How
does diabetes affect my feet?
Many
people with diabetes have mild to severe nerve damage. This can
cause diminished feeling in the feet. As a result you may not
feel cuts, scratches and breaks in the skin. These wounds can
lead to unnoticed infection.
For
example, if you have diabetes, you may not notice rough seams
in shoes or socks that rub against your skin and result in sores.
You may also not be aware of weakening joints, which can cause
you to change the way you put pressure on your feet as you walk.
Friction you can’t feel may cause your skin to blister or
crack, opening a path for infection.
Your blood nourishes tissues and carries infection-fighting cells
to those tissues that need them. Because diabetes can cause circulation
problems, your feet may suffer from a reduced blood supply, putting
you at greater risk for infection.
What
does the doctor mean by “diabetic foot” ?
You may have heard this term, which refers to the complete cycle
of foot irritation, skin breakdown, ulceration, necrosis (dead
skin) and bone infection that can lead to limb loss and/or the
spread of infection to other parts of the body. With proper foot
care, this cycle of events can be prevented or minimized.
What
can I do to prevent foot problems ?
The
primary goal of foot care for diabetics is to stop infection before
it starts. You can help prevent infection by keeping the skin
of your feet healthy and intact. Take immediate steps to care
for any irritation that occurs.
Do
I really need to see a podiatrist ?
Because
diabetes affects many organs of the body, management of the disease
often requires several medical specialist. Your podiatrist is
an integral part of the treatment team. Your podiatrist will give
you an individualized, easy-to-follow plan to help keep your feet
healthy.
Regular
visits to a podiatrist – at least annually,
if not more often – are important so that the health of
your feet can be closely monitored.
Foot
Health Checklist
Review
the list below .
Do
you have any of these symptoms? If you do, tell your podiatrist
during your visit today. It’s very important to tell your
doctor about these symptoms right away.
• Changes in the color of
the skin on your feet
• Changes in skin temperature
• Pain in the legs,
either at rest or while walking
•
Swelling of the foot or ankle
•
Open sores that
are slow to heal
•
Ingrown or fungus-infected toenails
•
Corns or calluses that bleed
within the skin
•
Cracks in the skin, especially
around the heel
Footnote
Regular
visits to a podiatrist – At
least annually, if not more often – are important.
A
daily routine
The
following self-care guidelines can help you minimize foot problems
that diabetes may cause. However, they are not a substitute for
professional care.
1.
Inspect
Each
day, inspect your feet for any skin breaks and changes.
A hand mirror can help you see the bottoms of your feet. If you
can’t see your feet clearly, ask someone to inspect them
for you.
Call you doctor or podiatrist if you notice any of the these conditions:
•
Inflamed areas (redness, swelling and heat indicate
a possible infection)
• Broken skin
(cracks, sores and ulcers may invite infection)
• Infected skin
(including breaks with pus or clear drainage, bleeding and/or
foul odor)
• Ingrown toenails
(irritated skin invites infection)
• Red streaks
(indicates possible internal infection)
• Pale or blue skin
(indicates poor circulation)
• Changes in “feeling”
such as pain, a tingling sensation, burning, numbness or complete
lack of feeling (may indicate nerve damage)
• Swelling or tenderness
( may indicate infection and/or poor circulation)
• Areas that are warm to
the touch (may indicate infection)
• Areas that are cold to the
touch (may indicate poor circulation)
2.
Wash
Wash
your feet each day with soap and warm (never hot) water.
Check the water temperature with your elbow or a thermometer since
you may not be able to feel temperature accurately with your hand
and foot.
3.
Dry
Dry
your feet thoroughly - especially between the toes.
Apply
moisturizing cream to feet (but not between the toes) to keep
them from becoming dry and perhaps cracking. Use powder to absorb
extra moisture.
What
should I look for in shoes ?
If
you have diabetes, take the extra time to buy the right shoes
in the right size. Poorly fitted shoes are often responsible for
the problems that lead to amputation.
Your
shoes should keep your foot in place when you walk and should
be snug but not tight. Ideally, you should be fitted by an experienced
shoe fitter who is knowledgeable about proper fit.
Here
are some tips to keep in mind: Buy shoes that fit you in the store.
Don’t expect tight shoes to stretch.
1.
The upper part of the shoe should be soft and flexible and the
lining should be smooth and free of ridges and seams.
2. Buy shoes made of leather or other breathable
materials. These materials help keep feet drier.
3. The toe box should allow all toes to wiggle
freely without rubbing against the front or top of the shoe. Your
should have about three-fourths of an inch between the big toe
and the front of the shoe.
4. The instep should cushion the arch comfortable
with causing irritation.
5. The heel should fit snugly with no slipping,
pressure or pinching.
6. The sole should flex easily at the ball of
the foot.
7. Avoid high heels and shoes with pointed toes.
Shopping
for shoes is best done in the afternoon because feet tend to swell
a little during the day. Buy shoes that fit you in the store.
Don’t expect tight shoes to stretch.
Diabetic
dos
•
Do check before putting on shoes
for pebbles, rough seams or other potential irritants
inside.
• Do check the soles of your
shoes before putting them on for imbedded objects.
Remove imbedded objects immediately.
• Do keep your toenails short
and cut them straight across to prevent ingrown
toenails.
• Do avoid weight gain, or
lose weight if necessary. This will minimize the
pressure on your feet and help keep your diabetes under control.
• Do wear thick, smooth-fitting
socks and stockings. Avoid mended socks or those
with seams that could cause blisters.
• Do stay active.
Walking is the best overall conditioner for the feet.
Diabetic
don’ts
•
Don’t use a heating pad or hot water bottle on
your feet for any reason.
• Don’t use medication
on your feet unless approved by your podiatrist.
• Don’t cross your legs
when sitting, which can compress blood vessels
even more.
• Don’t wear girdles,
garters or any garment that may restrict blood flow to your feet.
• Don’t cut corns or
calluses. You may invite infection.
• Don’t go barefoot,
even inside your home. A minor cut or scratch
that goes unnoticed could lead to a serious infection.
• Don’t smoke.
Don’t drink alcohol. Smoking can lead to circulatory problems
and alcohol can contribute to neuropathy (disease of the nervous
system).
Exercise
is good for everyone, but is especially beneficial for diabetic
blood flow, helps the heart and lungs work better, lowers blood
sugar levels, maintains body flexibility and burns calories.
Walking
is less stressful to joints and muscles than jogging
and requires no special equipment except properly fitted shoes
and socks that absorb moisture. Be sure to get your doctor’s
approval before beginning an exercise program.
Five
steps to healthier feet
Taking
good care of your feet is a daily investment in your lifelong
health and comfort. You can prevent or minimize most problems
by adopting a routine of daily foot care and following these simple
guidelines:
1.
Wear comfortable shoes and socks
that fit your feet.
2. Follow the daily routine recommended
earlier
3. Keep your toenails trimmed short
and straight across
4. Wear clean socks or stockings
and avoid wearing the same shoes
two days in a row.
5. See your podiatrist
for any severe or persistent foot problems.
Foot
note
Never
ignore any foot irritation or injury. At the first
sign of redness, cracked skin or a change in skin color or temperature,
call your physician or podiatrist and follow the instructions
you receive exactly.
Click
here to
download this page
in PDF format (PDF
file requires -
Adobe
Acrobat Reader)
