There are millions of diabetic patients in Turkey. One out of every 4 diabetic patients may experience a diabetic foot ulcer at least once. This may result in loss of toes, then loss of feet and legs, and even loss of life. 

Pointing out that patients experience loss of sensation due to diabetes and that these wounds can easily open and become infected because the blood flow to their feet is reduced, Yeditepe University Kozyatağı Hospital Plastic, Reconstructive and Aesthetic Surgery Specialist, gave the following information, “When the wound on the foot opens, first there is a light yellow discharge, and then the color of the discharge may differ according to the type of bacteria that reproduce on the foot. Since diabetic patients also have problems in their eyes, these discharges are easily overlooked and infection cannot be noticed, especially when dark socks are worn. Especially in these patients, since there is a loss of sensation due to diabetes, pain does not occur no matter how big the wound is. Overlooking the discharge, which is the only symptom, can result in amputation or life-threatening infections.”

Prolonged Avoidance of Physician Control Increases Diabetic Foot Cases

Stating that many patients could not go to the doctor for a long time due to the coronavirus epidemic and that they observed an increase in applications with diabetic foot ulcers, Yeditepe University Kozyatağı Hospital Plastic, Reconstructive and Aesthetic Surgery Specialist, made various warnings. Pointing out that diabetes patients should pay more attention to foot care with the coming of the summer months, specialist added: “First of all, patients should not hang their feet down while at rest. Putting or extending a soft pillow under the feet while sitting will prevent the feet from swelling. Socks are also especially important. They must be cotton and white. Because the discharge can only be noticed in this way. “

“Toenails Must Be Cut Straight”

Stating that a person with good vision should cut the toenails of diabetic patients, Yeditepe University Kozyatağı Hospital Plastic, Reconstructive and Aesthetic Surgery Specialist said, “Toenails of diabetic patients must be cut straight. When cutting nails, nail clippers specially produced for diabetic patients should be used if possible, and if not possible, care should be taken to cut them slightly long and straight. Many hospitals have professional foot care centers for diabetic patients. It would be more appropriate to have the toenails cut by the staff here.”

“Leave the Shoes Upright”

Specialist, who underlined that diabetic patients should mind leaving their shoes upright, said, “Diabetic patients should leave their shoes upright, not horizontal like ours. Because even if a very small piece of stone or a foreign object falls into it, it is missed. When the patient walks with this object, it may sting on his/her foot and cause wounds to open. In order to prevent this, the inside of the shoes should be checked visually and manually before wearing, and if there is a foreign object, it should be removed. In addition, shoes and slippers should never be left under the sun. These shoes, which stay under the sun, can sometimes heat up to 40-50 degrees, so burns can occur on the feet. Moreover, when choosing slippers, those that are closed in the front and that prevent the fingers from being traumatized should be chosen.”

“Do Not Wear New Shoes For More Than 2 Hours”

Pointing out that new shoes should not be worn for more than 2 hours a day, Yeditepe University Kozyatağı Hospital Plastic, Reconstructive and Aesthetic Surgery Specialist listed the points to be considered in this regard as follows: “Diabetic patients should buy their new shoes 1 size larger than normal and not to wear them for more than 2 hours. If a shoe that has not been worn for a long time is to be worn again, it should be ensured that the feet are not swollen and there should be a very slight gap between the foot and the shoe. Since many patients stay at home and do not go out during the pandemic, their feet may also be swollen during this time. For this reason, one must pay attention to these issues before putting on shoes while going out on the street. If the feet get a blister for some reason, the shoes should definitely be reviewed. Since these patients also have sweating and moistening disorders, the skin of the feet tends to dry and crack. For this reason, they should be moisturized regularly with a product approved by the Ministry of Health. Because when the foot skin is cracked, it becomes very easy for fungi or bacteria to enter from here. There are products suitable for diabetic feet. It is important to be careful about using them.”

What Should Be Done?

Stating that limbs can be saved with early intervention in circulatory disorders caused by diabetes, but this chance is much less when it progresses, Yeditepe University Kozyatağı Hospital Plastic, Reconstructive and Aesthetic Surgery Specialist listed the points that diabetes patients should pay attention to:

• White and cotton socks should be preferred and socks should be changed every day
• Toenails should never be cut from the bottom or in an oval shape. They must be cut straight and slightly long
• Shoes should be left upright in the shade so that nothing can get into them
• Newly purchased shoes or shoes that have not been worn for a long time should not be worn for more than 2 hours at first
• Feet must be moisturized every day and protected from the sun
• Since diabetes is a disease that requires follow-up, blood sugar should be measured regularly and checked by an endocrinologist every 3 months
• If the feet are swollen, shoes should not be worn
• Shoes that do not have a pointed toe and do not press against the toes should be preferred