Diabetes Foot Care: How people with diabetes should care for their feet.

Diabetes foot care is so necessary if you want to avoid a number of undesirable situations concerning the feet. Diabetes, a disease of the blood, can cause serious infections, amputations or even death if left uncontrolled. Once the disease is controlled though, diabetics can usually avoid serious complications.

If not monitored, diabetes can cause damage to the nervous system and blood vessels. Once the nervous system becomes damaged it becomes difficult for diabetics to fully judge the severity of wounds or sensations concerning their feet. This lack of feeling termed sensory diabetic neuropathy is usually accompanied by burning, tingling, pain or numbness of the feet and can cause serious problems.

This nervous system damage can cause sweat secretion impairment and thus reduce oil secretion which is how the skin on the feet receives needed lubrication. Nervous system damage can also cause the muscles of the foot to function erratically leading to improper balancing during walking or maneuvering. This can cause excess pressure in certain areas of the feet. All of these problems can work together to cause abnormal pressure on joints, bones and skin and also cause corns, calluses and sores.

To give an example of what the lack of sensation in the feet can cause; imagine a person without diabetes walking around with a foreign object in their shoe. This will automatically feel very uncomfortable prompting the person to stop and remove the object. However, persons with diabetes may have such diminished feeling in their feet due to nerve damage that this assessment may not happen. The diabetic will not realize the object is there, thus it will not be removed and can rub and scrape against the feet causing a cut or scrape to develop.

Since there is a lack of feeling, even after the wound has developed, the diabetic may still not realize and the wound is left to worsen and possibly become infected due to the lack of proper treatment.

This leads to the next major concern of decreased blood flow and damage to blood vessels and the immune system which leads to wounds not being able to heal properly. Decreased blood flow is the arms and legs is termed as peripheral vascular disease. When a proper supply of blood can not reach a wound, this can lead to bacterial infections of the skin, surrounding tissue, muscles and even bones! These infections can get as severe as ulcers or even gangrene – the death of tissue.

Due to the decreased blood flow, antibiotics may not be able to sufficiently get to the infection site and amputation may be the only course of action for survival. Amputation is sometimes needed to prevent the infection from getting into the bloodstream. If this happens death can occur.

Be Proactive about diabetes foot care!

The best thing for diabetics to practice in terms of diabetes foot care is prevention. Being vigilant in examining their own feet for wounds or other problems is of the utmost importance as it is very easy to overlook small nicks or cuts on the bottoms and sides of feet or in between toes. Also making wise choices to limit or stop foot problems is ideal.

As the feet are examined, the following points should be kept in mind.

• Persistent pain can be a sign of a sprain, bruise or improperly fitting shoes. Constant pain is never a normal situation.
• Leg pain should be brought to a doctor’s attention.
• Any change in the color of the skin should be brought to a doctor’s attention.
• Severe pain can mean loss of circulation, infection or severe nerve damage.

• Redness, swelling or localized warmness may be signs of an infection or under skin inflammation especially if it surrounds a wound. It may also be a sign of improperly fitting socks or shoes.
• Pain, redness or swelling around the toenails could mean an ingrown toenail, the leading cause of amputations in diabetics. Have it assessed by a professional.
• Swelling can also be a sign of poor circulation as well as pain in the hips and legs that get worse with walking and eases with rest
• Hair that no longer grows on the legs and feet and shiny hard skin on the legs may also be signs of poor circulation.
• Constant foot itching can be a sign of a fungal infection or dry skin, which can lead to serious infection.
• Calluses and corns are usually signs of continuing pressure in certain areas of the feet. These should always be removed by a professional if you are a diabetic (no home remedies).
• The appearance of pus is usually the sign of an infection.
• Continuous bloody discharge from a wound usually signals a very serious foot problem.
• Difficulty walking can result from improperly fitting shoes and abnormal pressure on the feet. This should be addressed as soon as possible.
• Limps and joint pains can also be signs of infections, joint problems or shoes that don’t fit properly.
• Fever or chills should always be checked out by a doctor.
• Fever or chills along with a foot injury is usually the sign of a very serious infection that can lead to amputation or death.
• Any redness or red streaking leading away from a wound is usually a sign of a spreading infection.
• Numbness can be a sign of nerve damage.
• Any injuries you receive to your feet and legs should be checked out by a doctor especially puncture wounds like nail punctures or animal bites as these are at high risk to get infected.
• Any open or draining sore should be brought to a doctor’s attention
• Dry cracks in the skin should be considered as open wounds and should be brought to a doctor’s attention before infection sets in.
• Foot odor that is unusual or unrelenting can be signs of some kind of infection or problem. Notify your doctor.
• Ulcers or wounds greater than 1 inch across can often threaten a limb.
• Any change in mental state such as confusion, especially if it accompanies an injury, may be the sign of serious infection that could result in amputation or death.

