Diabetes and the Feet
High blood glucose from diabetes causes two problems that can hurt the feet:
1. Nerve Damage. One problem is damage to nerves in the legs and feet. With damaged nerves, the ability to feel pain, heat, or cold can be effected. A sore or cut on the foot may get worse, because the individual may not know that it is there. This lack of feeling is caused by nerve damage, also called diabetic neuropathy. It can lead to a large sore or infection.
2. Poor blood flow. The second problem happens when not enough blood flows to the legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral vascular disease. Smoking makes blood flow problems much worse with diabetes.
These two problems can work together to cause a foot problem. For example, an individual may get a blister from shoes that do not fit. They do not feel the pain from the blister, because they have nerve damage in their feet. Next, the blister gets infected. If blood glucose is high, the extra glucose feeds the germs. Germs grow and the infection gets worse. Poor blood flow to the legs and feet can slow down healing. The infection may spread to the bone, or develops into gangrene. If a person has gangrene, the skin and tissue around the sore dies. To keep gangrene from spreading, a doctor may have to amputate (surgically remove) the affected area.
Common Diabetic Foot Problems
• Corns and calluses are thick layers of skin caused by too much rubbing or pressure on the same spot. Corns and calluses can become infected
• Blisters can form if shoes always rub the same spot. Wearing shoes that do not fit or wearing shoes without socks can cause blisters. Blisters can become infected.
• Ingrown toenails happen when an edge of the nail grows into the skin. The skin can get red and infected. Ingrown toenails can happen if you cut into the corners of the toenails when trimming them. If toenail edges are sharp, smooth them with an emery board. Ingrown toenails can also happen due to tight shoes.
Common Diabetic Foot Problems
• A bunion forms when a big toe slants toward the small toes and the place between the bones near the base of big toes grows big. This spot can get red, sore, and infected. Bunions can form on one or both feet. Pointed shoes can cause bunions. Bunions often run in the family. Surgery can remove bunions
• Dry and cracked skin can happen, because the nerves in the legs and feet do not get the message to keep skin soft and moist. Dry skin can become cracked and allow germs to enter. If the blood glucose is high, it feeds the germs and makes the infection worse.
• Athlete’s foot is a fungus that causes redness and cracking of the skin. It is itchy. The cracks between the toes allow germs to get under the skin. If the blood glucose is high, it feeds the germs and makes the infection worse. The infection can spread to the toenails and make them thick, yellow, and hard to cut.
• Wash feet in warm water every day. Make sure the water is not too hot by testing the temperature with the elbow or thermometer. Do
not soak the feet. Dry the feet well, especially between the toes.
• Inspect (Look at) feet every day to check for cuts, sores, blisters, redness, calluses, or other problems. Checking every day is even more important if the individual has nerve damage or
poor blood flow. A mirror may be used to check the feet, if the individual has difficulty bending over. If the individual has trouble seeing, they should ask someone else to check their feet.
• If the skin is dry, rub lotion on the feet after washing and drying them. Do not put lotion between the toes.
• Cut toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board.
• Always wear shoes or slippers to protect the feet from injuries.
• Always wear socks or stockings to avoid blisters. Do not war socks or knee-high stockings that are too tight.
• Wear shoes that fit well. Shop for shoes at the end of the day when the feet are bigger. Break in shoes slowly. Wear them 1 to 2 hours each day for the first 1 to 2 weeks.
• Before putting shoes on, feet the insides to make sure they have no sharp edges or objects that might injure the foot.
References: Prevent Diabetes Problems (Keep your feet healthy) National Institute of Helath National Diabetes Information Clearinghouse and (Living with Diabetes Foot Complications) American Diabetes Association.
The information in this newsletter is designed to provide information. It is not designed to replace the advice of or routine visitis to your primary care provider.