Diabetes’ effect on your feet

A diagnosis of diabetes means much more than just paying attention to blood sugar levels.  It also means paying especially close attention to one’s feet.  Years of high blood glucose or sugar in their bloodstream can lead to some serious complications involving the health of their feet. 

How diabetes affect the feet

There are two main foot problems that may affect people with diabetes.  One of them is also one of the most common complications from diabetes - diabetic neuropathy.  Over 200,000 cases of diabetic neuropathy are diagnosed each year in the United States. 

Diabetic neuropathy is a type of nerve damage that can occur in diabetes.  When blood sugar or blood glucose levels are elevated, this can damage nerve fibers throughout the body.  Diabetic neuropathy tends to cause the worst damage to nerves in the hands and feet.

Someone with diabetes can, overtime, develop nerve damage and have no symptoms.  Usually, though most people with diabetic neuropathy will have symptoms that include pain, tingling, or numbness or a “pins and needles” feeling in the hands, feet, and legs.  This is why it is crucial that each and every time someone with diabetes goes to the doctor, their feet should be as routinely looked at by the doctor as their blood pressure is.  Early detection of any infections or other complications developing can prevent possible amputations of a toe or worse.    

The second condition seen in diabetes affecting the feet is peripheral vascular disease.  Diabetes leads to changes in the blood vessels, including arteries.  Peripheral vascular disease is where fatty deposits block these vessels beyond the brain and heart.  It tends to affect the blood vessels leading to and from the extremities, reducing blood flow to the hands and feet.  Reduced blood flow can lead to pain, infection, and slow healing of wounds.  Severe infections may lead to amputation of a toe(s) or part of or the entire foot.

Recognizing and avoiding serious foot problems

To prevent damage from diabetic neuropathy, proper foot care is an important part of diabetes management.  To avoid serious problems, follow these important self-care tips:

·      Check your feet daily

Every day check the top and bottoms of your feet, especially between your toes.  If you can’t see the bottoms, use a mirror.  Look for:

·      Skin color changes

·      Pain in legs

·      Ingrown or fungal toenails

·      Corns or calluses

·      Swelling of feet or ankles

·      Open sores or blisters that are slow to heal

·      Dry cracks in the skin

·      Loss of feeling or numbness anywhere on the foot

·      Red streaks

·      Numbness or tingling sensation

·      Deformed foot appearance

·      Staining on socks

If an infection is present on a foot or foot ulcer, a person may also experience some of the following: 

·      Fever or chills

·      Uncontrollable blood sugar

·      Shaking

·      Shock

·      Redness

      Anyone experiencing any of the symptoms of an infection should seek emergency treatment.

·      Wash your feet daily

Wash feet with mild soap and lukewarm water in the morning or before you go to bed.  Gently dry your feet with a soft towel, especially between the toes and use a moisturizing lotion (not between toes) to keep skin from cracking.

·      Cut toenails regularly

 

Cut your toenails straight across and use a toenail clipper with a straight edge.  Avoid cutting into corners as this can trigger an ingrown toenail.  Toenails are easiest to cut after showering or bathing.

 

·      Wear proper footwear

Wearing the right type of shoes plays a major role in preventing foot problems associated with diabetes.   When choosing new shoes, make sure they are sturdy and comfortable.  They must fit the length and width of the foot leaving room for toes to wiggle.

Always wear socks (made of wool or 100% cotton) or stockings with your shoes and keep your feet warm and dry. 

Women should avoid wearing high heels, sandals, and pointed-toe shoes as they put too much pressure on your feet.  Avoid walking barefoot, even in your house or outdoors.  If you have an infection on the foot, do not wear nylon stockings. 

If you already have some loss of sensation in your feet, it is highly recommended that shoe fittings be done by a professional trained shoe fitter or board-certified pedorthist People with loss of sensation tend to buy shoes that are too tight because the size that feels right is too small. 

Buying shoes specifically made for people with diabetes is another option.   They can be rather expensive but a prescription from the doctor can help as some medical insurance companies will cover the cost.