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  • Diabetes and Foot Care

    IMAGE Managing diabetes does not just mean keeping your blood sugar levels in an acceptable range. It also means taking steps toward preventing health complications that can occur with diabetes. Diabetes can put you at risk for foot complications like foot ulcers , which, if not treated early, may lead to amputation . However, with proper attention and care you may be able to prevent such problems.

    Diabetes and Your Feet

    Poor Blood Flow and Damaged Nerves

    You may be wondering, “How are diabetes and foot problems related?”
    With diabetes, sugar levels build up in your bloodstream either because your body does not make enough insulin or because your body is resistant to insulin. Insulin is important because it helps move sugar from your bloodstream to your cells where it can be used for energy.
    Diabetes can lead to decreased amounts of blood flow to your legs and feet. If you smoke, this can worsen blood flow problems. Poor blood flow to your limbs is called peripheral vascular disease . Diabetes can also damage nerves, a condition known as neuropathy . With damaged nerves, you may not be able to feel pain, heat, or cold.

    How It All Fits Together

    Having both poor blood flow and damaged nerves in your legs and feet can make it difficult for you to notice foot conditions that may arise, as well as prevent these conditions from healing properly.
    For instance, what if you developed a blister or cut on your foot? Since your nerves are damaged, you may not feel the injured area to notice and treat it. Because of this, the injured area becomes infected. Since blood flow to your legs and feet is decreased, the white blood cells that fight infection may not get to your limbs fast enough, and the infection may heal slowly or not heal at all. This can lead to worsening problems like a spreading infection or gangrene .

    Types of Foot Problems

    It is essential that you routinely check your feet for any foot conditions or injuries. Doing so will allow you to spot problems before they worsen. If it is hard for you to bend down to check your feet, try using a mirror or ask someone to check for you. Here are some common foot problems to look out for:
    • Cuts and scrapes
    • Corns and calluses —thick layers of skin caused by continuous rubbing or pressure
    • Blisters—fluid-filled bumps caused by wearing shoes that do not fit well or by wearing shoes without socks
    • Ingrown toenails —when the edge of a toenail grows into the skin
    • Bunion —large bump on the big toe
    • Plantar warts —growths caused by a virus; usually found on the bottoms of feet
    • Hammertoe —curling of a toe caused by a problem with the middle joint of the toe
    • Athlete’s foot —infection caused by a fungus leading to itchy, red, cracked skin; may also infect the toenail causing it to appear thick, yellow, and brittle
    • Dry, cracked skin
    If you do notice any foot problems, tell your doctor right away. Doing so will ensure that you get proper treatment and prevent infection.

    Treat Your Feet Well

    In addition to routinely checking your feet, here are other things you can do to avoid foot problems:
    • See your doctor regularly and make sure she checks your feet at each visit. Take off your shoes once you are in the exam room so that she sees your feet.
    • When cleaning your feet, avoid soaking them in water. Instead, wash your feet in warm water every day.
    • Completely dry your feet. Do not forget to dry between your toes!
    • If you have dry skin, rub lotion on your feet after they are washed and dry. Do not put lotion between your toes.
    • Cut your toenails straight across. It may be easier to cut them after washing your feet, since the nail will be softer. Do not cut them too short.
    • Use a pumice stone regularly to keep calluses thin. Do not cut at them with sharp objects.
    • Wear socks or stockings. Wear them to bed if your feet are cold.
    • Wear shoes or slippers, even if you are at home. Make sure your shoes fit well. Also, make sure they are closed-toe. Do not wear sandals.
    • Keep your feet away from hot places, like a fireplace; hot bath or spa; or an electric blanket.
    • When shopping for shoes, try to go shopping at the end of the day. Your feet are biggest during this time of day, so you will be able to buy shoes that are not too tight.
    • If you can do so safely, put your legs up when sitting.
    • Keep blood flowing to your feet by wiggling your toes or rotating your ankles several times a day.
    • Do not use any medicine or ointments for your feet unless your doctor says it is okay.
    • Changes in the shape of your feet and toes can happen with nerve damage. Talk to your doctor about special shoes you can wear, rather than trying to force your feet into regular shoes.
    Paying attention to your feet, as well as maintaining a healthy lifestyle, such as not smoking, eating healthy, and exercising, will decrease the likelihood of dangerous infections, keeping you more in control of your diabetes and its complications.

    RESOURCES

    American Diabetes Association http://www.diabetes.org/

    National Diabetes Information Clearinghouse http://diabetes.niddk.nih.gov/

    CANADIAN RESOURCES

    Canadian Diabetes Association http://www.diabetes.ca/

    Team Diabetes CanadaCanadian Diabetes Association http://www.diabetes.ca/get-involved/supporting-us/team-diabetes/

    References

    Living with diabetes: foot complications. American Diabetes Association website. Available at: http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html . Accessed September 12, 2012.

    Foot and skin related complications of diabetes. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/disorders/diabetes%5Fmellitus/hic%5Ffoot%5Fand%5Fskin%5Frelated%5Fcomplications%5Fof%5Fdiabetes.aspx . Accessed September 12, 2012.

    Prevent diabetes problems: Keep your feet and skin healthy. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://diabetes.niddk.nih.gov/dm/pubs/complications%5Ffeet/ . Updated May 2008. Accessed September 12, 2012.

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