I have seen advertisements for laser treatment of fungal nails. Is that a good idea?
While it may stand to reason that laser therapy might be effective at killing fungus, the products and treatments currently being advertised really have no data behind them to back them up. If you have otherwise healthy feet and money to spare, you may want to give it a try. However, if you have neuropathy in your feet, vascular disease, or other skin conditions on your feet, I would suggest speaking to your doctor about how best to treat a fungal nail infection.
My feet have changed shape over the years, and it’s hard to find shoes that fit.
It is normal for your feet to flatten very slightly and to change shape, becoming longer and wider, as you age. It’s possible for your shoe size to increase by one or even two sizes over time. That being the case, it is very important to have your feet measured each year to assess your shoe size. A study conducted some years ago by our team in Arizona suggests that three-quarters of people with diabetes wear shoes that are at least one size too big or too small. (Shoes that are too big may allow the feet to slide around, possibly leading to blisters.)
I recommend, at the minimum, an annual visit to your foot specialist for an evaluation. If you have or develop risk factors for diabetes-related foot problems, your specialist may recommend prescription shoes or specific types of over-the-counter shoes. It may also be worth seeking out the services of a certified pedorthist if you have hard-to-fit feet. These footwear specialists may work in medical offices that provide foot care or are sometimes on staff at retail shoe stores that specialize in comfortable shoes. The Pedorthic Footwear Association Web site (www.pedorthics.org) has a search function to find credentialed pedorthists by location.
Shop for shoes later in the day, because feet can swell — sometimes imperceptibly — throughout the day. A shoe that fits well in the morning may be too tight by late afternoon. Buy shoes that provide arch support where you need it and enough room in the toe box for your toes to wiggle a little. Your heel should not lift more than half an inch when you walk.
It’s important that socks fit, too. Look for seamless socks or socks with seams that do not run across the bottoms of the feet or along any bony parts where they can cause pressure. White or light-colored socks are recommended, because any bleeding from a wound on the foot will be noticed quickly.
My feet smell terrible when I take off my shoes. What can I do about this?
This is a very common problem that is generally caused by the growth of bacteria on your feet. Alternating between pairs of shoes so that each pair gets a chance to dry out completely, and changing your socks more than once daily may help. Sprinkling the insides of your shoes with ordinary talcum powder may also reduce odor. If these steps are ineffective, speak to your doctor about alternative approaches. Do not try any home remedies without speaking first to your doctor.
Other common concerns
Unfortunately, many people with diabetes eventually develop neuropathy in their feet, so it’s important to have your doctor examine your feet at least once a year and to know how to protect your feet if you develop it.
My feet are sometimes numb when I wake up in the morning. Does this mean I have diabetic neuropathy?
You may, and your diabetes care doctor or foot specialist can evaluate this with a few simple tests in his office. It’s important to know whether you have neuropathy, or “loss of protective sensation,” in your feet, because that allows you to be proactive about protecting your feet.
Why do doctors say I should check my feet every day?
