Foot care is crucial for avoiding complications such as infections, ulcers, deformity, and even the extreme possibility of amputation. When you have diabetes, it is important that you check your feet regularly for signs of injury. You may not even be aware that you have a cut or blister until you check them.
Here are some reasons why people with diabetes are more vulnerable to foot problems:
Nerve damage (or neuropathy): people with diabetes may gradually lose the ability to feel pain, cold, or heat. As a result, it is easy to get a blister or a wound without knowing it, and this can lead to infection
Poor blood flow in feet and legs: poor circulation along with nerve damage can cause many complicated foot problems, including infections that heal very slowly
Skin changes: skin dryness, cracking, and peeling can occur in the feet. Calluses can build up faster, and ulcers can develop on the heel or the ball of the foot or on the bottom of the big toes
Deformities: nerve damage can cause joint damage that lead to foot deformities. People with diabetes and pre-existing foot problems (such as hammer toes, overlapping toes, or bunions) are more prone to infections
Taking Care of Your Feet
There are a few things you can do to care for your feet – here are some helpful tips:
Keep your diabetes under control. Be sure to maintain your blood sugar in the range that your doctor recommends. Work with your healthcare team to manage diabetes and prevent complications
Check your feet daily. Look for calluses and corns, blisters, dry skin, cracks, redness or swelling and infected toenails. Heel calluses can crack and become infected. Don’t forget to check the space between your toes. If you have trouble checking your feet, use a mirror or ask someone to inspect them for you
Make sure your feet are always clean. Wash your feet in warm water, using mild soap. And dry them very well, especially between the toes
Keep your skin smooth. Smooth corns and calluses gently. Apply a thin layer of lotion to your feet to keep them soft
Trim your toenails. If you are able to see them, trim your nails straight across, or use an emery board to file them. If you are unable to do this, ask someone to help you
Protect your feet from the extreme hot or cold. First test the water with your hands or elbow before putting your feet into hot water to avoid burns
Avoid walking barefoot. Wear shoes and socks to protect your feet
Wear shoes that fit. Buy shoes that are comfortable and provide enough cushioning and support
Keep blood flowing to your feet. Wiggle your toes for about 5 minutes about 2 or 3 times a day, move ankles up and down. Keep your feet up while sitting, and avoid sitting for more than an hour. Also avoid crossing your legs. Stand up and walk around whenever possible
Stop smoking (if you smoke). Smoking can contribute to poor blood flow
Ask Your Doctor to Check Your Feet
Sometimes during regular medical visits, a foot exam is overlooked. To make sure this doesn’t happen, take your socks off in every doctor visit to make sure your feet will be checked.
Your healthcare provider should examine your feet at least once per year
If you have had foot ulcers due to diabetes, your feet should be checked at every doctor visit, at least every quarter
Having diabetes increases the odds of having to have an amputation. The good news is that the improvement in overall diabetes care over the last decade has reduced the rate of non-traumatic lower limb amputations by 65%. The bad news is that more than half of these types of amputations still occur in people aged over 20 with diabetes
The sooner you see your healthcare provider or podiatrist to identify a problem, the better your outcome will likely be. Remember that when it comes to foot care, you are a key member of the healthcare team.
Reviewed by Diana Dills, MD, Senior Director on the Cardiovascular and Metabolic team at Pfizer.