What all steps can our friends with Diabetes take to keep their feet healthy?

Always remember, Prevention is better, cheaper and safer than cure.

Few pointers about footcare for patients with Diabetes. A thread 🧵

Do read and share.

#Diabetes #Footcare (1/n)
Diabetes can be dangerous to your feet🦶

Even a small cut can have serious consequences.

It can affect blood flow to the lower limbs, affecting healing and making prone to infection.

It can affect nerves leading to reduced sensation including pain. #Diabetes #Footcare (2/n)
If you have diabetes & develop a blister or cut or a sore, it could lead to a non healing wound that could progress & some cases requiring surgeries & even amputation. We see many cases in late stages, hence requires intervention. Many are PREVENTABLE. #Diabetes #Footcare (3/n)
Some basic guidelines. Do consult your Doctor & take advice if reqd.

Inspect your feet daily. Check for cuts, redness, blisters, or nail issues. Use a magnifying mirror to look at the bottom of your feet. Inform your Dr if you notice anything.
#Diabetes #Footcare #India (4/n)
Bathe feet in lukewarm water, never hot water.

Keep them clean by washing daily. Use lukewarm water- the temperature you would use in a newborn baby.

Be gentle, use soft washcloth. Make sure to dry between the toes.

#Diabetes #Footcare #Mumbai (5/n)
Moisturise your feet but not between the toes.

Use a moisturiser 🧴 daily to keep dry skin from itch or cracking. Keeping area between toes too moist may lead to fungal infection.

#Diabetes #Skin #Footcare (6/n)
Cut nails carefully.

Very important. Many cases of foot infections we see can start as an ingrown nail.

Cut nails straight across and file the edges. Don’t cut too short as they may lead to ingrown nails.

#Diabetes #Nails #Footcare (7/n)
Never treat corn or calluses yourself. Consult your Doctor and consult early. Early treatment with an expert can prevent a lot of complications and avoid surgeries.

Self medications, “bathroom surgery” may prove very costly.

#Diabetes #Footcare (8/n)
Wear clean and dry socks and wash/ change them daily. If required, consider products specific for diabetes.

If feet get cold at night, you can wear socks to bed. Never use heating pad or hot water bottle.

#Diabetes #Footcare (9/n)

Wear appropriate footwear/shoes as recommended especially during walking /exercise.Shoes that fit well

Shake out your shoes & feel inside before wearing. Due to reduced sensation, feet may not be able to feel small pebble or object & cause injury.

#Diabetes (10/n)
Keep your feet dry and warm.

Don’t let feet get wet in rain or snow. Wear warm socks and shoes in winter.

#Diabetes #Footcare (11/n)
Avoid walking barefoot 🦶

Even at home, you may step on something and get a scratch or a cut.

#Diabetes #Footcare #Mumbai (12/n)
Do you smoke?

Apart from other well known effects, smoking also restricts blood flow in your feet. It can increase the risk of complications faced by many of our patients with Diabetes.

#Diabetes #Smoking #Nosmoking (13/n)
Get periodic foot examinations with your doctor. It may be easier to detect early signs and take remedial measures. Early diagnosis and treatment greatly reduces risk of surgery and amputations.

#Diabetes #Footcare (14/n)
When to see your Dr

Pain in legs
Cramping in buttocks, thighs, calves on walking
Loss of touch, temperature sense, pain
Loss of hair on feet, toes, legs
Dry, cracked skin on feet
Fungus infection in between toes
Blister, sore,ulcer,corn,ingrown toe nail

#Diabetes (15/n)
Last and one of the most important.

Take good care of your diabetes, keep your glucose (sugar) levels under control. This helps in preventing complications.

Follow good balanced diet

Walk and exercise daily

Stay healthy 💐

#Diabetes (16/16)
@divya_sharmaMD would be great if you can share some of your foot-skin care tips and suggestions here too. Fungal infection in the skin between the toes is far too common and often the harbinger of serious complications.

