Foot care for diabetics

Foot care for Diabetics

One of the problems that affect the quality of life for diabetics is problems with their feet. This happens because diabetes, if not well controlled or if under treated, can cause damage to the smaller blood vessels of the hands and feet. The resulting poor circulation means the feet are more likely to recover slowly from any damage, such as blisters or wounds, resulting in sores and ulcers.

Increased levels of sugar in the blood also mean infections are more likely and are harder to treat. As well as the nerve endings in the hands and feet being damaged by the increased sugar in the blood, the damage doesn’t cause the usual pain that non-diabetics would feel after an injury.

As a consequence, diabetics need to be vigilant about checking their feet to ensure that any damage is minimised and treated as soon as it occurs. If left untreated for lengthy periods of time surgery is needed to remove the infected or dead areas, particularly in the lower limbs.

Diabetics should have their feet checked by their doctor, nurse or pharmacist at least annually to ensure that their circulation, nerves and skin is in tip-top condition. They should also spend some time checking out their feet themselves at least each week, regularly, as part of their diabetes management plan.

It is important to look at the skin on top of the feet, between the toes and on the soles of the feet. Placing a foot on a stool or chair brings the foot closer to the eyes, or you can inspect the feet while sitting down. The best time to examine your feet is after bathing or showering. Wash and dry them thoroughly, and use this time to spend about five minutes inspecting them.

To look at the soles of the feet place a hand mirror on the floor. You can then angle your feet over the mirror one at a time, rather than attempt any yoga moves that become more difficult past middle age as flexibility is reduced.

While you are checking out the feet, rub in some moisturising lotion and trim your nails carefully. After this, cover the feet with socks or slippers to ensure you don’t slip over and fall, causing further damage. If you notice callouses or corns then consult your pharmacist about suitable treatments that diabetics can safely use to prevent damage. If you need further treatment, then your community pharmacist can refer you to either your doctor or to a podiatrist to ensure your foot condition is managed to prevent or limit the risk of serious infections and damage requiring surgery or other invasive treatment.

While diabetics need to be particularly vigilant, all of us need to inspect our feet regularly to ensure they can continue to carry us about our lives as comfortably and painlessly as possible.

Swallowing difficulties (dysphagia)

Causes of swallowing difficulties

Swallowing difficulties can happen at any age. There are a wide range of causes for them, including:

some medicines, such as antipsychotics
heartburn and acid reflux
cancer, such as mouth or throat cancers
nervous system or brain disorders
muscle disorders
blockages or structural issues with your mouth, throat or oesophagus.

Symptoms of swallowing difficulties

Symptoms of swallowing difficulties may include:

coughing or choking when eating or drinking
bringing food back up, may be through your nose
the feeling that food is stuck in your throat
having issues chewing your food
problems with dribbling.

Swallowing difficulties can cause weight loss, dehydration and chest infections.

Diagnosing swallowing difficulties

Let your healthcare provider know if you have swallowing difficulties. They will ask you about your symptoms and check if any other health conditions you have may be the cause.

Your healthcare provider may refer you to a specialist for tests. These may include a:

gastroscopy—a camera is passed down through your mouth to look at your throat and stomach
swallowing study—your throat and stomach are x-rayed as you swallow small amounts of food.

Treating swallowing difficulties

How your swallowing difficulties are treated depends on the cause and how severe it is. Treatments may include:

medicines to treat acid reflux
swallowing therapy with a speech and language therapist
making changes to what you eat and drink, such as softer foods and using thickener in drinks
using special spoons, plates and cups
surgery to widen your oesophagus.
using special medication lubricants eg Gloup to help make it easier to swallow tablets etc. For more information click here.

Self care for swallowing difficulties

As well as seeing your healthcare provider, the following tips may help you to get food or liquids into your stomach.

Sit upright in a chair—at a table is best.
Have regular small meals instead of the main large meals.
Eat or drink small mouthfuls at a time.
If your voice is gurgly when you eat or drink, give a small cough to make sure your airway is clear.
Wet food will be easier to swallow as dry food can catch in your throat.
If your food has 2 consistencies, such as fruit in juice and cereal in milk, try to mix it into 1 consistency, or eat the solid and liquid portions separately.
Concentrate on eating and avoid talking.
Hot, ice-cold or fizzy liquids are easier to swallow than room temperature liquids.
If you are told to have thickened liquids, avoid ice-cream and jelly as they thin before swallowing.
Drink from the top half of you cup to avoid tipping your head back.

Have a look at our range of Gloup medication lubricants here which can help with difficulties swallowing tablets...

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