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Foot Care

For people with diabetes, prevention and management of their feet is very important.  According to the 2013 CDA Clinical Practice Guidelines, "Detectable sensorimotor polyneuropathy will develop within 10 years of the onset of diabetes in 40% to 50% of people with type 1 or type 2 diabetes".  Peripheral neuropathy along with peripheral arterial disease predispose people to foot ulceration and infection which can lead to ulceration and sometimes amputation. 

 

Risk Factors for Neuropathy

  • Elevated blood glucose levels
  • Elevated triglycerides
  • High body mass index
  • Smoking
  • Hypertension

Assessment

 

As a health care provider, a foot assessment should be done at least annually and more frequently for those at high risk. 

Remember to "look, feel and ask..."

 

1.  Skin:  Is the skin dry or calloused?

2.  Nails:  Are nails well kept or un-kept?

3.  Deformity:  Have there been changes to the bony structure of the foot?
4.  Foot wear:  Does the patients' footwear fit properly?

5.  Temperature:  Is the foot hot or cool?

6.  Range of Motion:  Check the hallux range.

7.  Sensation:  Use a monofilament to test 10 sites on the foot. For instructions, click here 

8.  Sensation:  Ask the following 4 questions:

  • Are your feet ever numb?
  • Do they tingle?
  • Do they ever burn?
  • Do they feel like insects are crawling on them?

9.  Pedal Pulses:  Are pulses present, absent or bounding?

10.  Dependent rubor:  This may be indicative of poor arterial flow or perfusion.

11.  Erythema:  This may be indicative of inflammation, infection or Charcot changes. 

 

For a clinician's brochure on foot assessment, click here

For an on-line version of foot assessment, click here

 

 

 

Prevention

 

If your patient has diabetes, it is very important to encourage daily foot care inspection.

 

 

Top Ten Daily Foot Care Tips

 

1.  Inspect your feet daily. Look for any cuts, cracks in your skin, ingrown toenails, blisters, discoloured or infected areas, callouses, corns or warts.

2.  Wash your feet in warm (not hot) water using a mild soap. Don't soak your feet as this can dry your skin.

3.  Dry your feet well after washing, especially between your toes.

4.  Apply lotion to your feet to prevent dry skin. Do not put lotion between your toes, as this is an ideal location for fungus or infections.

5.  Clean any minor cuts or scratches with mild soap and water and cover with a dry dressing to legs.

6.  Wear clean socks made of breathable materials (ie. cotton) that are not too tight around your legs.

7.  Trim your toenails straight across and file any sharp edges. This will help prevent ingrown toenails.

8.  Buy shoes at the end of the day when your feet are the biggest. Feet often swell during the day.

9.  Do not go barefoot.  Wear shoes at all times to prevent injury to your feet.

10.  Wear socks at night if your feet feel cold. Do not use hot water bottles or heating pads as they may burn you.

 

 

 

 

Are you interested in providing a prevention workshop?

 

The PEP Talk:  Diabetes, Healthy Feet and You Program is available throughout the Waterloo Wellington region.  This program is in collaboration with the Canadian Association of Wound Care (CAWC) and the Waterloo Wellington Self-Management Program.  This 2 1/2 hour workshop is targeted to people with diabetes who are willing to learn more about foot care.  For more information about this program, click here.

 

 

 

 

Management of Foot Ulcers

 

General principles of wound management involve:

1.  Referral to a multidisciplinary health care team with expertise in the management of foot ulcers

2.  The provision of a moist wound environment

3.  Debridment of nonviable tissue (nonischemic wounds)

4.  Offloading of pressure areas. For more information on the impact of offloading devices on diabetic foot ulcers, click here.

 

For More Information

 

If you would like to refer your patient for foot care, please complete a referral form and submit to Diabetes Central Intake, or if you prefer, the following chart identifies local foot care providers.  Please note that service fees apply to most services listed.

For more information on services in Centre or North Wellington, please see below or click here.

