When you are diagnosed and living with diabetes, there is a lot of information to take in, appointments to keep, and lifestyle changes to make. This can all feel overwhelming. Your feet may be the last thing on your mind, especially if they are feeling fine. It is important to know that foot complications in people living with diabetes are extremely common, it is estimated that approximately half of all people with diabetes have nerve damage, or neuropathy, of their feet. Education and prevention are key to helping reduce your risk of foot complications and to keep your feet healthy.
High blood sugar levels over time can cause blood vessel and nerve damage in your feet with symptoms of pain, numbness and tingling. It is also possible to have nerve damage with no symptoms at all. The effects of this damage can be a decreased ability to feel pain, hot or cold, and while this may sound like a good thing, it can lead to big problems. If you injure your feet or develop a sore or blister and you can’t feel it, it can become infected and quickly lead to serious issues before you even become aware of the problem. You are at higher risk for nerve damage in your feet if:
- You have had diabetes for a long period of time
- Your diabetes is uncontrolled
- You are overweight
- You are older than 40 years of age
- You have high blood pressure
- You have high cholesterol
- You have advanced kidney disease
- You drink alcohol excessively
Having diabetes also impairs your body’s circulation, especially in the legs and feet. This, combined with nerve damage, increases your risk of forming a foot ulcer. The likelihood of the ulcer becoming infected is also increased, and healing may be delayed or difficult, which can ultimately result in amputation.
What you can do:
- Stop smoking, as smoking further impairs the circulatory and immune systems.
- Check your feet daily for any changes, open areas, calluses or corns, redness, or swelling. Be sure to check the bottoms of your feet and between your toes. Ask a family member or friend to check for you if you can’t reach your feet or have limited mobility or vision.
- Keep your blood sugar well-controlled.
- Eat a healthy diet with limited sugar and salt, and plenty of vegetables, fruit, lean protein, and recommended portions of whole grains (follow your diabetes nutrition plan).
- Exercise daily. Exercise helps improve or maintain circulation in your legs and feet. Walking is great! Ask your healthcare provider what types of exercise are right for you.
- Wash your feet daily in lukewarm water, never hot. Dry feet gently and completely, especially in between your toes.
- Apply lotion to the tops and bottoms of your feet, never in-between your toes.
- Always wear well-fitting, supportive shoes. Try on shoes at the end of the day to check for a good fit. Wear cotton socks (white is best to make you aware of any bleeding).
- Never go barefoot – even inside or at the beach. Check inside your shoes before wearing for pebbles or sharp objects.
- Trim or file toenails straight across, or have your podiatrist trim nails for you. Avoid nail salons.
- Don’t use over-the-counter products to treat any foot issues such as calluses or corns unless instructed to do so by your podiatrist.
- Have your healthcare provider check your feet at each visit, and see your podiatrist at least once per year, and more frequently if you have nerve damage or any foot issues.
- Take your diabetes medications regularly as prescribed.
- Wiggle your toes several times per hour if sitting or lying down.
- Elevate legs while lying down when possible.
- Limit alcohol intake to no more than 1 drink per day for women and 2 drinks per day for men. Ask your healthcare provider if any alcohol is right for you.
- Ask your healthcare provider for other ways to keep your feet healthy.
See your doctor for:
- Tingling, burning or numbness of your feet
- Pain or cramping in your feet, legs, or buttocks
- Loss of hair on toes, feet, and lower legs
- Very dry, cracked skin on your feet
- A change in color or temperature of your feet
- Thickened, yellow toenails
- A fungal infection between your toes
- Any open areas, infected corns, or ingrown toenails
- Any changes to your feet
References:
Diabetic Foot Complications: A Retrospective Cohort Study – PMC (nih.gov)
What Is Diabetic Neuropathy? – NIDDK (nih.gov)
All Blogs are written by Professionals in the fields of Nutrition, Human Development and Diabetes.