If the Shoe Doesn't Fit...

"Change your shoes two or three times a day," Armstrong said. "In the time it takes you to take off the shoes and put on another pair, you can rest the skin and pressure points. And you can also look at your feet to see if any ulcers are occurring."

Armstrong's group studies the use of a new skin thermometer, which could help patients detect early when their feet are rubbing against their shoes.

Study author Leese agrees that there are steps people can take.

"Look at your footwear when it's on your feet," he said. "Look for bulging around the toes, which means that the shoe is too narrow." He recommends examining the feet every day, looking for signs of rubbing or redness, to catch any problems in the earliest stage.

"Fortunately, foot ulcers and amputations can be prevented at least half the time, if not more," said Dr. Aaron Vinik, research director of the Strelitz Diabetes Center at Eastern Virginia Medical School, in ABCNEWS.com's special Diabetes Resource Site.

The most important details, according to Vinik, include "excellent glycemic control, prevention of neuropathy, prevention of deterioration of blood supply to the foot, as well as inspecting the foot on a regular basis."

Treating diabetes becomes a struggle for physicians to recognize and respond to the absence of symptoms, rather than the symptoms themselves, according to Armstrong. And for patients, he recommends, "Use the gift of pain; let comfort guide you."

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