Diabetic foot care - minor grumble

LittleGreyCat

Well-Known Member
Retired Moderator
Messages
4,380
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
This is brought on by a discussion with a diabetic care team member.
One who takes bloods, and checks weight, height, BP, foot sensitivity etc.

As usual, to make things simple, I attended in bare feet inside Birkenstocks.
This avoids all the messing about unlacing and lacing shoes, taking socks on and off.

The phlebotomist said "I can see some bits on your soles. Do you walk around in bare feet?".
Noting that this particular person always tries to find something to criticise.

I said that I always walk around home in bare feet.
Shock, horror, you must never do that!
I pointed out that I had been diagnosed over 13 years.
They had just checked my feet and pulse was strong and there was no sign of loss of feeling.

Which brings me to my grumble - which I have voiced occasionally in the past.

Any advice or strategy must be considered in the context of the risk that it is addressing.

In the case of feet, the obvious risks are two fold.

(1) If you have difficulty in healing (as shown by, for example, leg ulcers) then any risk of damage to the feet (for example a small cut) increases the risk of having an open wound which will not heal.

(2) If you have a loss of feeling (neuropathy) then there is a risk that you can have a wound on the sole of your foot and not even be aware because you can't feel it.

In these cases it is sensible to provide extra protection to the feet, and also have someone (if possible) check your feet on a regular basis.
I assume you could also use a mirror laid on the floor to look under your feet if you (like me) find it difficult or impossible to bend enough to fully examine the soles of your feet.
[As an aside I think I just found another use for a selfie stick!]

Anyway, if you don't have these risk factors, that is you heal well and you can feel the soles of your feet, then walking around the home barefoot is to me a very low risk activity.

Trained and experienced Diabetic Specialist Nurses understand this.
They know the risks and where they apply.
Those without full training and experience tend to work from lists and parrot whatever they read.

[I have already sounded off about being told that a Libre is pointless for a T2 by someone who (in my opinion) doesn't know the difference between constant glucose monitoring and occasional finger prick testing and is applying the (outdated) advice about not finger prick testing but relying on the HbA1c test.]
 

hankjam

Well-Known Member
Messages
4,744
Type of diabetes
Treatment type
Diet only
Those without full training and experience tend to work from lists and parrot whatever they read.

While I agree with you in this case with you being as self aware as you are of the risks, ocassions may arise when this list checker is dealing with someone who is not as aware of the risks and might listen to the advice.

I take it there was no mention of the dangers of bare feet and Lego.
 
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LittleGreyCat

Well-Known Member
Retired Moderator
Messages
4,380
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Diet drinks - the artificial sweeteners taste vile.
Having to forswear foods I have loved all my life.
Trying to find low carb meals when eating out.
While I agree with you in this case with you being as self aware as you are of the risks, ocassions may arise when this list checker is dealing with someone who is not as aware of the risks and might listen to the advice.

I take it there was no mention of the dangers of bare feet and Lego.

My point is that the HCP should consider the risk assessment and take that into account when communicating.

13 years diagnosed and feet check out fine; "I assume that you are aware of the risk/advice".
Newly diagnosed - "The advice is this, because...."

I was scared by the "feet will drop off" approach when newly diagnosed so I am particularly aware of this issue.
Which isn't one if you have no neuropathy, have sound feet, and have good BG control.