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Monday, June 16, 2014

Diabetes Positive Approach Newsletter #1406 on Healthy Feet

Welcome to Diabetes Positive Approach Newsletter #1406 issue on healthy feet. Keeping feet healthy is a must for the diabetics in order to avoid complications so I devote all this issue for that topic which we think is a problem but I call it a challenge one can face square on and solve. Remove the symptom and solve the problem, isn’t that right? We will not worry about this because we have a healthy self-image. We will accept it for what it is and move on from there.

In This Issue: “Keep Your Feet Healthy To Avoid Complications"

Diabetes can put one at risk to develop nerve damage which leads to lost feeling in the feet. Because of this, one may not be able to feel the pain from cuts and blisters. This in turn can lead to foot injuries that could cause infections and ulcers. We all know that high blood glucose levels can over time lead to nerve damage. That is why, it is imperative that we keep the glucose level under tight control.

How to Avoid Foot Problems and Two Things to Remember

The First Thing is Blood Sugar Control

First off the bat is to control the blood sugar. We all know how to control the blood sugar but let‘s refresh our memory. Eating healthy, moving more and maintaining the correct weight should be the focus to control the blood sugar. The guideline now is to achieve less than 7% HbAIC level which matches up to the average blood sugar level below 154 mg/dL

The recommendation is also to try for fasting blood sugar of less than 131 mg.dL and below 180 mg/dL for peak after-meals reading. Do remember however there is no such thing as one size fits all so these figures can be adjusted according the individual needs. It is a challenge but it can be done. If we attend to the 3 M’s of moving more, medication and monitoring along with eating healthy, things should be fine.

The Second Thing is Good Foot Hygiene

Inspect your feet every day for sores, blisters and such. If you don’t find it easy to reach your feet, use a hand mirror and put it on the floor if it’s difficult to hold or request someone for help.

Wash your feet daily in lukewarm water. Dry them gently including between the toes.

Use lotion or moisturizing cream on the bottom and top of your feet to keep the skin smooth and soft.

Rub the skin gently with a pumice stone where calluses form easily. Smooth these and corns gently. Don’t try to remove them and other foot lesions yourself. Avoid more injury to the skin by not using scissors, nail clipper or nail file. Don’t use wart removers either. Consult your doctor or podiatrist on removing these lesions.

Trim your toenails straight carefully and regularly with the help of a caregiver or the podiatrist if you cannot do them yourself.

Wear shoes and socks at all times and don‘t go barefoot even at home. It is important to wear the right type of shoes that are made of canvas, leather or suede instead of those made of plastic and other materials that do not breathe. Wear comfortable shoes that perfectly fit with more room and provide cushioning and support for the feet. Get shoes with Velcro, laces or buckles that you can easily adjust.

Avoid high heels, sandals and flip flops and those with pointed toes and narrow shoes that crowd the toes. If one foot is larger than the other, get shoes that are one size larger. Speaking of these, the doctor may recommend orthopedic shoes that are especially designed to fit the shape of your feet exactly and evenly allocate weight on the feet and cushion them at the same time.

As for socks, wear clean dry ones that are made of fibers that pull sweat away from the skin like cotton and definitely not nylon. Don’t wear ones with tight elastic bands that impede the circulation. Neither should you wear bulky and thick socks that irritate the skin.

Protect your feet from hot and cold.

Keep the blood flowing to your feet.

Sprinkle talcum powder or cornstarch between your toes to keep the skin dry.

Quit smoking for this impairs circulation and lowers the amount of oxygen in the blood which can lead to circulatory problems that can increase the risk to develop more severe wounds that heal poorly.

Have regular foot checkups at least once a year so the doctor or podiatrist can inspect and see the early signs of foot problems.

Take foot problems seriously. If a foot sore does not heal in a few days, contact the doctor real quick as he will examine the problem, diagnose it and prescribe a course of action to treat the problem.

