Diabetes and foot care

The high blood sugar levels common in diabetes can lead to two types of damage that spell trouble for the feet:

• blood vessel damage: Blood vessel damage can reduce blood flow to the feet, which can make the feet more vulnerable to ulcers and infection and make wounds slower to heal.
• nerve damage (peripheral neuropathy): The nerves that carry messages from the feet to the brain and vice versa can be compromised by too much sugar in the blood. When that circuit is interrupted by nerve damage, your feet might have a painful burning or tingling sensation, or they might be numb, making you unable to sense pain from a cut or blister. That may sound like a good thing until you realize that feeling pain is what tells you that problems are afoot.

So say you wear new shoes, and they rub a blister onto your heel. With nerve damage, you can’t feel the blister so you might never know that the blister is there at all. A simple blister that goes undetected can grow into a deep sore, known as an ulcer. An ulcer that becomes infected is a serious condition. Add reduced blood circulation to the mix, and the healing process slows down. Ulcers and other foot injuries can affect mobility, changing a person's weight distribution on their feet, boosting their risk of additional blisters and calluses. Infections can even advance to the point of gangrene, which is tissue death. Amputation may be needed to prevent gangrene from spreading to other parts of the body. This is why people with diabetes have a higher risk of foot or leg amputation.

What can you do to care for your feet?

Foot care actually starts far from your feet. Undoubtedly, the first and best strategy is to manage your blood glucose levels. Keep your levels on target as often as possible, and you will minimize and even prevent damage to your nerves and blood vessels. And smokers with diabetes, be advised: smoking also decreases blood flow to your feet and can increase your risk of requiring an amputation.

Beyond blood sugar management and stopping smoking, there are several things you can do directly to manage your feet:

• Check all sides of your feet daily – tops, bottoms, toes, in between the toes, on the heels. You're searching for any sign of potential trouble: ingrown toenails, cuts, cracking or dry skin, calluses, blisters, sores, corns, or warts. Use a mirror to get a better view of the bottoms of your feet.
• If you notice any changes or troubling marks, consult your physician, primary health care provider, or foot specialist. Do not attempt to self-treat injuries or infections – even something as seemingly minor as an ingrown toenail.
• Wash your feet daily in warm water using a mild soap. This means wash, not soak. Soaking can actually dry the skin, increasing your risk of foot infection. And use warm water, not hot or cold. Nerve damage may make it hard to tell how hot or cold the water is, so test the temperature with your hand or your elbow.
• Dry your feet well. Be gentle. Use a soft towel to pat them dry and don't forget between your toes. Avoid scrubbing or rubbing the skin.
• Moisturize your feet – your heels and soles – in the morning and at bedtime. Dry skin can crack and leave you susceptible to infection. Excess moisture also welcomes germs, so don't use too much lotion, and never apply it between the toes.
• Before slipping your feet into your well-fitting, supportive shoes, look into each shoe and use your hand to feel around inside. You never know when a stray pebble, thumbtack, or paperclip could be awaiting your foot.
• Put your feet up when sitting. Don't cross your legs for long periods of time. Wiggling your toes and moving your ankles when sitting can help to maintain a good blood flow.
• Your health care team knows that foot care is a priority for people with diabetes. Beyond your daily foot check, you should have your feet looked at by your health care team at least once a year. Don't be foot-shy. If you have a question or concern, speak up.

All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/healthfeature/gethealthfeature/Diabetes-Self-Management