Diabetes leads to problems in an unexpected place: your feet. Like with the disease itself, many of the problems are preventable if you follow proper diabetic foot care.
by The Iowa Clinic on Wednesday, November 20, 2019
Diabetes is primarily a problem with your blood sugar. When you manage it properly, you can go on living a healthy lifestyle.
Problems arise when you fail to make the lifestyle changes necessary to lower your blood glucose levels or follow through on your treatment plan. Your risk of heart disease, stroke and cancer — the usual life-threatening conditions — go up. Your risk of foot problems is even greater. And those are issues that are unique to diabetes.
How does diabetes affect your feet?
Uncontrolled blood sugar affects the inner workings of your body in two ways: it damages your nerves and it impacts the flow of blood. Those two issues present in a wide range of diabetic foot problems.
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Nerve damage from diabetes is known as diabetic neuropathy. It can affect the nerves in any part of your body, including your internal organs, head, hands, legs, hips, thighs and butt. When it reaches your feet, it’s known as peripheral neuropathy.
Half of people with diabetes suffer from peripheral neuropathy. Your feet may tingle, burn or go numb. You might have a lot of neuropathic pain or just foot weakness. Peripheral neuropathy isn’t exclusive to the feet. It can affect your legs, arms and hands too. But when it does affect your feet, it can lead to a number of other problems:
- Loss of balance
- Frequent falls
- Changes in the way you walk or move
- Decreased muscle tone
- Foot deformities
- Difficulty sensing movement or feeling pain
Diabetic Foot Wounds
Damaged nerves ruin your senses. You can’t feel anything in your feet. It might sound great to not feel pain, but that’s a big problem if you suffer a foot injury or wound. You may not realize it for awhile.
Diabetes also impacts your ability to heal, so a simple blister or sore may linger for weeks. Without feeling and out of sight, a small foot issue can get infected. With your weakened immune system, it may never properly heal and cause a foot ulcer. You end up losing a toe, part of your foot or even the whole thing because amputation is the only solution.
Foot deformities are another result of peripheral neuropathy. Charcot foot is a rare but serious problem that affects the bones, joints and tissue in your feet and ankles.
Your foot can become so weak that it dislocates or breaks. Because of the nerve damage, you probably won’t notice the pain. If you keep walking on Charcot foot without knowing it, your foot collapses, leading to a deformity. That further increases your risk of developing diabetic foot ulcers.
If you can’t feel it, how do you know you have a foot problem?
You literally have to keep an eye on your feet. Every day. Without the sense of touch, you only have the sense of sight to rely on.
Make it a routine to check your feet. Use a mirror if you don’t have the flexibility to bend and see every part of your feet. Or have a spouse, family member or someone else do it for you. As part of this daily inspection, look for these signs of diabetic foot conditions:
- Swelling – It could be a sign of infection, foot injury or Charcot foot.
- Cuts, blisters, sores and spots – All of these issues can lead to infection if you don’t treat them early.
- Red, blue or dark colors – Redness is another sign of infection and can signal an early stage of Charcot foot. If your feet are blue, they have poor blood flow. And if the skin is dark, your foot tissue may have already died.
- Warm and cold spots – Warming points to infection while cooling means that part of your skin has poor circulation.
- Damaged toenails – Any time your toenail looks different than normal, it’s concerning. Toenail damage opens up the surrounding skin to infection.
- Dryness and cracks – Even small openings invite germs and have the potential to do long-term damage.
- Corns and calluses – These rough spots are caused by pressure and too much rubbing, which may mean your foot is changing shape.
What can you do to prevent diabetic foot problems?
In addition to your daily inspection to monitor the health of your feet, you can take a few additional steps to stop any of the issues before they start.
1. Wash your feet.
Add it to your daily foot routine. Before or after you check for problems, give your feet a bath. Feet are often neglected in the shower or tub. When you have diabetes, you need to thoroughly clean and rinse away the germs with warm water.
After a foot bath, gently dry your feet and toes off with a soft towel. Once the moisture is absorbed, powder your toes with cornstarch or talcum powder. The spaces between your toes hold moisture, creating an inviting environment for bacteria.
2. Practice proper foot grooming.
Once your feet are clean and dry, keep the hygiene routine going. Smooth the rough spots, corns and calluses with a pumice stone. Do it gently and in one direction to avoid tearing sensitive skin. Then moisturize your feet to keep the rough patches soft and to prevent dry, cracked skin. Don’t put any between your toes to avoid adding moisture.
It’s not part of a daily diabetic foot care routine, but correct toenail trimming is also important. You should cut toenails straight across with toenail clippers and smooth them with a nail file so sharp edges don’t puncture your skin.
3. Keep your feet just the right temperature.
Extreme temperatures can damage your skin. And diabetic feet are desensitized to them. Before stepping into the shower or bathtub, always use your hands to test the water temperature. Wear shoes on the hot pavement in the summer and sandals on the beach if you make a trip up to Big Creek or jet off for a sunny vacation.
When the freezing cold and snow of an Iowa winter hits, wear warm socks and lined, waterproof boots to protect your feet from the elements. Clean, seamless, breathable socks that fit well will prevent added pressure on the skin and help with circulation and moisture.
4. Help blood circulation.
Your extremities already have poorer circulation than the core of your body. Diabetes makes that problem worse. To make up for the lack of blood flow to your feet, avoid wearing tight socks that restrict circulation and elevate your feet when sitting. You can also move your feet several times throughout the day by wiggling your toes or rotating your ankles for a few minutes.
A lot of diabetic foot care is done on your own. But you’re not alone in managing your condition or monitoring the health of your feet. Podiatrists are foot doctors — physicians with specific training and expertise in the feet and ankles. They can examine any abnormalities you found in a daily inspection and help you treat foot problems before they devolve into major issues.
So as soon as you notice an infection, experience tingling or numbing, feel pain, have a cut that won’t heal or lose sensation in your feet, schedule an appointment with a podiatrist near you to get your feet checked out.