Foot Care Table 3. Patient Foot Care
` Loss of sensations of light touch, pain, and temperature typically occur early in DPN, resulting in high risk of foot ulcers
` Loss of proprioception may occur later in DPN, resulting in uncertainty as to where feet are and leading to falls or to injuries from stubbed toes
` Thorough foot examination should be part of any office visit ` Patient foot care can help avoid serious future complications: > Hygiene: ■ Clean feet daily, using warm water and mild soap; avoid soaking feet ■ Dry feet with soſt towel, carefully and thoroughly between toes ■ Moisturize feet with lotion, avoiding area between toes ■ File corns and calluses gently with pumice stone ■ Trim toenails regularly to shape of toes and file edges
> Inspection:
■ Check feet and toes twice daily for cuts, blisters, redness, swelling, corns, calluses, ingrown toenails, ulcers, or deformities
■ Any abnormality of feet and toes should be reported to primary care physician for possible referral to podiatric care
■ Any change of sensation in feet or toes (eg, numbness, discomfort) or proprioception should be reported to primary care physician for follow-up
> Footware: ■ Always wear shoes or slippers and thick seamless socks ■ Shoes should be well fitted and allow toe movement; break in new shoes gradually ■ Check insides of shoes for tears, sharp edges, or anything that might cause discomfort or injury
Adapted from: Argoff CE, Cole BE, Fishbain DA, Irving GA. Diabetic peripheral neuropathic pain: clinical and
quality-of-life issues. Mayo Clinic Proc. April 2006;81(4 suppl):S3-S11. Argoff CE, Backonja M-M, Belgrade MJ, et al. Consensus guidelines: treatment planning and options. Mayo Clinic Proc. April 2006;81(4 suppl):S12-S25. Argoff CE, Backonja M-M, Belgrade MJ, et al. Diabetic peripheral neuropathic pain. Consensus guidelines for treatment. J Fam Pract. June 2006;55(6 suppl):3-19.
Disclaimer
This Guideline attempts to define principles of practice that should produce high-quality patient care. It is applicable to specialists, primary care, and providers at all levels. This Guideline should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. The ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aſter consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool.
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