Q: I was recently diagnosed with diabetes and I understand I need to be very attentive to the care of my feet and legs. What precautions should I be taking?
A: The American Diabetes Association notes that about 29 million people in the United States have diabetes, and to these people, foot problems are a huge risk. Here’s why:
High blood sugar levels in as many as 60 to 70 percent of diabetics eventually leads to a nerve damage condition known as peripheral neuropathy, which can mean loss of sensation or numbness in the feet. People with neuropathy may not feel pain from a small cut, and they may not notice calluses, blisters, corns, or other types of wounds caused by ill-fitting shoes. Another complication of diabetes is called peripheral artery disease (PAD), or poor circulation of blood to the feet and legs. Because of this poor circulation, wounds may not get enough blood flow to heal and they may become infected, leading to ulcers, damage to tissue and bone, gangrene, or even the need for amputation.
The bottom line is this: people with diabetes do need to be very attentive to the care of their feet and legs.
The American Podiatric Medical Association recommends that people with diabetes see a podiatrist for a comprehensive foot exam at least twice a year, and estimates that podiatric medical care can reduce amputation rates by up to 85 percent.
Diabetic Foot Care — Exercise Caution
Here are some of the other precautions you should take if you have diabetes:
- Get your blood sugar levels under control with a healthy diet, exercise, and weight loss if necessary. This can go a long way in managing and living with this disease.
- Inspect your feet daily to be on the lookout for changes in your foot’s shape, swelling, color, feeling, and potential problems. Enlist the help of someone else and/or use a mirror so you can see all sides and the bottom of your feet. Alert your podiatrist if you notice any new calluses, corns, bunions, bruises, or wounds; don’t try to take care of them yourself with over-the-counter remedies.
- Wear shoes that fit properly and don’t cause blisters. If your podiatrist recommends it, wear shoes made especially for people with diabetes. Don’t go barefoot and risk injury. Wear warm socks and shoes in winter, and wear white socks so you’ll notice any draining sores immediately.
- Wash your feet every day with mild soap and warm water (make sure the water is not too hot if you have loss of sensation in your feet). Don’t soak your feet for a long time as the skin can break down and may be slow to heal. Dry your feet carefully.
- Trim your toenails straight across and avoid cutting the corners. If you have trouble cutting your own toenails, or if you develop an ingrown toenail, see a podiatrist.
- If you have loss of sensation, don’t put your feet on a radiator or in front of the fireplace, but do keep your feet warm. Wear loose socks to bed and make sure your feet stay dry in rain or snow.
- Don’t smoke or sit cross-legged for long periods as both of these activities decrease blood supply to your feet.
Following your physician’s instructions for managing your diabetes, practicing good hygiene, and visiting a podiatrist regularly — as well as common sense — can help you keep your feet healthy and minimize the risk to your overall well-being. If you have diabetes and have any concerns about how to care for your feet, please come and see me.
– Dr. Shier