Protecting Your Feet When You Have Diabetes

With diabetes, blood glucose (blood sugar) is too high. The hormone insulin normally helps glucose from food enter the body's cells: in type 1 diabetes the body doesn't make insulin, and in type 2 it doesn't make or use insulin well, so glucose builds up in the blood.

How diabetes harms the feet

Foot problems are common with diabetes. Over time, high blood sugar damages the nerves and blood vessels in the feet:

• Nerve damage (diabetic neuropathy) can cause numbness, tingling, pain or loss of feeling. Without feeling pain, you might not notice a cut, blister or ulcer (open sore), which could become infected.
• Damaged blood vessels reduce blood flow, so infections may heal poorly.

Infection plus poor blood flow can lead to gangrene, when muscle, skin and other tissue begin to die. Gangrene or an ulcer that doesn't respond to treatment may require amputation of a toe, foot or part of the leg — surgery that can stop a dangerous infection spreading and may save a life. But there's a lot you can do to keep a foot wound from becoming serious.

Daily foot care

The best protection is controlling blood sugar every day, which keeps nerve and blood vessel damage from getting worse. Then keep the skin of your feet healthy:

• Check your feet daily, bottoms included, for cuts, redness and changes in skin and toenails, including warts or spots your shoes might rub.
• Wash your feet daily in warm water with soap, but don't soak them, which dries the skin. After drying, talcum powder or cornstarch between the toes can soak up moisture that could cause infection. If you use lotion, keep it out from between your toes.
• Ask your doctor how to remove corns and calluses safely. Thick skin can rub and cause sores, but don't cut it or use medicated pads or liquid removers.
• Trim toenails straight across with a clipper. If that's hard, or your nails are thick or curve into the skin, have a podiatrist (foot doctor) do it.
• Always wear well-fitting shoes and socks or slippers, even indoors, and make sure shoes are smooth inside — a seam or pebble can rub skin raw.
• Protect your feet from heat and cold. Use sunscreen on exposed skin and don't go barefoot at the beach; in cold weather wear warm socks rather than warming your feet by a heater or fireplace.
• Keep blood flowing. Put your feet up when sitting, wiggle your toes and circle your feet during the day, avoid tight socks, and stay active in ways that are easy on the feet, such as walking.
• Have your feet checked at health care visits, even if you haven't noticed a problem.

When to see a provider right away

Serious foot problems can develop quickly. See a provider promptly for:

• a cut, blister or bruise that isn't starting to heal after a few days;
• red, warm or painful skin on your feet;
• a callus with dried blood inside;
• a foot infection that turns black and smells bad, which could be gangrene.

Sources

• MedlinePlus, National Library of Medicine: "Diabetic Foot," with information from the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.