Your Feet and Diabetes
Type 2, adult onset, diabetes is the most common form of diabetes and is the result of your body not using its available insulin properly. Some people can control their diabetes with diet modifications and healthy eating, but others may need to take medication or insulin daily.
A few diabetes affects the body include high blood sugar levels which can thicken the blood and impact vision. This can cause blurred vision or permanent vision loss (retinopathy). Diabetes can reduce the kidneys' ability to filter waste from the bloodstream which can lead to kidney disease. Diabetes can damage nerves in the body which may cause pain, tingling, the sensation of burning, and loss of feeling (neuropathy). Nerve damage in the feet can lead to the formation of foot ulcers which may become infected and lead to amputation if not treated.
The Diabetic Foot
Excess blood sugar levels can decrease the elasticity of the small blood vessels which can cause them to narrow and restrict blood flow. When these blood vessels aren't working properly, the blood that carries oxygen and nutrients can't reach the parts of the body it needs to get to. This can may lead to irreversible nerve damage (neuropathy), loss of feeling, and delayed healing. This can cause symptoms including:
Tingling or numbness
Burning pain
Paralysis
Muscle weakness
Cramps
Muscle twitching
Loss of muscle and bone
Changes in skin, hair, or nails
Loss of balance
Pain is a signal from your nerves that something may be wrong in the body. And with this diabetic related neuropathy the pain signals may never reach the brain. This is why it’s important to take preventative steps.
Diabetic Foot Ulcers
Diabetic foot ulcers (DFUs) are open sores which develop on the feet of people with diabetes. Due to neuropathy which causes a loss of sensation in the feet, trauma/injury can be caused by simply stubbing a toe or wearing ill-fitting shoes. But this trauma can go unnoticed since pain sensors are damaged and a wound can develop.
DFUs can become infected and may result in an infection of the bone called osteomyelitis. This can lead to amputation if not promptly treated. This is why it is important to take care of your feet if you have diabetes.
What Can You Do?
Check your feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or other change to the skin or nails. If you cannot see the bottom of your feet, then use a mirror or ask a family member to help.
Wash your feet every day in warm, not hot, water. Don't soak your feet. Be sure you dry your feet completely and apply a lotion to the tops and bottoms of your feet. Carefully dry between your toes but do not use lotion between them.
Never go barefoot. Always wear shoes and socks or slippers even when you are inside. Check the inside of your shoes before you put them on to be sure that there aren't any foreign objects in them. If you wear a shoe which is lined, be sure it is smooth without wrinkles or puckers.
Wear shoes that fit properly. Wear your diabetic shoes if prescribed by your doctor. Always wear socks with your shoes to prevent them from rubbing against your feet. If you purchase new shoes, break them in slowly by wearing them for an hour or two a day until they're completely comfortable.
Trim your toenails straight across and gently smooth any sharp edges with a nail file. Do not cut your nails short. If you can't see or reach your feet have your foot doctor trim your toenails.
Don't remove corns or calluses yourself. Let your foot doctor do this. Over the counter corn and callous removal creams can contain ingredients that can irritate your skin. It is advised not to use these products.
Get your feet checked at every visit with your primary physician. See a podiatrist yearly for a complete foot exam.
Keep the blood flowing. Wiggle your toes for a few minutes several times throughout the day if possible. Do not do this in tight fitting shoes. Exercise, such as taking a walk, 10-20 minutes a day if possible. But always consult your doctor before beginning any exercise regimen.
Stop smoking. Smoking can reduce blood flow to the feet by causing blood vessels to constrict. This may result in a delay in healing of wounds or worsen neuropathy.
Eat a sensible diet while limiting foods high in sugar, salt, and refined carbohydrates. Avoid less healthy carbohydrates, such as foods or drinks with saturated fats, sugars and sodium. Consult a nutritionist for more information on healthy food choices.
Monitor your blood sugar as indicated by your physician and keep a record of your results.
Take your diabetic medicines as prescribed by your doctor and follow up regularly with your primary physician and podiatrist.
Notify you doctor if you have:
A cut, blister, or bruise on your foot that does not start to heal after a few day
The wound or sore that gets infected. This may appear as skin that is red, warm, or painful to touch
A wound that is slow to heal or worsening
A callus with dried blood inside
A sore that turns black or smells bad
Ingrown, thickened, or yellow toenails
Dry or cracked skin on your feet
Pain or swelling in your legs, feet, or ankles
Diabetes can cause different types of problems with your feet. This usually happens because you have damaged nerves or blood vessels due to the long term effects of high blood sugars.
Managing your blood sugar is crucial for avoiding foot problems. It is important to monitor your glucose levels regularly, take your medications as prescribed, plan meals carefully, and keep your medical appointments as scheduled.
Be sure to add your feet to your daily diabetes care. And don’t hesitate to reach out to your healthcare provider if you have any questions or concerns about the health of your feet.
