Foot Care and Diabetes
Why Your Feet Require Special Care
People who have diabetes are at an increased risk of serious
foot problems. Although most problems occur in people over the
age of 40, or in people who have had diabetes more than ten
years, starting preventive measures early is the best way to
avoid trouble later on.
How diabetes affects the feet
If you have diabetes, your feet are more vulnerable to infection
for any or all of the following reasons:
- Decreased Circulation.
Diabetes can cause thickening of the walls of blood
vessels. This reduces circulation to the lower legs and
feet, so that if the food it cut or injured in any way,
healing may be slowed and the risk of infection
- Nerve Damage. One of
the complications of diabetes is neuropathy, or nerve
damage. This can make the feet feel numb--insensitive to
hot or dole or pain. A person with diabetes may not feel
a cut or bruise when it happens and be unaware of an
infection when it sets in.
- Reduced Resistance to Infection.
When blood sugar is above normal, the white blood cells
that fight infection do not work as they should.
Therefore, bacteria and other organisms invade more
rapidly and cause more damage to a person with diabetes.
Prevention is the key
A person with diabetes should view all foot problems as
potentially dangerous. All care should be taken to prevent foot
problems whenever possible, and medical assistance should be
sought as soon as problems occur. If you are the parent of a
diabetic child, be alert to the early signs of damage and be
ready to take preventive measures.
You must make every effort to prevent infection. Consider
these two facts:
- Neglect of foot problems results in 18,000 to 20,000
amputations each year in the United States alone.
- Prevention and proper treatment would eliminate up to 75
percent of foot amputations.
The point if clear. Foot care
makes a difference. And the responsibility for taking care of
your feet is up to you.
How to Take Care of Your Feet, Step-By-Step
Ways an infection might occur
Infections usually do not occur unless there is a break in the
skin. A break in the skin is an opportunity for germs to settle
into the tissues, multiply and cause damage. Watch out for:
- Blisters caused by rubbing.
- Cracks caused by dryness
- Cuts, scrapes and puncture wounds.
- Ingrown toenails.
- Structural changes.
- Funguses such as athlete's foot, which allows germs to
- Cuts caused by toenail trimmings.
Basic Rules of Good Foot Care
Avoid going barefoot. Wear shoes or slippers whenever possible.
- Wear comfortable shoes with good support and
- Break in new shoes slowly, wearing them only a
short time initially.
- Wear socks or stockings at all times--avoid
- Change socks or stockings daily.
- In socks with seams, wear socks inside-out so
that the seams won t rub skin.
- If skin is dry and scaly, apply skin lotion.
- If skin is moist, apply non-medicated talcum
- Avoid severe sunburn on feet.
- Cut nails straight across, and not too close to
- Do not cut into the corners.
- If possible, let a podiatrist take care of your
- Corns and Calluses
- Consult a podiatrist to evaluate and treat these
- Do not use do-it-yourself corn cures or adhesive
- Do not use a razor or cutting tool to remove
corns or calluses.
- Use a pumice stone after bathing.
- Promote Good Circulation
- Do not wear garters, rubber stockings or any
elastic support that might interfere with
circulation (unless instructed to do so by your
- Avoid crossing your knees when sitting.
- Keep your feet warm because cold contracts the
blood vessels. Wear loose stockings to bed and
don t bathe in cold water.
- Exercise is helpful to promote circulation.
Walking is safe and beneficial.
- Wash feet every day and dry carefully.
- Use mild soaps.
- Check bath water temperature with hands before
- Inspect Feet Every Night In Good
- This is absolutely critical to proper care of the
feet. (See the following section for more
- See your doctor promptly at the first sign of a
Examining Your Feet to Detect
Get into the habit of inspecting your feet each night for corns,
calluses, blisters, cracks, cuts, bruises, bunions, or
infections. Key indicators of infection include:
- Change in Foot Shape.
Infections are often accompanied by swelling. Get to know
the shape of your foot so you'll notice changes. If one
foot or toe looks larger than the other, it could mean an
- Change in Color.
Changes in skin color may indicate an infection. They can
also alert you to changes in blood circulation.
- Changes in Texture.
If an area starts to look rough, thick or shiny, pay
special attention. Keep an eye on small cracks or
openings that might require a doctor's care.
- Change in Odor. A bad
odor is often a sign of infection.
- Change in Feel.
Infected tissues often feel different from normal ones.
They may feel firm or hard. Pressing these areas may be
The Role of Your Doctor
Your Doctor Should...
On your first visit, your doctor should make a careful physical
examination of your feet and inquire about any relevant history.
This is the first step in defining current problems and averting
future ones. During annual or semi-annual visits, the doctor
- Ask you about foot or leg pain when sitting, standing or
- Physically examine your feet for any corns, bruises,
ulcers or any kind of problems.
- Check the pulse in your groin, behind your knees and on
top of your feet.
- Listen to the blood vessels in your legs with a
- Check the response of your feet and toes to light touch,
vibrations and pain.
Footcare for people with diabetes is a specialty few general
physicians are trained for. Therefore, those who require frequent
routine footcare should seek out a podiatrist or foot care nurse
specialist. Ask you diabetologist for a recommendation.
- See your doctor at least once a year, and make sure he
examines you in the manner suggested above.
- Consult with your doctor at the first signs of any
inflammation between the toes, any fungus infection, any
redness or blistering.
- Act quickly if you see a problem. Prompt attention could
mean the difference between an antibiotic pill and
hospitalization, even surgery, if you wait too long.
Prevention, detection and proper
treatment are key to avoiding serious problems. You and your
doctor should work as a team. Together, you can make the
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