By Michael E. Edmonds, Alethea V. M. Foster, Lee Sanders
3rd writer, Lee. J. Sanders, is the dep. of Veterans Affairs scientific heart, Lebanon, PA. bargains useful and scientific recommendation at the administration of long term foot difficulties in individuals with diabetes. Discusses prognosis and therapy, either scientific and surgical. top quality colour photographs illustrated a few of the issues. DNLM: Diabetic Foot--diagnosis.
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They should be taught the correct techniques for cutting normal nails as follows: • Nails should be cut straight across or in a gentle curve • The corners should not be cut out • The nail plate should not be cut in one piece: a gentle 'nibbling' technique should be used • The nail should not be cut so short that the seal between nail and nail bed is broken • The nails should not be left so long that they can catch on the socks, risking trauma • The nails should be cut regularly • The nails should be cut after the bath, when the nail plate will be softer and more flexible and easy to cut • If nail cutting is difficult or painful, patients should seek professional help.
Athletic shoes (trainers) are a reasonable choice for most patients. Patients who have neuropathy and don't know it will be accustomed to the tactile sensation of having shoes on their feet and may progressively buy tighter-fitting shoes to reproduce that sensation. This habit can cause pressure necrosis— patients with neuropathy should be warned to avoid tight shoes, and the implications of sensory loss should be emphasized. High-street shoes are not able to accommodate significant deformity which needs to be housed within stock shoes, modular shoes or bespoke shoes • Ready-made, off-the-shelf, stock shoes (Fig.
Patients may injure their feet if they become hypoglycaemic. One of our patients damaged his feet on three separate occasions during severe hypoglycaemic episodes. 30 Chapter2 Blood pressure control Hypertension (blood pressure greater than 140/90 mmHg) is a common comorbidity of diabetes, affecting 20-60% of people with diabetes, depending on age, obesity and ethnicity. Hypertension is also a major risk factor for cardiovascular disease and microvascular complications such as retinopathy and nephropathy.
A Practical Manual of Diabetic Foot Care by Michael E. Edmonds, Alethea V. M. Foster, Lee Sanders