People with diabetes are often told to pay close attention to their feet — and for good reason. While having diabetes doesn’t make it more likely that you’ll injure your feet in the first place, having certain common diabetes complications raises the risk of minor foot problems becoming major foot problems if not treated promptly.
One of those complications is peripheral neuropathy, or damage to the nerves in the feet and lower legs. Peripheral neuropathy can cause a loss of sensation in the feet, meaning that heat, cold, and/or pain may not be felt. As a result, a person becomes more vulnerable to getting burned if he steps into hot water or walks barefoot on hot pavement or sand, and he’s also more likely to let small blisters, cuts, and scrapes on his feet go untreated since he doesn’t feel them.
The other common diabetes-related complication that raises the risk of foot problems is reduced blood circulation to the feet. Blood carries oxygen and other nutrients and substances that are necessary for wound healing. When blood circulation is reduced, wounds heal more slowly and have more time to become infected.
The good news is that many if not most major foot problems are avoidable. How to do it? Maintain the best blood glucose and blood pressure control possible. Wear well-fitting shoes or slippers at all times (except for sleeping or bathing), and check inside them for foreign objects before putting them on. Check the tops and bottoms of your feet and between your toes every day, especially if you know or suspect you have either neuropathy or reduced blood circulation. Look or feel for any signs of rubbing, injury, or infection, such as redness, broken skin, or areas of unusual warmth.
If you develop a foot problem, attend to it immediately. Apply first-aid measures to small cuts or blisters, then check daily to see whether the wound is healing. Stop wearing any shoes or socks that rub on or bother your feet in any way. And call your diabetes care provider promptly if small wounds do not heal quickly or if you sustain a serious foot injury.
Resolving common problems
Having any kind of foot problem can interfere with your daily life. Here’s how to address some common complaints and keep your feet in good health.
I’d like to walk more for exercise, but my feet hurt when I walk.
Your feet may be hurting for a number of reasons, most of which can be prevented or treated by changing your activity, your shoes, or the insoles in your shoes.
In general, the more active you are, the better you will feel, and walking is a good choice of activity for many people. However, if you have diabetes-related foot problems, check with your doctor about how much walking is safe for you. It may be advisable to alternate between walking and activities that put less stress on your feet, such as bicycling, swimming, or water aerobics. (Be sure to wear water shoes when exercising in water.)
If walking is safe for you, choose walking shoes that are flexible enough to walk in easily but that also provide support and cushioning. Wear socks that provide some cushioning and that wick away sweat. Remember that even the best shoes won’t last forever, and the more you weigh, the faster your shoes will wear out. Generally, shoes will last for no more than 500 miles, which usually equals three to six months of regular walking. Plan on buying a new pair of walking shoes before the old ones wear out so that you can “break in” the new ones a little at a time. (Although shoes should fit well and be comfortable at the time of purchase, it’s recommended that you wear them for only short periods at first and gradually lengthen the time you walk in them.)