Foot Care Is Essential With Diabetes

From inspecting your feet for sores to keeping your skin dry, proper foot care is essential when you have diabetes. Practice these tips to reduce the risk of infection and protect your feet.

You may think of diabetes as a blood sugar problem, and it is. But the nerve and blood vessel damage caused by diabetes can also become a problem for your feet if you develop neuropathy and lose feeling in your feet or hands or get an infection. To ensure the best possible foot health, follow these 11 easy tips to avoid injury, and your feet will be healthy longer.

Nerve damage is a complication of diabetes that makes it hard to feel when you have sores or cracks in your feet. “Patients with diabetes are looking for any changes in color, sores, or dry, cracked skin,” says podiatrist Steven Tiller, MD, of Portland, Ore. Place a mirror on the floor to see under your feet or ask a friend or relative for help if you can’t see all parts of your feet clearly.

When people with diabetes develop nerve damage or neuropathy, it’s hard to tell if the bath water is too hot. “They won’t realize they are actually scalding their skin,” explains Dr. Tillet. Stepping into a bath before checking the temperature can cause serious damage to your feet, and burns and blisters are open doors to infection. Use your elbow to check the water temperature before getting into the tub or shower.

Shoe shopping for people with diabetes requires a little more attention to detail than you may be used to. Tillet advises looking for shoes with more depth in the toe box, good coverage of both top and bottom, and without seams inside the shoe that can rub on your foot. Likewise, seek socks without seams, preferably socks that are padded and made from cotton or another material that controls moisture.

Wearing shoes with good coverage outside to protect your feet makes sense to most people, but even inside your house, puttering around without shoes puts your feet at risk for small cuts, scrapes, and penetration by splinters, glass shards, and the misplaced sewing needle or thumbtack. If you have neuropathy, you might not notice these dangerous damages until they become infected. It’s best to wear shoes at all times, even in the house.

Make sure that drying your feet is part of your hygiene routine. “The space between the toes is very airtight,” says Tillet. “Skin gets moist and breaks down, leading to infection.” Prevent this by toweling off thoroughly after washing your feet and by removing wet or sweaty socks or shoes immediately. You can still use moisturizer to prevent dry, cracked skin — just avoid putting it between your toes.

Attend to bunions, calluses, corns, hammertoes, and other aggravations promptly, so they don’t lead to infection due to pressure sores and uneven rubbing. Even seemingly harmless calluses may become problems if you ignore them, notes Tillet. See a podiatrist, a doctor who specializes in foot care, instead of heading to the pharmacy for an over-the-counter product for feet — some products are irritating to your skin and can actually increase the risk of infection even while they treat the bunion, callus, or corn on your foot.

Because wearing the correct shoes is so important, orthotic footwear is a great investment in protection and comfort. Shoes made especially for people with diabetes are available at specialty stores and through catalogs, or you can visit your podiatrist for advice. Medicare will cover one pair of diabetic shoes a year, with the addition of three inserts to reduce pressure on your feet. Your doctor may recommend this type of diabetic shoe if you have an ulcer or sore that is not healing.

People with diabetes benefit from exercise, but you still must go easy on your feet. Many fitness classes and aerobics programs include bouncing, jumping, and leaping, which may not be the best activities for your feet, especially if you have neuropathy. Instead, look into programs, such as walking, that don’t put too much pressure on your feet. Just make sure you have the right shoe for whatever activity you choose.

The dangers of smoking run from your head to your feet. “The nicotine in a cigarette can decrease the circulation in the skin by 70 percent,” says Tillet. So if you smoke, you are depriving your feet of the nutrient- and oxygen-rich blood that helps keep them healthy and fights infection. “Diabetic patients already have risk factors that compromise their blood vessels. It’s never too late to stop smoking,” says Tillet.

“There’s a direct relationship between blood sugar level and damage to the nerve cells,” says Tillet. Out-of-control blood sugar leads to neuropathy, which will make it hard to know when your feet are at risk or being damaged. The better you are at controlling your blood sugar, the healthier your feet will be over the long term. Finally, if you already have an infection, high blood sugar levels can make it hard for your body to fight it.

Your doctor and your diabetes team are great sources of information if you need ideas and inspiration for taking care of your feet, quitting smoking, or staying on top of your “numbers” — your weight, blood sugar, and other measures of health, such as blood pressure. Of course, if you notice any changes in your feet that concern you, it’s a good idea to see your doctor before your next regularly scheduled check-up.