HEALTH PLUS MEDICAL CORRESPONDENT
Uncontrolled Diabetes is dangerous to your feet, even a small cut can produce serious consequences. There is a lot to manage if you have diabetes: checking your blood sugar, making healthy food, finding time to be active, taking medicines, going to doctor’s appointments. With all that, your feet might be the last thing on your mind. However, all diabetics are at risk of increased infection in the peripheries and serious complications, such as amputation.
How Can Diabetes Affect My Feet?
Diabetes can cause the major problems that can affect your feet:
Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat, cold, or pain there. This lack of feeling is called "sensory diabetic neuropathy." If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected. The muscles of your foot may not work properly because nerves to the muscles are damaged. This could cause your foot to not align properly and create too much pressure on one part of your foot.
Peripheral vascular disease
Diabetes also affects the flow of blood. Without good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called "peripheral vascular disease." If you have an infection that will not heal because of poor blood flow, you are at risk for developing ulcers or gangrene (the death of tissue due to a lack of blood). Most times, the treatment for a gangrenous toe or ulcerated lesion is amputation.
Red Flags to note
Any of these problems are warning signs that must be heeded and treated:
Changes in skin colour or skin temperature
Swelling in the foot or ankle
Pain in the legs
Open sores on the feet that are slow to heal or are draining
Ingrown toenails or toenails infected with fungus
Corns or calluses
Dry cracks in the skin, especially around the heel
Foot odour that is unusual or won't go away
How can I avoid developing Diabetic Foot Syndrome?
- Inspect your feet daily. Check for cuts, blisters, redness, swelling or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything. Get periodic exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes.
- Never walk barefoot. Not even at home! Always wear shoes or slippers. You could step on something and get a scratch or cut.
- Bathe feet in lukewarm, never hot, water. Keep your feet clean by washing them daily. Use only lukewarm water, the temperature you would use on a newborn baby. Never use a heating pad or a hot water bottle on your feet.
- Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting and carefully dry between the toes.
- Moisturise your feet but not between your toes. Use a moisturiser daily to keep dry skin from itching or cracking but do not moisturise between the toes - that could encourage a fungal infection.
- Cut nails carefully. Cut them straight across and file the edges. Do not cut nails too short, as this could lead to ingrown toenails. If you have concerns about your nails, consult your doctor.
- Wear clean, dry socks. Change them daily. Consider socks made specifically for patients living with diabetes. These socks have extra cushioning, do not have elastic tops, are higher than the ankle and are made from fibers that wick moisture away from the skin. If your feet get cold at night, wear socks.
- Shake out your shoes and feel the inside before wearing. Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on.
- Consider using an antiperspirant on the soles of your feet. This is helpful if you have excessive sweating of the feet.
- Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment.
Each one of these steps will help in preventing diabetic foot complications. First and foremost however, is keeping your blood glucose levels under control!