Foot Care & Diabetes

Diabetes can contribute to foot problems in three ways. It can cause decreased feeling in the feet, so that injuries such as cuts and scrapes may go unnoticed. It can cause decreased circulation to the feet. It can increase the time it takes to heal an injury. The risks of developing foot problems can be greatly reduced by following some simple principles of foot care, and by seeing your physician regularly.

Take Good Care Of Your Feet:
Wash your feet everyday. Use warm (not hot) water, and mild soap. Do not put your feet in the water without testing it first with your elbow, or asking someone else to test it. Do not soak your feet unless instructed by your physician. Pat your feet dry, making sure to dry between the toes. Do not rub the skin too vigorously. If your skin is dry, or shows evidence of cracking, use a moisturizing cream as prescribed by your doctor. Change stockings daily. Do not wear stockings that have been mended or have seams because these can injure or irritate the skin. Inspect the inside of your shoes before putting them on to make sure there is no object in them. Check your feet daily or have a family member do this to see if there are any inflammed or irritated areas.

Shoes that fit poorly can cause irritation and injury, lending to the formation of blisters or wounds. Shoes should fit snugly, but not tightly. Make sure there is plenty of room for your toes. Avoid shoes made of plastic or vinyl. Leather shoes allow your feet to breathe the best. New shoes should be broken in gradually. Remember, diabetic patients sometimes have decreased sensation and can be unaware of something inside the shoe. Walking or running shoes may be helpful for some diabetic patients. If you have foot deformities, you may need special therapeutic shoes and inserts. If you need special footwear, ask your podiatrist if you quailfy for medicare's diabetic shoe program.

Diabetes Never go barefoot, even at home. Always wear shoes or slippers, especially in the dark. Remember, an unnoticed minor cut, scrape, or burn can rapidly lead to a serious infection in a person with diabetes.

Toenail Care:
Be very careful to avoid injury when you trim your toenails. Trim them frequently, straight across, being careful not to cut them too short. Do not dig into the corners of the nails. It may help if you soften your nails by soaking them in warm water for 10 minutes before cutting them. If nails are thickened and difficult to cut, if you have a history of diabetic foot complications or poor circulation, see your podiatrist and ask them if they can cut your toenails.

No Home Surgery!
Do not try to remove ingrown toenails. Do not use razor blades, scissors, or knives to remove calluses or corns. A minor cut can rapidly develop into a serious infection. If left untreated, infections can spread to nearby tissues and become limb-threatening. Removal of an ingrown toenail, or a callus should be done by your physician.

Do not use a hot water bottle or heating pad. Wear cotton or wool socks to keep your feet warm. Wear protective footwear at the beach or around swimming pools. Do not use chemical corn or callus removers, as they can cause chemical burns and ulcers.

Women should avoid tight pantyhose, panty girdles, elastic garters, and socks with elastic tops. If you see lines or indentations when you take off socks or undergarments, they are probably too tight, and may cause swelling of the feet.

If you smoke, STOP!! Smoking narrows the blood vessels and decreases circulation to the feet. Smoking is not wise for anyone, and extremely dangerous for people with diabetes. Your chances of developing gangrene increase significantly when you smoke.

Warning Signs of Diabetic Foot Problems:
Inspect your feet every day. Remember, any injury to the foot or break in the skin is potentially serious in a person with diabetes. Look especially between the toes. If poor vision or arthritis make it hard for you to inspect your feet, have someone else do it. Notify your physician if you notice:

Puncture wounds
Cuts or scrapes that do not heal
Ingrown toenails
Thick discolored nails
Corns and Calluses
Problems due to poorly fitting shoes
Any injuries to the feet
Discoloration, pain, redness, or swelling
Pain in the calves during walking or exercise.

Remember: Exercise, good glucose control and proper shoe care are lifelong tools that go hand in hand. They are the three most important things you can do to prevent diabetic foot complications.