21 Things You Need to Know About Diabetes and Your Feet. Neil M. Scheffler

      

      Director, Book Publishing, Abe Ogden; Managing Editor, Greg Guthrie; Acquisitions Editor, Victor Van Beuren; Editor, Rebekah Renshaw; Production Manager, Melissa Sprott; Composition, ADA; Cover Design, Jody Billert.

      ©2012 by the American Diabetes Association, Inc.® All Rights Reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including duplication, recording, or any information storage and retrieval system, without the prior written permission of the American Diabetes Association.

      Printed in the United States of America

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      The suggestions and information contained in this publication are generally consistent with the Clinical Practice Recommendations and other policies of the American Diabetes Association, but they do not represent the policy or position of the Association or any of its boards or committees. Reasonable steps have been taken to ensure the accuracy of the information presented. However, the American Diabetes Association cannot ensure the safety or efficacy of any product or service described in this publication. Individuals are advised to consult a physician or other appropriate health care professional before undertaking any diet or exercise program or taking any medication referred to in this publication. Professionals must use and apply their own professional judgment, experience, and training and should not rely solely on the information contained in this publication before prescribing any diet, exercise, or medication. The American Diabetes Association—its officers, directors, employees, volunteers, and members—assumes no responsibility or liability for personal or other injury, loss, or damage that may result from the suggestions or information in this publication.

      The paper in this publication meets the requirements of the ANSI Standard Z39.48-1992 (permanence of paper).

      ADA titles may be purchased for business or promotional use or for special sales. To purchase more than 50 copies of this book at a discount, or for custom editions of this book with your logo, contact the American Diabetes Association at the address below, at [email protected], or by calling 703-299-2046.

      American Diabetes Association

      1701 North Beauregard Street

      Alexandria, Virginia 22311

      DOI: 10.2337/9781580404778

       Library of Congress Cataloging-in-Publication Data

      Scheffler, Neil M.

       21 things you need to know about diabetes and your feet / by Neil M. Scheffler, DPM, FACFAS.

       pages cm

       Includes bibliographical references and index.

       ISBN 978-1-58040-477-8 (alk. paper)

       1. Foot--Diseases--Popular works. 2. Diabetes--Complications--Popular works. 3. Foot--Care and hygiene--Popular works. I. American Diabetes Association. II. Title. III. Title: Twenty-one things you need to know about diabetes and your feet.

       RC951.S34 2012

       616.4’62--dc23

       2012036748

      eISBN: 9781580405324

      “This book is dedicated to my wife, Eleanor,

      who puts up with all the time I spend on my computer.

      Thanks also to those podiatrists

      who helped train me during my residency:

      Drs. Irvin Donick, Larry Block, Steven Berlin and Lanny Rubin.

      I can never thank you enough.”

Table of Contents

       1 Diabetes and Your Feet

       2 Diabetes Foot Care Team

       3 Diabetic Neuropathy

       4 Peripheral Vascular Disease

       5 Deformities

       6 Foot Ulcers

       7 Infection

       8 Nail Problems

       9 Shoes and Socks

       10 Additional Risk Factors

       11 Skin Care

       12 Melanoma

       13 The Aging Foot

       14 Arthritis

       15 Surgery

       16 Other Foot Problems

       17 Over-the-Counter Products

       18 Exercise

       19 Emergencies

       20 Seasonal Foot Care

       21 Prevention

       Resources

Diabetes and Your Feet

      Diabetes has become an epidemic in this country. This epidemic is costing hundreds of billions of dollars each year in direct and indirect costs while destroying the lives of those with this disease, as well as those of their friends and families. The personal costs to patients include financial as well as non-economic, emotional, social, and psychological burdens. The risk for death among people with diabetes is about twice that of people of similar age without diabetes.

      According to data from the 2011 National Diabetes Fact Sheet, 25.8 million children and adults in the United States—8.3% of the population—have diabetes. 79 million people have prediabetes. 1.9 million new cases of diabetes were diagnosed in people aged 20 years and older in 2010, and there is no end in sight. Diabetes rates in adults ages 65 and up may surge in the next 20 years as the population of senior adults is expected to double to more than 71 million by 2030.

      Lower extremity complications of diabetes account for more in-patient hospital days than any other complication of the disease. More than 60% of lower-limb amputations due to causes other than trauma occur annually in people with diabetes; this number is more than 65,000.

      If you want to be active and independent all of your life—whether or not you have diabetes—you need to have healthy feet. Most people take their feet for granted, but people with diabetes do not have that luxury. You are challenged by complications of diabetes that can make it easier for you to develop a foot ulcer that may not heal. Nonhealing ulcers often lead to amputation, which will severely limit what you can do for yourself.

      The good news is that by taking good care of your feet, you can often prevent diabetic foot complications. If you take care of your feet every day and get good medical care as soon as you suspect you might need it, you’re much more likely to avoid getting the infections that make amputation necessary. According to the Center for Disease Control (CDC), “comprehensive foot care programs, i.e., those that include risk assessment, foot-care education, and preventive therapy, treatment of foot problems, and referral to specialists, can reduce amputation rates by 45% to 85%.”

      This book will help you protect your feet. You will learn about the major lower extremity complications of diabetes: vascular