.4 + 1.1
Mean follow up
HbA1% 9.7 + 0.9 9.6 + 0.9
PVD** 49 (24.7%) 27 (15.3%) χ2=4.53 P<0.03*
Neuropathy** 134 (67.7%) 67 (38.0%) χ2=31.7 P<0.001*
* Significant
** Chi square test, all others were compared by the 't' test
14. Diabetic foot infection is a common cause for
hospital admission of diabetic patients in India.
Probable reasons
a. Socio-cultural practices such as bare foot walking.
b. Poor knowledge of foot care among diabetic patients.
c. Delayed referral of patients with foot infection to
specialists.
d. Inadequate facilities for diabetes care.
e. Poor socio-economic conditions.
15. Studies in Europe
Recurrence rate of 34% during a follow-up of 1 year and
70% over a period of 5 years.
Apelquist et al. J. Intern. Med..1993.
16. Routine foot examination : the first step
towards prevention of diabetic foot amputation.
Aim of the study
To determine the prevalence of common
foot problems among apparently healthy
diabetic patients.
Vijay Viswanathan et al.
Practical Diabetes International [2000].
17. PATIENTS AND METHODS :
Every third diabetic patient who came to the foot clinic
for routine testing of feet for neuropathy and PVD.
1010 patients (M:F - 706:304) were examined by the
foot educator.
Patients were examined for (i) Dry skin (ii) Heel
fissures (iii) Fungal nail infection (iv) Ingrowing toe
nails (v) Intertrigo (vii) Callus.
Dr. Vijay Viswanathan / DRC.
21. Teaching patients how to practise foot care is widely
accepted as an important part of diabetes education
programs in order to prevent amputations.
Barth et al. “Diabetic Medicine” (1991).
23. What needs to be controlled
for foot at risk?
Metabolic control
Hyperglycemia
Hypertension
Hyperlipidaemia
Cessation of smoking
24. What needs to be controlled
for foot at risk?
Deformity
The importance of Callus removal in Neuropathic
Diabetic Foot - decrease plantar pressure
Dry skin and fissure management
25. What needs to be controlled
for foot at risk?
Debridement and ulcer management
Mechanical control
Off load, Off load, Off load
by rest, crutches, walkers, protective shoes, heel protective pad,
decrease plantar pressure by removal callus
The importance of callus removal in NFU
shows full dimension of the ulcer
deep swab possible
drainage of exudate, removal of dead tissue
Infection control
Education
26. • Learn to take good care of your feet.
• Practice what you learn every day.
• Foot problems must be detected and treated
properly.
• Take help of a Foot care specialist or your
Diabetes Care Team.
Need of the hour –Self care
27. Diabetes and your Feet
Why People with Diabetes require good
care of their Feet?
There are several reasons
• Loss of Sensation .
• Poor Circulation ( Slow Healing of wounds)
• Higher likelihood of developing foot infections that heal
slowly or improperly.
28. Self Foot Care
Recognize the Symptoms of Foot Problems
• Pay attention to peculiar sensations such as the feeling of
walking on Cotton or or on nuts.
• Beware of feeling of wearing tight socks even when the
feet are bare.
• Stabbing pain or burning sensations.
These all are major risk factors for the development
of serious foot problems.
29. Daily Foot Care
You can prevent major foot problems, if you can
• Inspect your feet daily
• Keep your feet clean and dry
• Trim your toenails carefully
• Protect you feet with appropriate footwear
• Have your doctor or nurse examine your
feet regularly (especially if you have any loss of
sensation in your feet or toes)
30. Daily Foot Care
Inspect your feet daily
• Examine your feet in good light after bath.
• Check for calluses, dry skin or areas that are reddened
• Check to see that the nails are well trimmed.
• Use a mirror to see the bottom of
and between the feet.
• Look and feel carefully for possible injuries, for breaks in
the skin, cuts, scratches, bruises, blisters, sores, and
discolouration.
31. Inspect your feet daily
Learn to recognize the early signs of Infection
• Unusual warmth over the injured area
• Redness
• Swelling
• Pain ( if you still have good Sensation)
• Drainage of pus from an opening in the skin.
If you find any of these immediately take Doctor’s
advice or ask your Diabetes Care team.
32. Keep your feet clean and dry
• Wash your feet everyday.Wash them as you wash your
hands, using soap and lukewarm water.
• Use a moisturising cream to add oil to your skin and keep
it smooth and soft.
• Dry your feet carefully after bathing, especially between
the toes where moisture can lead to a fungal infection.
• Use mirror, if required.
33. Trim your Toenails carefully
• It helps to avoid ingrown toenails, which can lead to
infection.
• Cut toenails after a bath, when soft and pliable.
• Cut your toenails straight across the top and not too far
back on the sides.
• Do not use a sharp instrument to clean under the nail, or
in the grooves.
• If your toe nails are too thick to cut, you can have them
cut by your Diabetes Care team.
34. Protect your feet with appropriate
footwear
Many foot problems can be avoided if you
are careful to protect your feet at all times
• Don’t walk barefoot.