Here’s a video on Peripheral Neuropathy

2. Must-Reads from Around the Web

Prevent Diabetes Problems

Foot Complications

How Diabetes Affects the Feet

Diabetes, Foot Care and Foot Ulcers

3. “Alerts I Can’t Resist To Send You

Illegally Sold Diabetes Treatments!

FDA Cracks Down on Diabetes Marketing

FDA Cracks Down on Illegal Diabetes Drugs

FDA Cracks Down on Illegal Diabetes Remedies

FDA Targets Companies Marketing Bogus, Unapproved Diabetes Treatments

4. A Success Quotation of the Month“

“Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time.” Thomas Edison

5. Dessert Recipe”

Fruit Cake

6. Some Humour - Let's laugh together at the joke below even if it's not funny. You see, I believe in the healing power of laughter. As Comedian David Nathan said, “Laughter is part of the human survival kit.” I also believe that laughter is the best medicine. It keeps one in the proper mood to do the best to keep better. The only trouble is that my jokes are kind of lame so if you have funny ones or even if they are not funny, I will feature them in the next issues with your name on it! How is that for a bribe?

Robot Slaps the Liar Again

Father bought a robot that slaps anyone who lies so he tried it out on his son.

Father: Where were you last night?

Son: I was at the library researching my assignment.

Robot slaps the son.

Son: Oh, okay I was at a friend’s house watching the game of soccer.

Robot slaps the son.

Son: Oh, okay I was watching porn.

Father: What? When I was your age I didn’t know about porn.

Robot slaps father.

Mother: He’s certainly your son!

Robot slaps mother.

7. Do you have a question or comment for the team?

Drop us a line at Put on the subject line “Diabetes Positive Approach” so no one can mistake it as spam. Write your questions or comment there.

You may see your question answered in an upcoming issue of Diabetes Positive Approach like the one below.

7. How About If I Get Foot Ulcer?"

Answer: That‘s quite a wide-ranging question so I will answer that as completely as possible on all you need to know about foot ulcer. Anyway, diabetes increases the risk to develop foot ulcers and it is the most common reason why the PWD get to be admitted in the hospital. Though often painless, foot ulcers take so much time to heal - weeks or months even. That is why whether we have it now or not, we have to know what to do to take care of our feet.
  • Debridement

    So, what happens when we do get foot ulcer? At the hospital, the doctor or nurse removes the dead skin and tissue in order to see the foot ulcer. The process is called debridement and there are different ways to do this. One way is with the use of scalpel and special scissors. The nurse cleans and disinfects the skin around the wound.

    The nurse uses a metal instrument to determine how deep it is and to find out if there are foreign objects lurking around there. He then cuts away the dead tissue and washes out the ulcer. At this point after the nurse debrides the wound, the red or pink ulcer will appear bigger and deeper.

    Here are the other ways to remove the infected or dead tissue:

    1. Use a catheter and a syringe to remove and wash away the dead tissue.

    2. Put the foot in a whirlpool bath.

    3. Apply enzymes, a special chemical, on the ulcer that will dissolve the dead tissue from the wound.

    4. Put wet-to-dry dressings to the wound to pull off the dead tissue.

    Taking Pressure off Your Foot Ulcer

    It is crucial to take the pressure off the foot ulcer as too much pressure on a particular foot is what partially causes foot ulcer. Make sure to wear shoes that do not put too much pressure on the foot and over the ulcer too. The doctor may recommend for you to wear special shoes or a special cast or brace. You may even have to use crutches or a wheel chair to take the pressure off the ulcer. This will help heal the foot ulcer faster.

    Taking Care of the Wound

    Now you may be asking what you have to do to take care of the wound. Here they are:

    Take fewer steps at home to keep the pressure off the ulcer.

    Clean the wound every day with the use of bandage or dressing.

    Keep the ulcer clean and bandaged.

    Walk in your shoes and not barefoot unless the doctor gives you the go-ahead signal.

    Maintain a tight control of the blood sugar level.

