For people living with diabetes, foot problems are a common occurrence that cannot be ignored. The staple recommendation given by healthcare specialists is to look after your feet and learn to recognize the signals.
The American Diabetes Association estimates that around 30.3m Americans suffer from diabetes. The organization also estimated that 7.2m diabetes sufferers remain undiagnosed.
Furthermore, around 60% of diabetic patients have neuropathy. This is nerve damage in the feet that makes it difficult or impossible to feel pains like blisters or rubbing stones that cause cuts. Open wounds can be a severe problem.
You can significantly reduce your chances of complications by taking precautions. Looking after your feet is one of the precautions you should introduce to your daily routine, alongside monitoring your glucose and blood sugar levels.
Taking good care of your feet is strongly recommended by the medical experts. To make life a little easier for you, we’ve put together a comprehensive list of foot care tips for diabetics.
Table of Contents:
- 1 Understanding Diabetic Foot Problems
- 1.1 What Does Diabetes Do To Your Feet?
- 1.2 Diabetic Foot Ulcers
- 1.3 Diabetes Foot Care Guidelines
- 1.3.1 Diabetic Foot Care Nursing
- 1.3.2 Find a Good Podiatrist
- 1.3.3 Check Your Feet Every Day
- 1.3.4 Wash Your Feet in Lukewarm Water
- 1.3.5 Keep Your Feet Moisturized
- 1.3.6 Use an Antiperspirant on Your Feet
- 1.3.7 Wear The Right Shoes
- 1.3.8 Check Your Shoes Before Putting Them On
- 1.3.9 Wear Diabetic Socks
- 1.3.10 Wear Socks At All Times
- 1.3.11 Protect Your Feet from Extreme Hot and Cold
- 1.3.12 Keep Blood Flowing To Your Feet
- 1.3.13 Don’t Trim Corns Or Calluses
- 1.3.14 Cut Nails Carefully
- 1.3.15 Stay Active
- 1.3.16 Never Walk Barefooted
- 1.3.17 Avoid Hot Water Bottles or Heating Pads
- 1.3.18 Do Not Ignore Pains
- 1.3.19 Learn To Understand Your Feet
- 1.3.20 Adapt Your Lifestyle
- 1.3.21 Prepare a Good Diet
- 1.3.22 Glycemic Control
- 1.3.23 Don’t Smoke
- 1.3.24 Get Periodic Foot Examinations
- 1.4 Read Our Latest Posts:
Understanding Diabetic Foot Problems
Diabetics can develop many foot problems. Two primary concerns are peripheral artery disease (PAD) and peripheral neuropathy (PN). Both conditions can increase the risk of encountering problems with your feet.
Foot issues usually develop because of a lack of oxygen caused by vascular disease, or because nerve damage blunts sensations in your feet. Diabetic foot ulcers and damage to your feet are more likely.
Common diabetic foot problems include the following:
If you don’t take good care of your feet, you will also develop dry, red patches and possibly also experience an ingrown toenail.
In severe cases, there is a risk of gangrene and possible amputation of the foot or leg. Gangrene is caused by an absence of blood flow, and if a bacterial infection develops, the condition could be life-threatening.
The good news is that most diabetes-related foot problems are preventable. If you manage your diet, watch your blood sugar levels and take appropriate care of your feet, diabetics should not have any complications to worry about.
What Does Diabetes Do To Your Feet?
People living with diabetes typically feel intermittent periods of tingling or numbness in their feet. It is not uncommon for these early signs to go unnoticed by the patient, and is initially detected by a podiatrist during the examination.
The cause of the tingling and numbness is due to a weakening of the peripheral nerves. Diabetics experiencing neuropathy for the first time may not always notice the absence of feeling because the subconscious mind is still tuned into the presence of the foot.
Damaged nerves in the legs and feet are known as diabetic neuropathy. This condition causes you to lose feeling in your feet thus there is a higher risk of causing damage to your feet.
- Example: If a small stone becomes lodged in your shoe and grates your skin, it can cause a cut or a graze without you noticing.
As you are already aware, cuts and sores have a higher risk of becoming infected when you are a diabetic.
