Guidelines for care of the feet for patients with Diabetes/p

Following guidelines should be taken into consideration while caring of the feet for patients with diabetes/peripheral vascular disorders.

1-Feet should be washed each night with a mild soap and warm water. Dry thoroughly between the toes. Do not rub vigorously as this is apt to break the delicate skin.
2-While feet are thoroughly dry, rub well with vegetable oil to keep them soft, prevent with excess friction, remove scales and prevent dryness. Care must be taken to prevent foot tenderness.
3-If the feet become too soft and tender, rub them with alcohol about once a week.
4-When rubbing the feet always rub upwards from the tips of toes. In case of varicose veins, massage feet very gently. Never massage the legs.
5-If toe nails are brittle and dry, soften them by soaking for one half hour each night with moderately warm water containing 1 table spoon of powdered sodium borate (Borax) per quarter. Follow this by rubbing around the nail with vegetable oil.
6-Clean around the nail with an orangewood stick. If the nail becomes too long, file them with an emery board. File them straight across and no shorter than the underlying soft tissues of the toe.
7-Cut toenails straight across. Never cut the corner of nails.
8-Shoes should be loose fitting and preferably custom fitted. Wear low healed shoes of soft leather that fit the shape of feet correctly. The shoes should have wide toes that will cause no pressure. Fit close in arch and grip the heels comfortably.
9-While wearing new shoes, use them one half hour on the first day and increase by one hour each day following.
10-Wear clean, thick, warm and loose socks. White socks are preferable as the dye in some color socks may be irritating.
11-Do not cut corns or calluses. See your therapist.
12-To remove excess corns or calluses, soak the feet in moderately warm water, using a mild soap, for about 10 minutes and then rub off the excess tissue with a towel or file. Do not tear it off. Under no circumstances must the skin be irritated.
13-Prevent the callus formation under the ball of toes
a-by active ROM exercises such curling and stretching the toes several times a day
b-By finishing each step on toe and not on ball of the foot
c-By wearing shoes that are not too short and that do not have high heels.
14-Never use tobacco in any form. Tobacco contract the blood vessels and so reduce
the circulation.
15-Be careful to not impede the blood flow in extremities. Do not wear tight or constricting clothing.
16-Keep warm. Wear warm socks and other clothing. Cold contract blood vessels and reduces circulation.
17-Do not sit with crossed legs. This may compress leg arteries and shut off the blood supply to feet.
18-If the weight of bed cloths is uncomfortable, place a pillow under the covers at the foot of the bed.
19-Don not put medications or ointments to feet unless they have been medically prescribed.
20-Do not apply heat in the form of hot water, hot water bottles, or heating pads without a therapist’s consent. Even moderate heat can injure the skin if circulation is poor.

If any body has more ideas or suggestions, please feel free to add.