Diabetes Self-Management Articles

These articles cover a wide range of subjects, from the most basic aspects of diabetes care to the nitty-gritty specifics.

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Diabetes and Your Skin
Protecting Your Outermost Layer

by May Leveriza-Oh, MD

Wounds should be treated promptly. Since people with diabetes may not heal as well as others, it is important to give immediate attention even to cuts and wounds that seem minor. Injuries to the skin should be kept covered and inspected on a regular basis to make sure they are not worsening. The hands and feet should be inspected daily for the presence of cuts or scrapes, since these parts of the body may have decreased sensation due to neuropathy, and wounds may therefore go unnoticed. Dryness and itching can be self-treated, but more serious conditions should be brought to the attention of a doctor.

Preventing foot ulcers
Proper foot care is a vital part of preventing minor wounds from developing into ulcers. This means the feet should be inspected daily for cuts, sores, or other forms of irritation. The toenails should be cut straight across. (If a person cannot see or reach his feet, a health-care provider should cut his toenails.) The feet should be washed daily in warm water and carefully dried, especially between the toes. A moisturizing lotion should then be applied, but not between the toes.

A health-care provider should examine the feet at least once a year. People with risk factors for developing a foot ulcer, such as neuropathy, foot deformities, calluses, or a history of foot ulcers, should have their feet inspected by a doctor more often, preferably every one to six months. If a person notices a blister, cut, scratch, sore or other form of irritation, he should be sure to notify his health-care provider immediately.

People with diabetes should avoid walking barefoot, even when indoors. Socks or stockings should also be worn to reduce friction between the foot and the shoe. If possible, choose seamless socks and stockings. Socks with lumpy seams can be worn inside out to prevent irritation to the skin.

Wearing shoes that fit is very important, since ill-fitting footwear is a major cause of foot ulcers. People who have not lost the protective sensation in their feet can choose off-the-shelf shoes. Shoes should have some room, preferably 1/2–5/8 inch, between the front of the shoe and the longest toe. The width of the shoe should accommodate the ball of the foot, and the toes should not be cramped. Selecting a store with a certified pedorthist on staff is a good idea, since this person will know the subtle differences between various styles. It is best to select shoes toward the end of the day, when feet are at their largest.

People who have lost the protective sensation in their feet due to neuropathy or those who have peripheral vascular disease, foot deformities, calluses, ulcers, or other special circumstances should discuss getting customized shoes with their physician.

The skin you’re in
A large part of keeping your skin healthy involves maintaining practices that are good for your whole body, such as eating a balanced diet, drinking plenty of water, managing stress, and controlling your blood glucose level. Good diabetes management is especially important, since many skin conditions are related to complications resulting from high blood glucose. By sticking with healthy habits and keeping an eye on your skin, you can avoid many common ailments and be happy with the skin you’re in.

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