Furthermore, infections take longer to heal because of the reduced amount of blood circulation. Blood flow in affected areas helps to speed up recovery times and fight infections, bacteria, and fungi. You might find a Revitive Circulation Booster Machine helpful with this problem.
If the infection does not heal, there is a higher risk of contracting gangrene or a diabetic foot ulcer.
Diabetic Foot Ulcers
Foot ulcers can occur in anyone, but people living with diabetes are a higher risk. Experts at Diabetes.co.uk estimate that around 10%-15% of people with diabetes will develop a diabetic foot ulcer.
They are caused when a patch of skin is broken on the foot or leg. When the sore does not heal, it will develop into an ulcer. The signs of an ulcer are when the affected area turns yellow and then black.
Ordinarily, a sore or wound to the foot will heal in good time. Diabetics are different, however, because of the reduced blood flow to the affected area. Blood flow to affected regions of the body help to speed up healing times.
When blood pressure is low, even a mild injury such as a cut, blister, bruise or chafing can take longer to heal. Furthermore, wounds are more prone to infections and could lead to ulceration.
In severe cases, gangrene may occur. This can lead to the amputation of a toe, foot or leg to prevent the infection from spreading to other areas. Gangrene is also life threatening so undergoing surgery could save your life.
Diabetes Foot Care Guidelines
When living with diabetes, it is important to check your feet on a daily basis. Include foot care guidelines in your daily schedule. Most diabetics can prevent any serious repercussions by taking good care of your feet.
There are a number of things you could do to keep your feet healthy. Medical professionals recommend diabetics should be aware of 15 critical healthcare essentials. We’ve prepared a list of 25 so that you do not miss anything that might have a serious impact on your overall health.
Diabetic Foot Care Nursing
Diabetics need a team of qualified healthcare providers. Professionals perform a variety of essential functions, such as developing a regulatory diet that is right for you and performing exams to ensure your blood sugar levels are okay.
You should also be looking for your doctor to give you some advice about diabetic foot care nursing. It is vitally important that you take good care of your feet and seek a foot examination at least once a year.
If you experience a cut or skin break, seek the attention of a doctor. Neglecting cuts and sores can lead to infections. Likewise, if you notice a change in color, or if your feet become swollen.
Remember that people living with diabetes are more prone to problems with the feet. Furthermore, these problems could have dramatic consequences.
Having a good healthcare team for support keeps you in good health and gives you peace of mind.
Find a Good Podiatrist
Because of the importance of maintaining the health of your feet, it’s in your best interests for diabetics to add a podiatrist to your healthcare team. Studies have shown that foot care nursing reduces the risk of hospitalization for diabetes-related amputations.
Visiting a podiatrist for an annual check-up can help reduce the risk of diabetic foot ulcers. Even if you do develop a foot ulcer following an infected cut, a podiatrist can help to reduce the risk of amputation by up to 80 percent.
A good podiatrist that understands the complications diabetics are susceptible to will want to know about your diet. Seek out professionals that ask you what you typically have for breakfast, lunch, and dinner.
For diabetic patients with poor circulation, neuropathy, or thick deformed nails, a podiatrist is essential. Ideally, you should be visiting a foot care specialist at least once a month.
As a diabetic, ignoring problems with your feet is not worth the risk.
Check Your Feet Every Day
If you do have diabetes, you may be fed up of hearing this advice; but check your feet every day. The importance of keeping your feet in good condition cannot be stressed enough.
Diabetics can develop peripheral neuropathy which causes you to lose feeling in your legs and feet. Subsequently, you may not be aware that you have a blister, cut, sore or bruise on your foot.
Any damage to your feet needs to be treated straight away. Diabetics have a higher risk of picking up infections which could lead to even severe problems. If you were to get gangrene due to a minor cut on your foot because you didn’t have it treated, it could result in an amputation.
Get into the habit of checking your feet on a daily basis. Try and factor it into a routine such as while you’re having a bath or shower at the end of each day. Some diabetics develop a practice of examining their feet immediately after removing their shoes.
