Diabetes and Your Feet

Diabetes adversely affects the nerves and small blood vessels in your feet and lower limbs. As a result, people with diabetes are at a much higher risk to develop a number of potentially serious and lifestyle limiting problems, such as:

Infection: People with diabetes are more prone to infection due to weakened immune systems and reduced circulation. Even the smallest cuts, sores, and ingrown nails, can quickly develop into potentially serious blood and bone infections that often result in amputations or worse. In fact, diabetes is the leading cause of lower limb amputations outside of accident or trauma. People with diabetes are also more susceptible to plantar warts and fungal infections of the nails and skin.

Neuropathy: Diabetes can result in damage to the nerves of the lower limbs resulting in a condition called neuropathy. Symptoms include tingling, burning, pain and cramping, reduced sensation, or even complete loss of feeling. Neuropathy greatly affects people’s mobility and painful cramping and “pins and needles” tends to reduce the quality of sleep. Neuropathy is also a problem because the reduced sensation can lead to secondary problems like burns because sufferers can’t sense that the bath water is too hot, and infections because they can’t feel blisters or cuts.

Wounds / Ulcers: Cuts, scrapes, bruises, blisters, and pressure points can deteriorate into a stubborn wound in the diabetic foot known as an ulcer. Ulcers are extremely difficult to treat and they can spread in size and depth. Not only are they painful, the open flesh is a portal for all kinds of nasty germs, viruses, and fungus to enter the foot and cause serious infections such as gangrene.

Prevention is the key to helping avoid complications from diabetes, and prevention begins at home. Here are some ways to help avoid problems:

• Inspect your feet daily, including the soles, for cuts, cracks, redness, blisters, bruising, or any other unusual marks or blemishes. See your Chiropodist right away if you find any of these things.
• Wash feet daily in warm water using mild soap or antibacterial cleanser.
• Do not soak feet in water for more than five to ten minutes, and never use hot water since excessive soaking and heat can damage or dry out the skin.
• Always test the temperature of bathwater with your hand or elbow first to make sure it isn’t too hot. Or, use a temperature gauge.
• A soft nail brush may be used to clean toe nails. Pat them dry with a clean towel. Pay particular attention to dry between your toes where moisture can cause damp skin to break down or macerate. You can use a swab of isopropyl alcohol to help dry skin.
• Use pumice or a file to lightly exfoliate or rub off any rough areas on your skin.
• Never use scissors or sharp objects to remove callus or rough spots on the skin. Excessive callus buildup may be a sign of other problems. See your Chiropodist.
• Use a moisturizer on your skin, but never between your toes.
• Even though it is commonly done, do not use powder between the toes, unless prescribed by your Chiropodist for a specific condition. Powder can cause your skin to break down since it absorbs and traps moisture.
• Never use over-the-counter wart or corn remedies. They contain a chemical that burns the skin and creates an opening that may cause serious wounds or infections. See your Chiropodist.
• Always wear a pair of indoor shoes or slippers. This will help avoid potentially serious cuts, punctures, bumps, and bruises to your feet.
• Footwear should be in good repair and fit properly. Your Chiropodist can provide proper footwear advice.
• If you have been prescribed orthotics, use them in all of your footwear!

Beyond home prevention, it is important to see a foot health specialist for maximum benefit. In Ontario, the only legally regulated specialists exclusively trained and licensed in complete foot health and orthotics are Chiropodists / Podiatrists. You should make a visit to your Chiropodist / Podiatrist at least once each year for a complete foot health check up the same way you would to have your eyes checked or for your annual physical. Even better, seeing your Chiropodist / Podiatrist for regular nail and foot care will help ensure that problems can be prevented or detected early for treatment.

For more helpful foot health information, visit our Web site at www.totalfootcare.ca.