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Caring for Your Feet

by Rita Weinstein

When you have diabetes, your feet need extra-careful attention. That’s because diabetes places you at a higher risk of getting foot infections. There are several reasons for this, and they are all related to high blood glucose levels. First, high blood glucose is associated with damage to blood vessels, which can result in reduced circulation to the feet. If you get a cut or sore on your foot, decreased blood flow will slow the healing process. Second, high blood glucose can keep white blood cells from effectively fighting off an infection. In addition, many people with diabetes develop neuropathy, or nerve damage, in their feet. When nerves are damaged, the ability to sense heat, cold, pressure, and pain may be diminished.

Often, changes in sensation in your feet occur over a long period without you even knowing it. You may experience a tingling, “pins and needles” feeling in your feet, or the nerves may become numbed and you may feel very little. When you lose feeling in your feet, you lose the ability to know when you have a sore, blister, or injury. This is called loss of protective sensation. When you don’t feel the pain, you’re less likely to treat the problem — and that could cause serious complications. Leaving a wound untreated can allow it to become infected, and the infection could become serious enough to require amputation.

Unfortunately, diabetes-related lower-extremity amputations are on the rise. The financial and emotional costs of such losses are considerable. The good news is that if you pay attention to your foot health daily, you can do much to prevent the conditions that can lead to amputation. About three-fourths of all diabetes-related amputations are preceded by chronic foot ulcers. Therefore, a person with diabetes has a very good chance of avoiding the loss of a toe, foot, or leg if chronic foot ulcers can be prevented. The following is a list of simple, practical things you can do to take care of your feet. Be sure to contact your health-care team right away if you notice a problem.

Take a good look
Take a good look at your feet daily. What you are looking for are sore spots, cuts, reddened or swollen areas, and infections around or under your toenails. Remember, you might not feel any pain at all, so the visual check is crucial. The easiest way to make sure you don’t forget is to set a definite time, for example, just before bed. Sometimes it’s hard to see all surfaces of your feet, so feel free to use a mirror. You might also ask a family member or caregiver to help you out. If you do notice a sore, cut, blister, bruise, infection, or area of soreness or swelling, don’t hesitate to call your doctor’s office and let the doctor or nurse know, especially if the spot doesn’t begin to heal after the first day.

Keep ’em clean
Keep your feet clean. Using warm — not hot — water and mild soap, thoroughly wash your feet once a day. Soaking your feet is not a good idea, because it makes the skin very soft and vulnerable to injury in the short term, and it causes skin to dry out and crack in the long term. Dry, cracked skin is an open invitation to a variety of bacteria.

After washing your feet, use a soft, absorbent towel to make sure you’ve dried them completely. Pay special attention to drying the areas between your toes (extra moisture here can lead to skin breakdown). A light sprinkling of talcum powder between your toes will help keep that area dry and infection-free.

Moisturize the tops and bottoms of your feet daily, but keep the areas between your toes completely dry. The skin on the tops and bottoms of your feet should be kept soft and smooth with skin lotion or petroleum jelly. There are many good products available at the drugstore. Some are specially formulated for diabetic foot care, but the best product for you is the one that you feel helps and that you can afford to use every day. Massage the lotion in well, and use only small amounts. If you overdo it, you could create a germ-friendly environment.

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Also in this article:
Foot-Care Checklist
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