 

Ayr
Foot Care Nurse
BioPed - Outreach Site 2958 Greenfield Rd 519.632.1229
Connie Tanner, RN, CDE Home visits available

226.339.2349

Jenuine Care 33 Northumberland St 519.632.8122
Cambridge
Chiropodist / Podiatrist
Achilles 366 Hespeler Rd 519.624.4122
Anthony Zamojc 56 Grand Ave N 519.623.4410
BioPed 600 Hespeler Rd 519.622.5959
Cambridge Foot Clinic 14 George St 519.623.5444
Roshni Patel 3-697 Coronation Blvd 519.623-3000
York Foot Health & Orthotics Clinic 5-209 Pinebush Rd 519.623.0222
Foot Care Nurse
Connie Tanner, RN, CDE Home visits available 226.339.2349
Feet First Foot Care 424 Eagle St 519.650.6079
Mobile Feet 56 Carter Cres 519.716.4481
We Care Home Health Services Cambridge and Ayr 519.576.7474
Guelph
Chiropodist / Podiatrist
Anthony Zamojc 218 Speedvale Rd E 519.836.1142
Custom Foot Clinic 203-806 Gordon St 519.823.1450
Feet for Life 245 Edinburgh Rd S 519.821.0297
Guelph Complete Foot & Ankle Clinic 3 Paisley St 519.850.8686
Shael Weinberg 202-55 Cork St E 519.836.2740
Wellington Foot Clinic 245 Edinburgh Rd S 519.546.3737
Foot Care Nurse
Amelia Martin Home visits available 226.820.5666
BioPed 102 Wyndham St N 519.821.7310
Foot Patrol Guelph 519.341.0268
G&S Wellness Clinic Guelph 519.571.4273
We Care Home Health Services Guelph 519.576.7474
Centre Wellington
Chiropodist / Podiatrist
Groves Memorial Community Hospital 235 Union St E, Fergus 519.843.2010 x3205
Foot Care Nurse
Amelia Martin Home visits available 226.820.5666
Foot Patrol Aberfoyle, Elora, Fergus 519.341.0268
We Care Home Health Services Fergus, Elora 519.576.7474
Kitchener
Chiropodist / Podiatrist
Family Foot & Orthotics Clinic 120 Ottawa St N, Unit 117 519.954.4415
Grand River Hospital 835 King St 519.742.3611
Podiatric Consultants 1354 King St E 519.576.8960
The Centre for Family Medicine 25 Joseph St 519.578.2100
Foot Care Nurse
BioPed 842 Victoria St N, Unit 12 519.576.9440
Complete Foot Clinic Inc 751 Victoria St 519.579.9223
Connie Tanner, RN, CDE Home visits available 226.339.2349
Feet on the Go Home visits available 519.654.6363
Happy Feet Complete Foot Care 6 Cray Cres 519.498.7978
Karen Mielke RN Foot Care Nurse 63 Wren Place 519.893.5459
Linda, The Foot Nurse 121 Old Chicopee Dr 519.893.2969
Shoppers Drug Mart Sunrise Centre, 1400 Ottawa St 519.742.6160
We Care Home Health Services Kitchener 519.576.7474
New Hamburg
Chiropodist / Podiatrist
Physiotherapy Alliance 10 Waterloo St, Unit 4 519.662.4676
Heel~n~Hands, Amy Guilhauman, RN New Hamburg, Wellesley, Baden 519.634.5195
Waterloo
Chiropodist / Podiatrist
Foot Works 200 King St 519.888.6274
KW Foot & Orthotics Clinic 279 Weber St N, Unit 17 519.884.4200
Sarah Ferguson Chiropody 99 Northfield Dr, Suite 202 519.725.9941
Dr. Stephen Hoke 130 Weber St N 519.885.1511
Waterloo Foot Clinic 50 Westmount Rd N, Unit 207 519.884.3668
Foot Care Nurse
BioPed 583 King St N 519.747.3222
Feet on the Go Home visits available 519.654.6363
Susan Jarosz RN Footcare Services Waterloo 519.884.8954
We Care Home Health Services Waterloo 519.576.7474
Waterloo Region
Chiropodist / Podiatrist
Elmira Medical Centre - Jane Warner 2 Park Ave W, Elmira 519.669.5493
Foot Care Nurse
G&S Wellness Clinic Waterloo Region 519.571.4273
Just Feet with Kathleen Elmira 519.669.5835
Sherrie the Footcare Nurse Waterloo Region 519.893.2272
We Care Home Health Services New Hamburg, Baden 519.576.7474
Rural East Wellington
Chiropodist / Podiatrist
Acton's Head 2 Toe Healthcare 65 Mill St E, Acton 519.853.8557
Erin Physio Fitness 6 Thompson Cres, Erin 519.833.0606
Foot Care Nurse
Amelia Martin Home visits available 226.820.5666
We Care Home Health Services Rockwood, Erin 519.576.7474
Rural North Wellington
Chiropodist / Podiatrist
Betty McTague 160 King St W, Mount Forest 519.323.3668
Groves Memorial Community Hospital 235 Union St E, Fergus 519.843.2010 x3205
Foot Care Nurse
Amelia Martin Home visits available 226.820.5666
Caring Sole (Kelley Eves) Mount Forest 519.820.7187

 

 

 

 

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