Key Points of Diabetic Foot Care

Written by Zhao Xin Lan
Endocrinology
Updated on September 09, 2024
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First, a daily foot examination is necessary, including the top, bottom, and toes. Carefully observe the skin's color, temperature, and moisture level, check for edema, skin lesions, and assess sensory and motor reflexes.

Second, maintain a daily routine of soaking the feet in warm water. The water temperature should not exceed 40°C, with the soaking time ideally between 10 to 20 minutes.

Third, regularly trim your toenails. Long toenails can easily break and damage the surrounding tissue, thus it is important for diabetic foot patients to regularly trim their nails.

Fourth, the breathability of shoes and socks is important. It is advised not to wear sandals or slippers that expose the skin of the feet since exposed skin is more susceptible to injuries.

Fifth, never walk barefoot.

Sixth, avoid using electric blankets, hot water bottles, heating by the fire, and cupping therapy, to prevent burns on your feet.

Seventh, maintain proper skin moisture. For patients with sweaty feet prone to excessive sweating, fungal infections may occur. It is recommended to wipe the spaces between toes with medical alcohol during foot baths, and to add a small amount of vinegar to the footbath water, as a bifunctional environment discourages fungal growth.

Eighth, actively control blood sugar levels in diabetes.

Ninth, maintain moderate exercise. Frequently elevate the affected limb to facilitate blood return and improve circulation in the lower limbs.

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Diabetes dietary taboo fruits

Many patients have a misconception after being diagnosed with diabetes; they think that fruits are sweet and they should avoid all fruits. This statement is half right—fruits are indeed sweet, but not all fruits are off-limits. Diabetes patients can still consume fruits, provided that they pay attention to the quantity and type of fruit they eat. First, let’s discuss the fruits that should not be eaten by diabetic patients, which are those high in simple sugars. Consuming these fruits can cause a rapid spike in blood sugar levels. Examples include dates, whether dry or fresh, longans, whether dry or fresh, lychees, whether dry or fresh, and bananas, which all have very high sugar content. These fruits are not recommended for diabetic patients; on the other hand, fruits like kiwis, cherries, kumquats, and grapefruits are generally suggested as suitable for diabetic patients.

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How to determine if you have diabetes

If a patient experiences significant symptoms of dry mouth, excessive thirst, increased urination with more foamy urine, increased appetite, but an unexplained weight loss, known as the "three polys and one low" symptoms, it is necessary to monitor fasting blood glucose. If the fasting blood glucose exceeds 7.0 mmol/L or the blood glucose two hours after a meal exceeds 11.1 mmol/L, or if there are no clear "three polys and one low" symptoms but random blood glucose levels exceed 11.1 mmol/L on two occasions, a diagnosis of diabetes can be confirmed. At the same time, it is essential to rule out secondary effects on blood sugar levels caused by infections, trauma, or the use of steroid medications. It is also recommended that the patient undergo tests for glycated hemoglobin, as well as insulin and C-peptide release tests, to further clarify the diagnosis.

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What does a diabetic diet include?

The diet for diabetes primarily includes the following aspects: First, it is recommended to eat at regular times and in fixed amounts daily. Second, avoid consuming foods with a high glycemic index, such as porridge, glutinous rice, and rice noodle rolls, as these are not recommended. Third, the diet should be bland, as many diabetic patients also suffer from high blood pressure, high blood lipids, and high uric acid. Therefore, a bland diet is emphasized. Fourth, overly sweet fruits such as lychee, longan, banana, and grapes are not suitable for consumption.

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Symptoms of Gestational Diabetes

The symptoms of gestational diabetes differ from those of non-pregnancy diabetes; non-pregnancy diabetes is mainly characterized by excessive drinking, eating, urination, and weight loss. During pregnancy, excessive drinking and eating may be physiological responses due to increased appetite, and frequent urination may be caused by the enlarged uterus pressing on the bladder during early pregnancy. Weight loss is generally not apparent in gestational diabetes due to the growth of the fetus, the uterus, and the increase in amniotic fluid. For women who had a higher body mass index before pregnancy and a family history of diabetes, it is recommended to start glucose tolerance screening from the time of planning to conceive. For those who gain weight rapidly after becoming pregnant and have a significant increase in amniotic fluid, we typically conduct routine diabetes screening between 24 to 28 weeks of pregnancy. Gestational diabetes has severe impacts on the pregnant woman, the fetus, and the newborn, thus early detection and treatment are advised.

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Gestational diabetes symptoms

Gestational diabetes refers to the abnormal glucose tolerance that occurs during pregnancy, typically characterized by mild, asymptomatic elevated blood sugar levels without obvious symptoms such as dry mouth, excessive thirst, and frequent urination. However, when blood sugar levels are high, symptoms typical of diabetes such as dry mouth, excessive thirst, and frequent urination may occur. If excessive amniotic fluid, a large fetus, or recurrent infections of the external genitalia occur during pregnancy, it is important to be vigilant for the presence of diabetes. It is generally recommended that patients undergo the OGTT (Oral Glucose Tolerance Test) during the mid-stage of pregnancy to confirm whether gestational diabetes is present. Women's blood sugar levels generally return to normal after childbirth, but the risk of developing diabetes later increases significantly. Therefore, patients with gestational diabetes should be screened for diabetes 6-12 weeks postpartum and monitored over the long term.