Foot care. Everyone with diabetes is advised to do a daily foot check. If you have some remaining vision, using a long-handled, magnified mirror can make examining your feet easier. When using a mirror, be sure to inspect the backs of your feet. Propping feet on furniture for long periods of time can cause sores.
Nonvisual techniques can be used to inspect the feet as well. An unpleasant odor when removing socks may be the first noticeable sign of a fungal or other infection. Use your fingers to feel all areas of each foot after washing and drying the feet. Apply lotion during the foot exam. First, feel around and between the toes. (Do not put lotion between your toes.) Move the fingers to the outer edge of the foot, the heel, the bottom of the foot, and finally the top. Note any pain or changes in temperature or texture of the skin. Changes can mean corns, calluses, cuts, or infection. The back of the hand may be more sensitive to temperature change than the fingertips. If you notice any changes in your feet, have a sighted person check them.
Medicine and supply management. Keep all your diabetes supplies and medicines together in a plastic container or cake pan. When you pour medicines into a pill organizer or into your hand, do it over a large bowl or other container. Pills are easier to find if accidentally dropped into a container than onto the floor.
People who take a lot of pills sometimes remember to take them better if they use a pill organizer. Pill organizers come in different sizes, colors, and types. Some have room for a day’s worth of pills, some for a week’s worth, and some have even more space. Several pill organizers have an alarm that can be set to remind you to take your medicine. The MedReady pill dispenser even has a locking mechanism, allowing access to only one compartment at a time to prevent taking double doses by accident.
Even if you use a pill organizer, you need to be able to tell which pill is in which bottle. One option is the Talking Rx, a talking prescription bottle holder that can play recorded directions. (It can only be used for one bottle at a time, however, so if you take several medicines, you would need several devices.) A less expensive option is to ask your pharmacist to use different size bottles for pills that could be easily confused because of their size, shape, or color. You could also use color coding, numbers, large print, Braille, or other tactile markings on the bottles to tell them apart. Wrapping a number of rubber bands around a pill bottle can help you keep track of the number of doses to take. If you take two types of insulin, wrap a rubber band around vials of one type to tell the difference.
Everyone with diabetes is advised to make a list of all their medicines, allergies, doctors, and emergency phone numbers and to bring it to doctor appointments and to the pharmacy. Such a list can prevent drug interactions and improve communication. For people with low vision, the list should be in a format they can access such as large print, audiocassette, or Braille.
Losing your vision does not mean you’ve lost your intelligence, knowledge, or skills, but you may need to learn some new ways of doing things to remain independent. Let your diabetes care team members know what areas you are having difficulty with so they can suggest resources or techniques to assist you. With proper training and practice, people with diabetes and visual impairment can manage their diabetes and other daily activities. Your goals to live confidently, independently, and productively can be achieved.