    Using Different Kinds of Dressings to Treat the Ulcer

    Use wet-to-dry dressings first. There are other types of dressings like skin substitutes and dressing that contains growth factors or calcium alginates. What to do is just apply a wet dressing to the wound. Make sure you keep the dressing and the skin area around it dry. We don’t want the healthy tissue to get too wet from the dressing we apply. Why? This will make the healthy tissue soft and may lead to more problems.

    When the dressing dries up, it soaks up wound material. Some of this tissue comes off with the dressing when you remove it. Ask your doctor or your health care team how frequently you have to change the dressing. You may be able to change the dressing yourself or a family member or friend may be able to help you. A visiting nurse can also help.

    Should You Call The Doctor? If So, When?

    The following are the signs that will tell you when you call the doctor.

    Firmness around the wound is increased.

    The pain has also increased.

    There is pus.

    There is swelling around the wound, redness has appeared and warmth increased.

    You can smell odor from the wound.

    There is extra drainage.

    You feel chills and fever.

    The foot ulcer has turned very white, blue or black.

    8. Got something to say? Please write down your questions and comments in Facebook.

    Just go to the Just copy and paste that on your browser. Facebook will want you to join me first before you can send me a message.


    There you have the facts on how to take care of the feet to avoid complications. The choice is ours to make. This is something we have to accept. Nobody else can do this for us. But remember this, whatever your choice is, I will be here rooting for you, praying for you because sometimes no matter how hard we try, things just do not go the way we want it to. Do not let other people make you feel inferior because of this. No matter what happens, you are good, good till the very end.

    Your Turn

    How about you? What works well for you? Let us know at the email address below the authors’ names.

    Warm Regards,

    Roger and Evelyn Guzman

    Want to know How to End Chronic Peripheral Neuropathy & Diabetic Nerve Pain Without Drugs, Surgery or Guesswork? Find out from this doctor about The Neuropathy Solution Program. This is what Dr. Randall C. Labrum says of this extraordinary solution: My Self-Treatment Program Provides a Simple, PROVEN Solution.  And Yes, It Is Guaranteed.

    Here is some of what has been proven about this extraordinary Solution in my clinical work, through its many successful home users, and in indeed in my own case:

    • It works time and time again. Virtually without fail.
    • Works regardless of your age, background, ethnicity or gender.
    • Resolves chronic peripheral neuropathy & diabetic nerve pain in both the feet & legs and hands & arms.
    • Is very often permanent because it corrects your pain at the source by restoring damaged peripheral nerve endings.
    • Works whether your PN results from diabetes, chemotherapy, hypertension, or the process of ageing.
    • Works for Peripheral Neuropathy as a result of almost any other major causative factor or factors.
    • Is effective even if you are currently using prescription  meds or other protocols to control your PN symptoms.
    • Can be used effectively after neuropathy surgery, even in cases where neuropathy surgery has failed.
    • Is is so simple that anyone can do it, and when done correctly the results can often be felt immediately.
    As a retired clinician with over 35 years of experience my heart goes out to all neuropathy sufferers.  If you are one of them, I'm fairly certain I know what you're going through right now.  I feel for you.  I honestly do.

    One of things that pains me most in fact, is how so many sufferers like you end up completely capitulating all semblance of their former lives to Peripheral Neuropathy. ...Especially when a ready, proven Solution exists but isn't used only because the sufferer knows not where to find it. Here is the link again. The Neuropathy Solution Program.


    American Diabetes Association. Standards of medical care in diabetes -- 2012. Diabetes Care. 2012 Jan;35 Suppl 1:S11-63.

    Inzuchi SE, Sherwin RS. Type 2 diabetes mellitus. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Saunders; 2011:chap 237.

    Leg and Foot Amputation.

    Take Care of Your Feet for a Lifetime - a booklet for people with diabetes. Download this for free.

    Diabetes Foot Ulcer.

    Diabetes Blood Sugar

    Diabetic Foot

    Copyright 2014 Roger Guzman, M.D. and Evelyn Guzman All rights reserved.