Consigli per il piede diabetico, come prevenirlo con una corretta igiene e con l'utilizzo di plantari e calzature adeguate



Tiziana

Il piede diabetico è una complicanza che si ha quando si è portatori della malattia diabetica. La malattia diabetica è molto diffusa, ma oggi cura bene se si è aderenti alla terapia e se si frequentano gli ambulatori. La cosa più grave del diabete sono invece le complicanze, una di queste è appunto il piede diabetico. Però la bella notizia è che si può prevenire rivolgendosi ad ambulatori strutturati, multiprofessionali, dove sono presenti sia il medico che gli infermieri e le altre figure professionali.

Intervistatore

Ecco Tiziana, cosa comporta l'instaurarsi del piede diabetico in una persona?

Tiziana

Comporta una grossa spesa economica, perché vuol dire molti ricoveri, vuol dire una degenerazione lunga, una riabilitazione, vuol dire una grossa sofferenza per il portatore di questa complicanza e per i suoi familiari.
Spesso anche la qualità della vita si abbassa, perché si può andare incontro anche a delle amputazioni totali o parziali del piede e capite bene che questo comporta magari anche assenza dal posto di lavoro. Quindi un costo molto pesante sia per la persona che per la collettività e la famiglia.

Intervistatore

Quindi è molto importante anche la cura del piede per evitare ulteriori problemi.

Tiziana

Sì, perché presso questi ambulatori, dove ci sono le figure infermieristiche che fanno l'educazione sanitaria, viene insegnato ai pazienti come prendersi cura dei piedi. I piedi sono molto importanti, ci permettono di muoverci, di saltare, di camminare, ma spesso li trascuriamo. Bastano poche norme di igiene e di educazione per invece conservarli.

Intervistatore

Ecco, un piccolo esempio Tiziana?

Tiziana

Un piccolo esempio vuol dire osservare un l'igiene personale quotidiana, vuol dire che il paziente diabetico non deve fare delle cure fai da te, usare dei callifughi da solo, ma deve stare molto attento, perché può avere delle infezioni molto pericolose. Basta controllare bene, fra un dito e l'altro, l'igiene del piede, asciugarlo bene con un asciugamano morbido, anche fra un dito e l'altro, perché spesso questo spazio tra le dita è ristretto e fa sì che la cute è bagnata, umida, maceri e quindi c'è la formazione poi di ragadi che possono infettarsi.
Bisogna togliere anche la pelle secca perché si possono formare delle ragadi, fonti di infezione e bisogna scegliere anche poi le calzature adatte.

Intervistatore

E questo è molto importante. Come deve essere esattamente la calzatura?

Tiziana

La calzatura giusta è importante per tutte le persone, in particolare per persone con diabete. Un consiglio: è sempre meglio acquistare le calzature alla sera anziché al mattino. Così si evita di comprare delle scarpe troppo strette, che poi durante la giornata il piede si gonfia e quindi ci troviamo con una misura magari inferiore. Quindi meglio la sera, quando il piede è nella sua massima dimensione. Poi meglio infilare la mano all'interno, per accertarsi di sentire bene le cuciture che ci sono. Le scarpe nuove non andrebbero mai essere indossate per molte ore, finché la scarpa non assusme la forma del piede. Accertarsi che tutte le dita del piede siano ben distese e non tendano a sovrapporsi, perché questo comporterà delle deformità, oppure delle zone di pressione che possono poi far insorgere degli ematomi e conseguentemente, infezioni che poi provocano la necessità di doversi rivolgere al dottor Perrino.

Intervistatore

Però è una cosa naturale anche comprare scarpe, diciamo femminili, che possano far accavallare le dita...

Tiziana

Questo è vero, però una persona che porta il diabete deve stare molto attenta. Quindi limitarne l'uso, magari a meno ore della giornata. Il tacco non dovrebbe mai superare i 5 centimetri. Le persone con diabete possono fare una vita normale, ma devono avere una maggior cura dei piedi, quindi devono sapere che non possono abusare di certe cose.

Intervistatore

Allora Nicola abbiamo dato qualche accorgimento inerente alla scarpa, però questa è una materia da tecnico ortopedico vuole approfondire meglio?

Dott. Nicola Perrino

Sì, innanzitutto è importante sensibilizzare il paziente diabetico perché, come potete ben capire, è una malattia che può creare veramente dei seri problemi, dei danni importanti. Quindi proprio per questo è importante rivolgersi, quando vi è poi la necessità, quando vi è l'indicazione dello specialista per per erogare un plantare o una calzatura adeguata, che ci si rivolga appunto al tecnico ortopedico che è l'unica figura, l'unico professionista sanitario, abilitato a erogare un plantare con una calzatura adeguata. Quindi proprio per questo è importante conoscere, sapere, verificare che si ha a che fare con un tecnico ortopedico serio.

Intervistatore

Nicola in che modo possiamo farlo?

Dott. Nicola Perrino

In qualità di vicepresidente dell'associazione dei tecnici ortopedici italiani, non è sufficiente leggere l’insegna “ortopedia” per avere purtroppo la certezza che in quel negozio ci sia un tecnico ortopedico abilitato.
Noi abbiamo promosso l'iscrizione a un albo dei tecnici ortopedici e qui si può verificare se il professionista a cui ci rivolgiamo è iscritto all’albo.

Intervistatore

Tu che sei un tecnico ortopedico, che consiglio ci puoi dare?

Dott. Nicola Perrino

Io partirei proprio a dire che cosa non bisogna fare. Non utilizzare scarpe con punte troppo strette, perché ovviamente ci saranno delle compressioni che poi generano lacerazioni della cute. Non usare scarpe troppo larghe per evitare quindi che il piede scivoli in avanti; inoltre, una scarpa con una pianta larga, provoca delle flessioni nella calzatura stessa, quindi, si formano delle pieghe che poi sono motivo di compressione delle dita, specie quando abbiamo dei piedi con delle dita griffe e quindi questo ulteriormente è motivo di problemi di ulcerazione.

Intervistatore

Il paziente diabetico deve evitare assolutamente le iperpressioni?

Dott. Nicola Perrino

Esatto. Bisogna pretendere, quando ci si rivolge al tecnico ortopedico per l'erogazione di un plantare, che il plantare sia efficace: il plantare ha dei supporti di scarico, di spinta, insomma, permette di trovare un giusto equilibrio al piede, quindi riduce i picchi di pressione, ha la funzione di correggere, di contenere, quindi di alloggiare le deformazioni.

Intervistatore

Ma la tomaia, la suola?

Dott. Nicola Perrino

La tomaia deve essere all'interno imbottita, quindi non devono esserci delle cuciture, deve essere ben allacciata, la punta che non deve toccare contro l'alluce, la parte posteriore non deve sfregare.




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