Along with examining the feet, the following situations should be addressed in your diabetes foot care routine to reduce risk of foot related complications.

• Diabetics should be sure to have properly fitting footwear. Improperly fitting shoes can cause sections of the shoe to rub against the feet causing redness, sore spots, blisters or calluses without the diabetic even being aware, especially if the diabetic has foot abnormalities such as flat feet, bunions or hammertoes. If any of these are present either inserts or medically prescribed shoes may be necessary.
• Minor fungal infections of the toe nail or even athlete’s foot can lead to serious bacterial infection for diabetics. These infections should always be treated swiftly.
• Ingrown toenails also should be assessed and handled by a professional right away.
• Smoking any form of tobacco can actually damage tiny blood vessels in the legs and feet. This damage interferes with the healing process and increases the risk for infections and amputation. It is best that diabetics not smoke!
• Avoiding any trauma to the feet is critical. When getting a pedicure it is important that the skin not be nicked or punctured to be totally safe.

For most problems on this list, seeing a doctor within about 3 days is usually acceptable. Judge the severity of the situation, you may need to see the doctor sooner for the more serious problems.

Self Diabetes Foot Care

Keeping your diabetes under control is the best thing you can do to avoid complications with your feet. Taking your medications and following your diet is the best way to stay safe and be as healthy as you can be. Keeping your blood sugar level as close to normal as possible is the best way to avoid damage to your blood vessels, eyes, nerves and kidneys.

Exercising will also help to maintain good circulation and it will do wonders for bone and joint health in your legs and feet. Talk to your doctor before beginning an exercise regimen though.

Wear comfortable, properly fitting shoes to keep your feet protected. Your podiatrist can help fit you with the right shoes or you can find stores that specialize in shoes for diabetics. Special prescription shoes or inserts may be needed if you have bunions, hammertoes or flat feet. Try to stay away from elastic socks of hosiery that can clamp down on the skin as these can impair circulation.

STOP SMOKING! Smoking promotes blood vessel damage in the legs and feet. This can lead to poor circulation which can lead to infection and/or amputation. Quitting smoking will be one of the best choices you’ll ever make as a diabetic.

Keeping your pathways clear so that you won’t bump and injure your toes and feet will be a great thing to do as well. Try to keep hallways and passages lighted at night so you don’t damage your toes accidentally.

Always use safety clippers and not scissors to cut your nails. This is the safest way to go. Always cut straight across and above the skin to prevent ingrown toenails. If you have any difficulty seeing or cutting your nails yourself, maybe you should let a doctor do it or let your doctor train a family member or friend how to do it for you safely.

Examine your feet daily! Especially after any injury to trauma to be sure there are no wounds that need to be brought to the attention of your doctor. To prevent dry skin and cracking, which can lead to infection, use a water based moisturizer (just not between your toes, it can lead to fungal infections). Only wear cotton or wool socks.

Diabetes foot care doesn't have to be as hard as you think. The best way to avoid complications with your feet is to be proactive. With that simple rule, like itself for diabetics can be simpler.

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