beingwell magazine Summer 2007
People with diabetes are more susceptible to foot problems because poor blood sugar control may damage nerves and reduce blood flow to the feet over time. Even what seem to be ordinary foot issues can lead to serious problems; in extreme cases, even amputation.
If you have diabetes, it is important to examine the tops and bottoms of your feet daily for a number of potential foot problems.
Dry skin: Nerves controlling the oil and moisture in the foot don’t work in people with diabetes, making the skin of the foot susceptible to peeling and cracking. Wash feet daily in lukewarm water and mild soap: test the water temperature with your elbow or thermometer, not your foot.
Pat dry and massage tops and bottoms with a small amount of plain petroleum jelly or an unscented cream or lotion, such as Uremol 20 per cent, which is available at most drug stores. Don’t put oils or creams between toes or soak the feet for too long: extra moisture will further dry the skin.
Corns and calluses: These are a buildup of hard skin and occur more often on the feet of those with diabetes and, if not trimmed, can get too thick, cause pressure and become open sores known as foot ulcers. Don’t try to trim them yourself or use over-the-counter medicines that can burn the skin. Have them trimmed by your doctor, podiatrist, chiropodist or foot care nurse. To control calluses, use a pumice stone after daily bathing, when they are softer.
Shoes and socks: Never walk barefoot — even at the beach or at home. Bare feet are susceptible to cuts, burns and infections. Always wear thick, soft socks with no seam, and avoid pantyhose or leg-wear that constricts circulation to the feet and legs. Don’t wear open-toes sandals, high heels or shoes with pointed toes. Check for roughness or loose objects inside shoes before putting them on. A speciality shoe shop or pedorthist (shoe specialist) can help you select an appropriate, well-fitting shoe.
Poor circulation: Blood vessels in feet and legs narrow and harden in people with diabetes, making it harder to fight infection and heal. To promote circulation, don’t smoke and keep blood pressure and cholesterol in check. Promote leg and foot
circulation by wiggling your toes and moving your ankles up and down. Not crossing your legs will also help.
Swelling of the ankles may be a sign of other diabetes-related problems and your doctor should be contacted immediately.
Nail problems: Toenails may become infected with fungus, get thick, brittle and possibly crumbly. This may be treated with topical medication or oral antibiotics.
Prevent ingrown toenails by trimming nails straight across — with toenail clippers only — and filing with an emery board once a week. If you can’t reach your toes or have a vision problem, do not attempt to cut your own nails. Have someone else do it for you or ask your doctor to help.
Athlete’s foot: This fungal disease causes itching, redness and cracking. Your doctor can treat it with a pill or cream.
People with diabetes should always be sensitive to the condition of their feet and take daily preventative care to avoid serious problems. A visit to the doctor or emergency room is essential in the event of an open sore that does not heal in a day or two, if the sore has a foul smell, drains blood or pus, or becomes hot or red in colour. Black discolouration on any part of the foot also requires immediate attention.