When examining your feet, pay close attention and look for any changes that may cause difficulties at a later stage:
- Cuts, sores, or bruises
- Red spots, or chafing
- Corn and calluses
- Ingrown toenails
- Foot fungus, such as athlete’s foot
- Fungal nail infections
- Plantar warts
- Warm spots
Diabetes reduces the blood flow to your feet which starves them of oxygen. Blood flow provides the skin with essential nutrients that help the body to fight bacteria and aid the healing process.
Diabetic treatments help stimulate blood flow to the feet. If you do develop any of the conditions mentioned above, consult your doctor or podiatrist, and ask them to recommend an appropriate treatment.
Wash Your Feet in Lukewarm Water
Podiatrists recommend washing your feet in lukewarm water rather than hot water. A recommended temperature is between 90 to 95 degrees Fahrenheit.
If your feet are not sensitive to heat, test the temperature of the water first. You can use a thermometer but dipping your elbow in first will be enough.
Wash your feet gently with soap. Do not leave them in too long, you don’t want to soak your feet as this will cause your skin to become dry. After rinsing your feet, dry them thoroughly with a soft towel and apply some talcum powder.
If you have a skin complaint, athlete’s foot, a cut or sore for example, apply an appropriate moisturizer or foot care cream rather than talcum powder. It is vital to fighting potentially harmful bacteria and foot fungus infections early.
Keep Your Feet Moisturized
On the subject of creams, get into the habit of keeping your feet moist with a thin layer of lotion on the tops and soles of your feet. If you allow your skin to become dry and cracked due to a lack of moisture, it makes it easier for bacteria to get into the gaps.
People with high levels of glucose typically develop dry skin and are less able to stave off bacteria. Subsequently, this can increase the risk of skin infections such as foot fungus.
Moisturizing your feet keeps the skin smooth and soft. However, don’t rub the standard moisturizing cream in between the gaps of your toes as they do not receive a lot of oxygen.
Moist skin can break down and invite bacterial infections that thrive in damp, dark environments.
Use an Antiperspirant on Your Feet
Diabetics are twice as likely to develop onychomycosis. Diabetic nerve damage and the reduced flow of blood to your feet make you more susceptible to developing fungal infections without you noticing.
Fungi develop in warm, moist and dark environments. If you suffer from sweaty feet and wear shoes that bury your feet in the dark all day, you are more likely to develop onychomycosis. The risk can be reduced by wearing quality anti-fungal socks.
Toenail fungus and athlete’s foot are not life-threatening but can be irritable. These conditions cause dry, flaky skin and cause your foot to itch. If left untreated they can cause your toenail to turn black and fall off – and that could be bad news for a diabetic.
To help reduce the amount of perspiration expelled from your feet, invest in an excellent over-the-counter antiperspirant. And make sure it is an antiperspirant, not just a deodorant. You need a product that blocks the sweat glands and regulates the amount of sweat your feet expire.
The best antiperspirants to buy contain aluminum chloride hexahydrate which inhibits the pores and reduces the amount of perspiration released on to your skin. Spray versions are quicker and easier to administer although roll-on sticks are also available.
Also, make sure you are buying an antiperspirant that is designed for the feet as they have a higher concentration of active ingredients that underarm sprays. Ordinary antiperspirants typically contain between 10 and 15 percent of aluminum chloride hexahydrate. The International Hyperhidrosis Society recommends solutions that include at least 30 percent.
Wear The Right Shoes
Living with diabetes means your feet are more vulnerable to cuts, sores, fungi, and abrasions. It is important that you take precautionary measures to prevent damage to your feet.
Investing in the right shoes is especially important if you suffer from peripheral neuropathy and do not have any feeling in your feet. Having comfortable-fitting footwear means you don’t put pressure on one area of your foot that can cause pressure sores. Your shoes also need to be smooth and undamaged to prevent bunions, corns, neuromas. Create extra space in your footwear with a shoe stretcher.
A study published in the Journal of Foot & Ankle Surgery found custom-made shoes designed by a professional orthotic redistribute weight and reduce plantar pressures. Wearing the right shoes with correct padding helps to prevent pain and deformities.
Ask your doctor about Medicare coverage for therapeutic footwear that is specially designed for people with diabetes.
Check Your Shoes Before Putting Them On
Another way of preventing injury to your feet is to check your shoes before putting them on. Stones and ripped fabric can grate against your skin and open up wounds that increase the risk of infection.