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More from @baxirahul

22 Aug
Yoga doesn't work, Anulom Vilom Pranayama doesn't work, Cardiac coherence breathing does #Yoga #CardiacCoherenceBreathing (1)
This article by @AskDrShashank et al sheds light on role of yoga based lifestyle modifications in Type 2 Diabetes and associated factors #Diabetes #Yoga (2) ncbi.nlm.nih.gov/pmc/articles/P…
This editorial in @j_metb talks about evidence for effect of yoga in #Diabetes and #Prediabetes #Yoga (3)

Read 6 tweets
23 May
In the sea of tweets about high glucose levels, let’s not forget something which can be equally important and more dangerous. Hypoglycaemia (low glucose levels). Below are some of the symptoms which can be due to low glucose levels #Diabetes #COVID19 #Steroids (1/n)
Many patients who are on steroids may be on medications for hyperglycemia(tablets as well as Insulin). Once steroid dose is gradually reduced, the glucose levels will tend to improve. Some may have low glucose levels in morning too #Diabetes #Hypoglycemia #COVID19 (2/n)
As steroids r reduced & stopped, its important to continue monitor glucose levels & consult ur Dr so the diabetes medicines can be adjustd accordingly. I have seen few cases who continued diabetes medicines & had weakness but didn’t check glucose levels regularly #diabetes (3/n)
Read 5 tweets
14 Apr
This chat with wife of one of my #Diabetes patients adm with #Covid19

1. Please trust the Doctors taking care of you. They know best at that point of time.

2. Steroids may be one of the drugs used for treatment especially when oxygen saturation low (1/n)
3.Steroids can significantly affect glucose levels.They can typically cause rise in after meal glucose levels during the day & morning fasting glucose levels are better

4.Some oral agents (tablets) for Diabetes may need to be stopped on admission(2/n)

#Diabetes #COVID19India
5. Insulin will be required in most patients on steroids. Please allow your Doctors to use this drug to control your glucose levels.

6. You may see glucose levels u have never seen or heard all your life. Levels of upto 300-400 mg% are likely to be seen(3/n)

#Diabetes #COVID19
Read 8 tweets
6 Apr
Me: Since how many years u have Diabetes?

Patient: Sir, I had ‘borderline diabetes’ since 5 years. Not on medicines, only diet. First time now, I have checked in yrs,sugars 220 (Fasting) 310 (after food)

What’s ‘borderline diabetes’ Thread. #PreDiabetes #Medtwitter (1/n)
What is #Prediabetes

When glucose levels don’t meet criteria for Diabetes but r still high to be considered normal. Includes

1. IFG - Impaired Fasting glucose - FPG 100-125 mg%

2. IGT (75 gm OGTT)- Impaired Glucose Tolerance - 2 hr PG 140-199 mg%

3. HbA1C - 5.7-6.4% (2/n)
#Prediabetes increases future risk of Diabetes and cardiovascular disease (CVD).

It may be a/w Obesity, Dyslipidemia (deranged cholesterol levels) and Hypertension (high blood pressure) (3/n)
Read 9 tweets
8 Jul 20
In this thread I will mention precautions to be taken by #Diabetes patients in today’s scanario with #COVIDー19 #coronavirus #India #Mumbai (Ref IDF) @drmohanv @DrAmbrishMithal @AskDrShashank @docanoopmisra @Unnikri @DrDeepakKrishn1 @serioustaurean @DNeurosx @viswas_mr (1)
Recommendations for general public are doubly important for patients with #Diabetes & those living in their close contact 1.Wash hands thouroughly and regularly 2.Avoid touching face before washing and drying hands #COVIDー19 #coronavirus (2)
Clean and disinfect any objects & surfaces touched frequently (door handles, mobile phones, tv remotes). Don’t share towels, food, glasses. (3)
Read 13 tweets

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