Diabetes and Foot Problems By Pierre Mouchette | Bits-n-Pieces Foot problems are common in people with diabetes. You might be afraid you will lose a toe, foot, or leg to diabetes or know someone who has, but you can lower your chances of having diabetes-related foot problems by taking care of your feet every day. Managing your blood glucose levels, also called blood sugar, can help keep your feet healthy. How can diabetes affect my feet? Over time, diabetes may cause nerve damage, also called diabetic neuropathy, that can cause tingling and pain and can make you lose feeling in your feet. When you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot, which can lead to cuts and sores. Cuts and sores can become infected. Diabetes also can lower the amount of blood flow in your feet. Not having enough blood flowing to your legs and feet can make it hard for a sore or an infection to heal. Sometimes, a nasty infection never heals. The infection might lead to gangrene. Gangrene and foot ulcers that do not get better with treatment can lead to an amputation of your toe, foot, or part of your leg. A surgeon may perform an amputation to prevent a nasty infection from spreading to the rest of your body and to save your life. Good foot care is critical to avoid severe infections and gangrene. Although rare, nerve damage from diabetes can lead to changes in the shape of your feet, such as Charcot’s foot. Charcot’s foot may start with redness, warmth, and swelling. Later, bones in your feet and toes can shift or break, which can cause your feet to have an odd shape, such as a rocker bottom. What can I do to keep my feet healthy? Work with your health care team to make a diabetes self-care plan, which is an action plan for how you will manage your diabetes. Your plan should include foot care. A foot doctor (podiatrist) and other specialists may be part of your health care team. Include these steps in your foot care plan: Check your feet daily - you may have foot problems but feel no pain. Checking your feet daily will help you spot problems early before they worsen. An excellent way to remember is to check your feet each evening when you take off your shoes. Also, check between your toes. If you have trouble bending over to see your feet, try using a mirror to see them or ask someone else to look at your feet. Look for problems such as:
Wash your feet every day. Wash your feet with soap in warm, not hot, water. Test the water to make sure it is not too hot. You can use a thermometer (90° to 95° F is safe) or your elbow to test the warmth of the water. Do not soak your feet because your skin will get too dry. After washing and drying your feet, put talcum powder or cornstarch between your toes. The skin between the toes tends to stay moist. Powder will keep the skin dry to help prevent an infection. Smooth corns and calluses gently Thick patches of skin called corns or calluses can grow on the feet. If you have corns or calluses, talk with your foot doctor about how to care for these foot problems. If you have nerve damage, these patches can become ulcers. If your doctor tells you to, use a pumice stone to smooth corns and calluses after bathing or showering. A pumice stone is a type of rock used to smooth the skin. Rub gently, only in one direction, to avoid tearing the skin. Do NOT:
To keep your skin smooth and soft, rub a thin coat of lotion, cream, or petroleum jelly on the tops and bottoms of your feet. Do not put lotion or cream between your toes because moistness might cause an infection. Trim your toenails straight across. Trim your toenails, when needed, after you wash and dry your feet. Using toenail clippers, trim your toenails straight across. Do not cut into the corners of your toenail. Gently smooth each nail with an emery board or non-sharp nail file. Trimming this way helps prevent cutting your skin and keeps the nails from growing into your skin. Have a foot doctor trim your toenails if:
Wear shoes and socks at all times. Wear shoes and socks at all times. Do not walk barefoot or in socks, even when you are indoors. You could step on something and hurt your feet. You may not feel any pain and may not know that you hurt yourself. Check the inside of your shoes before putting them on to ensure the lining is smooth and free of pebbles or other objects. Ensure you wear socks, stockings, or nylons with your shoes to avoid blisters and sores. Choose clean, lightly padded socks that fit well. Socks with no seams are best. Wear shoes that fit well and protect your feet. Here are some tips for finding the correct type of shoes:
Protect your feet from hot and cold. If you have nerve damage from diabetes, you may burn your feet and not know you did. Take the following steps to protect your feet from heat:
Keep the blood flowing to your feet. Try the following tips to improve blood flow to your feet:
Stop smoking. Smoking can lower the amount of blood flow to your feet. If you smoke, ask for help to stop. You can get help by calling the national quitline at 1-800-QUITNOW or 1-800-784-8669. For tips on quitting, go to SmokeFree.gov/ Get a foot check at every health care visit. Ask your health care team to check your feet at each visit. Take off your shoes and socks when you are in the exam room so they will remember to check your feet. At least once a year, get a thorough foot exam, including a check of the feeling and pulse in your feet. Get a thorough foot exam at each health care visit if you have:
When should I see my health care provider about foot problems? Call your health care provider right away if you have
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