Shake out your shoes every time you take them off. And check all your footwear before putting them on. Push your hand inside to feel for any torn lining or rugged seams that might rub against your skin. The slightest ridge can produce a blister or chafing.
If you do detect anything that might potentially cause damage to your foot, wear an extra layer of protection such as a plaster or bandage to prevent injury. If possible wear another pair of shoes that will not cause a disturbance on your skin.
Wear Diabetic Socks
You can also reduce the risk of injury to your feet by investing in diabetic socks rather than wearing an ordinary pair. Diabetic socks are specifically designed without seams and non-elasticated cuffs to avoid the risk of blistering or chafing.
Also, diabetic socks are made from natural materials that wick away perspiration and control moisture. This helps to reduce the risk of fungal infections as well as keeping bacteria away.
Diabetic socks also regulate temperature to keep your feet warm, and the soft material provides cushioning to prevent foot ulcers.
Wear Socks At All Times
Although you may be tempted to go outdoors on a hot day without socks, doing so increases the risk of causing damage to your feet. The best advice we can give to diabetics is to wear socks with shoes at all times.
Protect Your Feet from Extreme Hot and Cold
Diabetic patients need to pay attention to the well-being of your feet. Pay particular attention to conditions that could expose your feet to extreme temperature conditions. It’s not an obvious thing to do, and if you are also suffering from peripheral neuropathy, you will not be able to detect when a surface is too hot or too cold.
- Example: If you are walking on a tropical beach, no matter how much you want to feel the sensation of loose sand between your toes, you won’t be able to feel the intense heat and risk burning your skin. If you develop a blister, there is a higher risk of developing an infection.
In cold temperatures, you should be looking to protect your feet by wearing a good pair of woolen socks that keep your feet toasty warm. Cold temperatures can damage your feet too. Frostbite is very unpleasant, and if you already have poor blood circulation, the cold could make the nerve damage worse.
Keep Blood Flowing To Your Feet
Because diabetics already have a lower blood circulation, you should be paying extra attention to keep blood flowing to your feet. Many people with diabetes experience discomfort in their legs and feet such as tingling, numbness, and cramp.
- Fact: This disorder is caused by hardened and fatty plaque in the arteries. According to Science Direct, it causes peripheral arterial disease. This affects about 12 million Americans (PAD) but is more common in diabetics. Around one-third of diabetes patients over 50 have PAD.
Weakened nerve fibers may give you false sensations, and the feeling of discomfort can be extreme such as severe cramping, pain or burning. This can also result in muscle weakness, loss of reflexes, foot deformities, impaired balance, and coordination or a change in gait.
It’s, therefore, important for diabetes to keep the flow of blood moving to the lower portion of your body. Don’t sit cross-legged for any length of time, take regular walks, and put your feet up when sitting. Make a habit of wiggling your toes and rotating your ankles two or three times a day.
Don’t Trim Corns Or Calluses
Because your body cannot heal as quickly with diabetes, your feet are extra vulnerable to infections. And although taking good care of your feet is a priority, attempting to trim corns and calluses yourself is not a good idea.
If you do develop corns or calluses on your feet, visit an experienced podiatrist. They can treat the condition and offer you advice about the best foot care treatments for you.
Never cut or pick at a corn or callus to pull the skin away. This can create unnecessary wounds which expose you to bacteria which cause infections.
Foot sores can take a while to heal. Be patient. To help manage the problem use a pumice stone after bathing to grate away from the dead skin.
Cut Nails Carefully
Diabetics also have to be careful when cutting your nails. The best option is to use a professional grade toenail clipper. However, if you prefer scissors, cut them across and file the edges with an emery, so they are round.
Don’t cut your nails too short. This can lead to ingrown toenails which are painful and potentially complicated for diabetics. If you cannot comfortably reach your toenails to cut them, visit a podiatrist.
Staying active and fit is important regardless of whether you suffer from diabetes or not. However, for diabetics its even more crucial that you do some form of exercise to keep the blood circulation flowing.
