Diabetic Foot Care Fact and Fiction

I know that foot care isn’t the most exciting topic to read about. But foot care is a crucial part of diabetes self-management. Neglecting your feet can lead to serious problems down the road; even minor problems, such as a scratch, can lead to an infection or foot ulcer, which, if not caught and treated early on, can increase the risk of amputation. Not a cheery thought, for sure, but by paying a little attention to your feet on a daily basis and taking care of your diabetes at the same time, you can greatly lower your risk of developing problems. And since April is National Foot Health Awareness Month, what better time to start? This week, let’s look at some facts as well as misunderstandings about foot care.

Fact or Fiction: Only people who have high blood sugar levels should check their feet.

Fiction. Everyone who has diabetes should get into the habit of checking their feet daily, no matter their HbA1c[1] or blood sugar levels. Looking at your feet every day for cuts, sores, redness and swelling is time well spent to avoid serious issues down the road.

Fact or Fiction: It’s not a good idea to soak your feet if you have diabetes.

Fact. Soaking your feet in tub of warm water can sure feel good, especially if you’ve been standing all day. However, foot soaking is pretty much a no-no when it comes to diabetes foot care. It may seem strange, but keeping your feet immersed in water can actually dry out your skin. The water removes natural oils on your skin that help to protect your feet. Dry skin is more prone to cracks, which can literally open the door to fungus and bacteria. Also, if you have any nerve damage in your feet that has caused a loss of sensation, you risk burning your skin if the water is too hot.

Fact or Fiction: Avoid putting lotion on your feet.

Fiction. It’s actually a good idea to put a thin layer of alcohol-free lotion, cream, or petroleum jelly on the tops and bottoms of your feet after you’ve washed them (daily, of course). However, bypass putting lotion between your toes. That area tends to stay moist naturally, so adding lotion may lead to moisture buildup, which, in turn, can set the stage for fungal infections.

Fact or Fiction: It’s perfectly fine to get a pedicure.

Fiction. Summer is coming and we all want our feet to look good in sandals. But pedicures can be very risky — and not just for people who have diabetes. Before you head off to the salon to get your toenails polished with Samoan Sand, consider the following:

• If you’re in good health (and that includes your feet) and free of complications, a pedicure poses very little risk. However, if you have any cuts or sores or have neuropathy, skip the trip.

• Investigate the salon. Ask very careful questions about the salon’s sanitization practices. The foot baths should be cleaned and sanitized after each pedicure. The nail tools should be sterilized in an autoclave and the package shouldn’t be opened until you’re sitting in the chair. Also, avoid salons that use any wooden tools or that reuse emery boards. You can bring your own nail tools, but make sure you clean them thoroughly when you get home.

Fact or Fiction: Go ahead and walk barefoot on the beach.

Fiction. Kicking off your shoes and feeling the sand between your toes is one of life’s finer pleasures. But unless you’re walking on super-soft sand that’s free of rocks, shells, and glass, your best bet is to don a pair of beach shoes or flip-flops. However, because it’s likely unrealistic that you’ll never walk barefoot, let alone on a sandy shore, keep these tips in mind:

• Once again, if you have loss of feeling in your feet, protect your feet at all times. You can easily get a pebble or piece of glass embedded in your foot and not feel it.

• If the beach seems especially rocky, don’t take the chance, even if your diabetes is well managed. You can still end up cutting your foot or stubbing a toe. Wear shoes.

• Inspect your feet once you get back home — check for the usual cuts, scrapes, redness, etc.

Fact or Fiction: A podiatrist (foot doctor) is a key member of your diabetes care team.

Fact. Your own doctor should be doing a foot check at least once a year, if not at every visit. And your job is to check your feet every day (or ask someone at home to check them for you if you have trouble reaching or seeing your feet). But there are instances when you should see a podiatrist. These include:

• If you have warts, corns, or calluses on your feet. Don’t do bathroom surgery!

• If you have thickened or yellow toenails — a podiatrist should trim your nails for you.

• If you can’t see or reach your feet to inspect them.

• If you have a bunion, hammertoe, or any other foot deformity. A podiatrist can advise you on how it can best be treated and the right type of shoes to wear.

• If you see a cut or a sore that doesn’t seem to be healing, or if you notice any redness, warmth, or swelling. These could all be signs of an infection.

Endnotes:
  1. HbA1c: https://www.diabetesselfmanagement.com/diabetes-resources/definitions/hba1c/

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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.

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