• Choose Proper footwear of the correct shape and size.
• Always shop for shoes in the evening when the feet are the
largest.
• Check the size of the shoes wearing the thickest socks.
• Choose cotton or wool Socks.
• Socks should be free of wrinkles and holes.
35. Proper Footwear
• Shoe should be comfortable and fit well.
• Never wear Shoes which are too short or too narrow.
• Rounded toes give more space to the feet.
• Always choose flat shoes with thick, sturdy soles to protect the
feet from sharp objects.
• Leather shoes let the foot breathe freely.
• When buying a pair of Shoe, take in to account any bunions or
other irregularities. These will require wider and deeper shoe
to avoid pressure points.
36. Pressure Sores or Ulcers
• It starts with a callus, which is a sign of continuous
pressure or friction on a particular part of feet
• It is always advisable to treat the callus before an ulcer
occurs. See your Doctor or Diabetes Care Team
immediately.
• If not treated properly , such ulcers can lead to serious
foot problems like Gangrene.
• The presence of Gangrene can sometimes lead to the
removal of a toe or foot (Amputation).
38. Cuts, and Injuries
• Keep the affected area or Injury clean and apply a sterile
bandage.
• If you have decreased sensation in your feet , you have to
be more careful to avoid Injuries such as minor accidents,
Burns etc.
• In absence of pain (alarm system), these minor injuries
may become serious and can lead to amputation or
removal of that part of the foot.
40. Blisters and Cracks
• Never squeeze or puncture a blister.
• Proper bandage and Careful inspection is most important.
• If the blisters appears to contain blood or becomes
inflated see your doctor or Diabetes care team.
• Cracks are difficult to heal and Infections occur easily.
Daily use of foot cream to soften the skin as well as a
shock absorbing insole is recommended.
42. • It often caused by Improper nail trimming or
poorly fitted shoe.
• The problem can be solved by correcting the
footwear. You can ask you Diabetes Care Team
for assistance.
• As with all foot problems , prevention is the best
cure for ingrown nails.
Ingrown Nails
44. Corns and Calluses
• Usually Corns and calluses result from poorly
fitted footwear that puts pressure on certain area
of the Foot.
• A deep ulcer or crack can result if the callus is left
untreated.
• Consult your Doctor or Diabetes Care Team for
further treatment of Corns and calluses.
46. Nerve problems and Foot Care
• Nerve fibers carry messages between the brain and all
parts of the body.
• Nerve damage in your feet may lead to loss of sensations
and muscle weakness.
• It decreases your ability to sweat or impair blood flow to
your feet.
• It can affect the way you walk, leading to joint fractures
that occur without any apparent accident or other cause.
47. Symptoms of nerve problems in your
feet
• Tingling, or a feeling of “PINS and NEEDLES”.
• Numbness
• A peculiar feeling of walking on cotton or nuts.
• Stabbing or burning Pain.
• Pain with light touch of a bed sheet.
• A feeling like wearing tight stockings.
• Keeping your blood sugar as close as normal ( 90-
110 mg/dl) can slow the development of Nerve problems.
48. Who is at a risk of Foot Ulcers ?
Some People with Diabetes have a greater risk of
developing foot ulcers than others. The factors which
may play a role are:
• Those with more than 15 years of poorly controlled diabetes
• Impaired Vision
• Smoking
49. You should take more care of your feet if you
have any of the following
• Loss of sensation in your feet
• Poor Blood circulation as in pain at rest.
• Bunions or other foot deformities
• Previous foot ulcers
Who is at a risk of Foot Ulcers ?
50. Blood Sugar Control
• Poor blood sugar control is a risk factor for the
development of foot ulcers.
• Good control can prevent the development and
progression of nerve problems ( Loss of
Sensations).
• The better you blood control , the better your
body can take care for itself.
51. Poor Vision
• Poor vision puts your feet at risk, because you
may not be able to see the minor sores and other
foot problems at the bottom of the feet.
• Ask your diabetes care team for complete
inspection of the feet.
52. Smoking
• Do not smoke as nicotine causes blood vessels to
shrinks and slows down the blood flow to the
foot.
• Impaired blood circulation can increase the foot
Problems.
53. Examination of your feet
• Assess the general condition of your skin and nails
• Check for signs of poor circulation.
– Cold extremities, absent or weak pulsations
• Check if you can feel normal sensations.
• Look for the deformities such as bunions.
• Note any calluses.
• Check for signs of infection, injury and ulcers.
• Watch the way you walk and note any changes.
54. Tests Done On Feet
• For the loss of protective sensation like pain.
• Your ability to feel vibration.
• Light touch with a monofilament.
• For impaired blood circulation, or foot pulses.
• Toe blood pressure.
• An angiogram of arteries if required.
55. Foot at risk - 1
• Our job – look after “NDF at risk”
• A: Preventive measures
• Treatment - rapid and intensive
• Rest
• Off load
• Antibiotics
• Foot wear
• Patient education