Aggressive sports are out of the question as there is a higher risk of injury. The best routines for diabetics are oriental exercises such as yoga, tai chi, and qigong that are designed to energize your circuitry and keep your muscles and joints nimble.
Alternatively, try cycling. If you do enjoy riding a bike stick to routes that do not present any danger. Swimming is also a good option, but you shouldn’t walk barefoot in public changing rooms where there is a chance of picking up a fungal infection on your feet.
Diabetic patients that are at an advanced age should be looking to take regular walks. When you’re at home, stimulate blood circulation by wiggling your toes and rotating your ankles.
Never Walk Barefooted
Diabetic patients should never walk around barefooted – not even at home. Even something seemingly innocuous such as stubbing a toe can lead to a foot ulcer.
Outdoors is even more dangerous. Parks, beaches, and roads have pieces of broken debris that can puncture the skin and cause severe wounds.
Because diabetics are more susceptible to infections that could lead to gangrene you have to be more careful about where you are putting your feet – so air on the side of caution and also keep them protected and covered.
Avoid Hot Water Bottles or Heating Pads
If you have diabetes and peripheral nerve damage, you are not sensitive to heat on your legs or feet. You, therefore, may not be able to feel when a hot water bottle or heating pad is burning your skin.
This can lead to severe burning and a blister which increases the risk of infection. The best option is to avoid hot water bottles altogether. If you do get cold in bed at night, try wearing socks or invest in an electric blanket.
Do Not Ignore Pains
Aches and pains can be caused by all manner of reasons. Although there may not be any need for concern, diabetics patients should take minor niggles seriously. There could be an underlying problem that leads to other conditions associated with diabetes.
A secondary condition known as peripheral artery disease is common in people with diabetes. This condition causes numbing, aching, and tingling pains. Sometimes the sensations can be extreme and very painful.
If you are feeling an abnormal amount of pain and have diabetes, consult your doctor immediately. Even if there is nothing to worry about, the peace of mind helps.
Learn To Understand Your Feet
Patients with diabetes have to inspect your feet on a daily basis. But there is little point in checking your feet if you don’t know what signs you should be looking for.
Whereas cuts, bruises, and wounds are easy to identify, fungal infections are less noticeable.
Fungal infections on the feet are typically identified by:
- Itching, dry and flaky skin on the soles of the feet or between the toes
- Stinging or burning
- Cracking and peeling skin
- Discolored, yellow skin on the soles of feet
- White gunk under the toenails
- Toenails pulling away from the toenail bed
- Blackened toenail
If you have peripheral nerve damage, you may not be able to feel the physical sensations. It is therefore important to look out for visual symptoms.
Adapt Your Lifestyle
Patients that have recently been diagnosed with diabetes have a lot of information to absorb. On top of that, you have to change your lifestyle and develop new habits; eating habits, eye checks, heart health, sugar levels, etc.
Looking after your feet may also mean you have to adapt your lifestyle. Just because you have diabetes, it may not necessarily mean you have to stop doing the things you love, but you may have to change your routines slightly.
You should always be mindful of how you may cause damage to yourself. Take extra care to prevent the risk of damage to your legs and feet.
Prepare a Good Diet
Watching what you eat is par for the course for a diabetic. Your diet also has an impact on your feet. People with poor immune systems, for example, are more likely to develop fungal infections on their feet because their body is unable to fight it.
The best food for diabetics is whole foods. Avoid processed foods. Fruit and vegetables are essential. Also, try to add power foods to your diet that are recommended for diabetes.
Controlling glycemic acids has been shown to reduce the number of foot ulcers and infections. As a result, the risk of amputation is less likely. Experts recommend aiming for levels of A1C <7.0%.
Studies have shown that smoking restricts the blood to your feet. This can cause PAD, which prevalent in about 60% of diabetic patients anyway.
Diabetics that smoke is four times more likely to develop PAD which contributes to potential problems. Patients with PAD are five times more likely to suffer cardiovascular disease and six times more likely to die from coronary heart disease.
Get Periodic Foot Examinations
We cannot stress enough how important it is to take good care of your feet if you are a diabetic. We trust this guide has helped, but you should also seek consultations with an experienced podiatrist at least once a year – and more often if you do develop problems with your feet.