Foot Care for Diabetes
People with diabetes often have foot problems. That's mostly because diabetes increases the risk of two conditions, peripheral vascular disease and peripheral neuropathy. Both of these make the feet more vulnerable to injury. Peripheral vascular disease reduces blood flow to the legs and feet. Peripheral neuropathy is a type of nerve damage. It can cause feet to lose feeling and go numb.
Foot problems may include ulcers that heal slowly or not at all. In extreme cases, an infected ulcer must be treated by amputating part of the foot. With careful preventive care, amputation is not necessary for the
large majority of foot ulcers.
In your regular physical exams, your doctor will test for numbness. You also can monitor your feet for this change. If you do not have normal feeling in your feet, you should check them frequently. Look for signs that they may be rubbed or pressed by poorly fitting shoes.
One obvious sign of rubbing or pressure is a buildup of thickened skin, called a callus. It may seem like a callus would protect your foot from pressure. Actually, it makes your foot more vulnerable. Soft underlying tissues may be injured by the pressure of a callus. A blood blister can form beneath the thick skin. Irritation from the blood blister can wear away the center of your callus from the inside out. This creates a hole. It's the way many ulcers get their start.
Wounds such as ulcers heal slowly if they do not get enough blood. Cold feet can be one sign of poor circulation from narrowed arteries. A more reliable clue to artery trouble is a pain in the legs or buttocks that occurs when you are walking. It will stop soon after you begin to rest. This symptom is called intermittent claudication.
Exercise is a good treatment for poor blood flow. With regular exercise, you should be able to walk longer before you feel pain in your legs.
Injury to your feet can come from many sources. They include:
- A break in the skin
- A penetrating wound (such as stepping on a tack)
- Walking barefoot on a hot surface
- Continued pressure in one spot, as from a tight shoe
- Poor cushioning in your shoes
If your feet are at risk, you need to be on guard. You can take steps to prevent injuries and prevent them from getting worse when they do occur.
- Bathe your feet daily. Wash carefully, with warm water and soap. Then rinse and dry thoroughly. Make sure you dry completely between the toes.
- Trim your toenails with a nail file. Do not use scissors or clippers, which can break the skin. File your nails straight across. You can file a curve at the edge of each nail to avoid bothering the next toe. But don't clip the nail with scissors at its corners. It is easy to cut the nail too close to the nailbed at the corners. This can lead to an "ingrown" nail.
- Don't use commercial corn or callus removers or trim calluses yourself. Try to figure out pressure points that might be causing a callus. Then decrease the pressure by changing or stretching your shoes. See a podiatrist or foot specialist for treatment.
- If the skin on your feet is dry, a moisturizing cream will help. Apply it sparingly, however, and not between the toes.
- Inspect your feet daily. Be on the lookout for:
- Red spots
- Warm or hot spots
- Ingrown toenails
- A change in color
- Anything else that's abnormal
- Never go barefoot, particularly if any part of your foot is numb.
- Finally, make sure your shoes fit right. Tight shoes can cause blisters and calluses. Loose shoes also can cause ulcers or blisters as they rub against the foot. Make sure socks aren't rubbing either.
If your daily foot inspection shows anything that concerns you, see your doctor or podiatrist. Causes for concern might include a new sore, an irritated spot that isn't getting better, or a break in the skin. Foot problems can be treated in several ways:
- Medicines (primarily anti-fungal drugs)
- Bed rest and elevating the feet
- Debridement (scraping away of dead tissue)
- A cast
- Special shoes
- Vascular surgery (artery surgery) or bone surgery
calluses,diabetes,exercise,peripheral vascular disease