• Dr. Jennifer Nicole Falk

10 Foot Care Tips for People with Diabetes


According to the American Diabetes Association, in 2015, more than 30 million Americans had diabetes with 1.5 million new cases diagnosed each year (1). As the number of individuals affected by diabetes increases, so should the awareness.


From head to toe, diabetes can have significant and detrimental effects on the body, causing such things as poor eye vision, kidney damage, and peripheral neuropathy. Therefore, it is important to not only control your blood sugar levels, if you have diabetes, but to also take preventative measures to help minimize the risk of the potential complications and comorbidities associated with diabetes.


WHY FOOT CARE IS IMPORTANT IN PEOPLE WITH DIABETES


Peripheral neuropathy in the feet, related to diabetes, can lead to deformities, ulcerations, severe infections, and even amputations. Because of this, it is vital to not neglect your feet until it is too late. Check out my 10 foot care tips below to help keep your feet healthy!


FOOT CARE TIPS


1. Look at your feet daily

It is important to examine your feet on a daily basis, especially the bottoms, to make sure there are no new skin lesions, open wounds, or signs of infection (e.g. increased redness, swelling, pain, and/or abnormal drainage). If you notice anything new and/or unusual, report it to your doctor right away.


2. Never walk barefoot

Along the bottoms of your feet, you have sensory receptors, which help protect you and let you know when you have stepped on something and when it is painful. With peripheral neuropathy, you can lose that protective mechanism, which means you may not realize you have stepped on something, even something as sharp as a needle! Therefore, you should always protect your feet with proper, supportive shoe gear. My go-to brands for tennis shoes are New Balance, Brooks, Saucony, and ASICS. For specific models that work best for your feet, ask your podiatrist or a shoe store expert.


3. Wear white diabetic socks


Diabetic socks are specially designed to be more padded, looser fitting, and seamless. To learn more about them, check out the Orthofeet website. Another thing to keep in mind is the color of the socks. I suggest wearing light-colored socks because they are better for noticing any drainage that may be coming from the feet.


4. Look inside your shoes before putting them on


Foreign objects can easily fall into shoes, so it is good to check inside your shoes, and even shake them out before putting them on. I have actually pulled a safety pin out of a patient's shoe before!


5. Make sure to keep the area between your toes dry


After you bathe, dry well between the toes. Too much moisture can cause skin maceration, breakdown, and open wounds. Increased moisture can also result in athlete's foot, which can become itchy and painful.


6. Use a daily moisturizer


Dry skin can result from the elevated blood sugars in diabetes, so it is important to keep your feet hydrated with daily moisturizer; however, avoid putting it between your toes because, as mentioned above, it can make the areas too wet and cause subsequent problems.


7. Visit a podiatrist routinely

Having a podiatrist, or another healthcare specialist, look at your feet on a routine basis is good preventive care for patients with diabetes. In certain circumstances, some preventative routine foot care services (e.g. nail care, shaving of corns/calluses) are a covered benefit.


8. Consider custom orthotics and/or diabetic shoes


Custom orthotics are special-made devices that go into your shoes to help cushion, support, and/or control abnormal motion(s) of your feet. They can also help slow down the progression of foot deformities.


There are two main different types of custom orthotics: functional and accommodative. Functional orthotics tend to be made with more rigid materials, while accommodative orthotics or usually made with softer materials, thus being more “accommodating”. Therefore, if the purpose is to support the foot and control abnormal motions, a functional orthotic may be used. If the person has a severe deformity and peripheral neuropathy, an accommodative device may be more appropriate.


Ask your doctor about custom orthotics, as they may also be a covered benefit if you have diabetes and other associated risk factors.


9. Control your blood sugar levels

High blood glucose levels contribute to nerve damage and peripheral neuropathy. Elevated readings can also make it more difficult for you to heal an open wound or heal after surgery.


Blood glucose vs. HbA1c

The blood glucose test you use at home, by pricking your finger, is a measure of your current blood glucose level, whereas the HbA1c reading is a 2- to 3-month estimated average of your blood sugar levels. For healthcare professionals, the HbA1c level can give a better insight into where your blood sugar averages. It may also be a better predictor for healing potential.


Check out the Accu-chek website to learn more about the differences between individual blood glucose readings and HbA1c levels.


10. Don’t delay care if you notice anything unusual


Small wounds can become severe infections and lead to amputations very quickly, so it is crucial to make sure your doctor (primary or specialist) is aware of any new open wounds or signs of infection.


What things should you look for?

Skin discoloration

  • Increased redness can be a sign of infection

  • Purple or black can be a sign of poor circulation and skin necrosis

  • Bruising may result from a broken bone

Blisters

  • Do not pop any blisters. Instead, keep them protected and closely monitor for signs of infection (e.g. increased redness, swelling, pus drainage) until you can talk, or follow-up, with your doctor.

Open wounds/sores

  • Keep any open sores covered/protected and notify your doctor right away.

  • If you notice the area worsening, you have any signs of infection (e.g. increased redness, swelling, pain, pus drainage), or you experience any symptoms of infection (e.g. nausea, vomiting, fevers, chills), go to your nearest emergency room immediately for further work-up and evaluation.


DISCLAIMER: The above information is meant for educational purposes only and should not be construed as medical advice. Please consult the doctor, or your own healthcare professional, should you have questions or concerns related to your health.


References:

1. Statistics About Diabetes. American Diabetes Association (Reviewed & edited on March 22, 2018). Retrieved from http://www.diabetes.org/diabetes-basics/statistics/ on October 11, 2018.


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