Monday, November 16, 2009

Pearls for Ulcer Prevention

One of the most devastating side effects of diabetes mellitus is the peripheral neuropathy that eventually develops when the disease is uncontrolled. Peripheral neuropathy is loss of partial or complete sensation to the extremities. In diabetics it most commonly begins in the feet and is characterized by numbness, tingling, prickling, and sometimes even a burning sensation. Peripheral neuropathy places you at a greater risk for developing ulcers on your feet because you cannot feel when you step on sharp objects. Complete peripheral neuropathy is also often a sign of a more advanced stage of disease. Therefore, your immune system’s response to healing even the smallest of wounds is diminished. That’s why it is important to keep a step ahead of ulcers by preventing them from occurring in the first place.
So what is an ulcer anyway? It is a wound that penetrates through both the epidermal and dermal layers of the skin.
In addition to stemming from puncture wounds caused by stepping on sharp objects, ulcers are also caused by the rubbing of ill-fitting socks and shoes, as well as pressure points from changes in bone structure. Several things can be done to prevent ulcers as outlined in the "Keep Your Feet Fit For Life" checklist. It is essential to incorporate a thorough foot inspection into your daily routine. Don’t forget to look between and beneath your toes! If you have trouble seeing them, do not hesitate to use a mirror to assist you (http://focusonyourfeet.com/products_check.php , http://www.lifesolutionsplus.com/telescoping-self-examination-mirror-p-400.html).
It’s very important to keep ulcers in check. When left untreated, the surrounding subcutaneous tissue can become infected. If the infection is not contained it can spread to the bone. Once the bone becomes infected, the risk of amputating the portion of the toe or foot infected significantly increases.
In addition to following the tips in the "Keep Your Feet Fit For Life" checklist, if you’re diabetic it’s important to visit your podiatrist regularly for a thorough foot inspection. We’ll trim any calluses that build up on the soles of your feet since ulcers can sometimes be sneaky and develop beneath them. Whatever you do, do not trim calluses yourself with a blade or pick at anything you suspect might be a pre-ulcerative wound. You may accidentally introduce bacteria to the site, and this either accelerates progression to an ulcer or makes the pre-existing ulcer take longer to heal.