Diabetes and Foot Complications

Diabetes and Feet

Serious complications develop as a result of the impact that diabetes has on blood vessels and the body's circulatory system. Among other complications, diabetes can cause nerve damage (neuropathy). It is especially common for people with diabetes to have diminished feeling in their feet. Unable to feel pain, diabetics are particularly susceptible to foot problems that, left untreated or detected too late, often lead to amputation. From 60% to 70% of diabetics are affected by neuropathy. The American Diabetes Association (ADA) reports that about 56,000 lower limb amputations are performed on diabetics each year. The ADA adds that at least half of these could be eliminated through proper preventative foot care. Otherwise minor conditions such as ingrown toenails, corns and calluses can be precursors to serious problems for people with diabetes. Diabetics are also at higher risk for fungus infections of the skin and toenails. Also, because diabetics have difficulty feeling problem areas, a hammertoe or bunion that is constantly rubbing against one's shoe, for example, can progress to infectious ulcers.

People with diabetes must engage in daily foot care and have regular podiatric check-ups. Once a foot problem develops, it can be difficult to resolve. Poor circulation combined with limited sensation, also prohibits or delays proper healing. Someone newly diagnosed with diabetes should have their feet checked and any problem areas corrected. Bunion or hammertoe surgery early on, for example, will prevent serious problems from developing. Or, sometimes, changing a person's shoes is all that is necessary. In fact, for eligible patients, Medicare offers a Diabetic Shoe Program through which the patient is entitled to a specially fitted shoe. Everyone with diabetes should have at least one podiatric check yearly.

The following information about "Diabetes and Your Feet" has been compiled by the Massachusetts Department of Public Health.

Self-Care: How to Check Your Feet

• Wear your glasses
• Sit down in good light
• Take shoes and socks off
• Use a mirror to look at areas that are hard to see, such as the soles of your feet
• If you have trouble seeing your entire foot, ask someone to help you

What to Look For
Call your primary care physician or podiatrist if you have:

• Foot injuries that do not heal within three days
• Swelling
• Redness
• Areas that are "hot" to touch
• Pain
• Blisters or bleeding
• Calluses, corns, or plantar warts
• Ingrown toenails
• Rashes
• Dry skin
• Unusual itching
• Change in color (from pale to deep purple or red)
• Thick, rough or hard areas
• Areas of very shiny skin
• Bad smell

How to Care For Your Feet

• Keep your blood sugar in control.
• Wash your feet every day with warm water and soap. Dry well, especially between the toes.
• Look at the tops and bottoms of your feet for red areas or sores.
• If your feet are dry, use lotion, but not between the toes.
• If your feet sweat, use powder.
• Trim your nails straight across after washing your feet. Smooth them with an emery board.
• If you have nerve disease, check with your doctor to see if it is safe to trim your toenails.
• Wear cotton or wool socks or stockings.
• Exercise with your doctor's consent.
• Always wear shoes or slippers that fit well. Check shoes for rocks or other objects before you put them on.
• Make sure your doctor or health care provider checks your feet at each visit.
• Ask your doctor to check the sense of feeling and pulses in your feet at least once a year.

Remember

• Do not smoke. Smoking can cause a decrease in the blood flow to your legs and feet.
• Do not walk barefoot.
• Do not use chemicals such as alcohol, peroxide, or iodine on your feet.
• Do not cut corns or calluses with a razor blade.
• Do not bathe in water that is too hot. Check the temperature of the water with your elbow or arm before getting into the bathtub or shower.
• Do not go out in the cold weather without wearing warm shoes or boots.
• Do not use an electric heating pad or a hot water bottle on your feet.
• Do not get sunburned. Cover your feet to protect them from the sun.
• Do not wear tight-fitting shoes; wrinkled or tight stockings; tight sandals, straps, garters, or bandages.

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Newton-Wellesly Hospital News - http://www.nwh.org/