Foot care should be an important part of diabetes management for those with type 1 diabetes. As a multi-system disorder, diabetes is frequently associated with other conditions, such as high cholesterol and high blood pressure. Together, these conditions can contribute to poor circulation throughout the body, but particularly to the feet.
“Effective management of the feet and toes requires reducing injury and frequently checking for any changes or signs of damage,” said foot care expert Michael Trepal, DPM, professor of surgery with the New York College of Podiatric Medicine.
Signs of foot injury
There are numerous signs of foot injury, including:
5. Color discoloration
6. Thick or callused skin
9. Cracked skin
12. Blistered skin
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“Keep an eye out for early signs of injury to the feet, because unfortunately many patients come in too late when serious damage may not be reversible,” added Trepal. “The telltale signs that something may be wrong are changes in the skin in terms of dryness, shininess and cracks.”
Foot ulcers, for example, which are estimated to affect as many as 1 out of 10 people with diabetes, can easily develop from blisters and small wounds. Even small ulcers on the foot may heal extremely slowly and need rigorous treatment to heal properly. Also be aware of any cracking from dry skin, as this could develop into an ulcer over time.
Proper footwear: diabetic shoes
Diabetes can cause poor blood flow to the feet, so it’s important to wear properly fitting footwear. “Wear shoes that fit comfortably to avoid any rubbing or blistering,” explained Trepal.
When buying shoes, there are a few tips recommended by the Joslin Diabetes Center. Shop in the afternoon, because feet swell during the day, and have shoes fitted with your socks. Break in new shoes by wearing them for a few hours before going for a long walk. Also avoid walking barefoot, which can more easily lead to damage.
See a foot care specialist
Since type 1 diabetes can affect blood circulation and the nerves in your feet, it’s critical to see a foot care specialist (podiatrist) at least once a year for an exam. If you have any chronic health issues with your feet, then more frequent exams will be needed. “Nerve damage such as diabetic neuropathy can come on slowly, which is why an examination is essential,” said Trepal. “If the nerves in your feet or legs are injured your feet can lose sensation and become numb.”
During an examination, your doctor will often ask a few specific questions about your feet and your overall health. Your toes and other parts of your feet will be tested to see if your nerves are detecting any feeling. If you have trouble checking your own feet, ask a spouse or loved one to help you. It’s for a good cause: regular exercise like walking will help better manage your diabetes.