Different foot problems are quite common in people with diabetes. The feet problems are often a result of constantly high blood regular levels. Prolonged periods of high blood sugar levels may cause nerve damage (diabetic neuropathy) and peripheral vascular disease. These two conditions are the main reasons why people with diabetes develop foot problems.
Most often when you are a person with diabetes, you are more worried about your diet, your blood sugar levels, your exercise routine, but forget about your feet. Taking care of your feet is equally important as it helps you avoid serious foot complication. In fact this topic of diabetes and the feet is such an important topic that needs to be incorporated on all diabetes discussions.
Diabetes feet associated problems
As discussed earlier, there are two main foot problems that occur in people with diabetes: diabetic neuropathy and peripheral vascular disease.
Prolonged high levels of glucose (sugar) in the blood can cause damage to the nerves. When this happens, the affected body part loses the ability to sense pain and temperature (hot and cold). Loss of sensation means you may not feel an injury to the affected part. In diabetes, this commonly occurs in the feet. Neuropathy makes it difficult for a person to be aware of anything that affects the feet like tight shoes, infections or any injury to the feet. Imagine walking all day with tight-fitting shoes and not noticing that they are tight!
When you are not able feel any pain on your feet, you are at a higher risk of having blisters (from tight shoes), cuts and even burns. You are at a higher risk of noticing the wounds when they are already infected, which may result in complications as you may seek medical attention late. Late treatment of infected wounds often results in gangrene which may require amputation.
Peripheral Vascular Disease
Uncontrolled blood sugar levels often lead to damage of the blood vessels. They become narrow and hard. The damage reduces blood flow to the affected areas. Poor blood flow can slow down the healing process of any cuts, sores or infections. The risks of complicated infections and gangrene are then increased.
Blood vessels in the hands and feet are more commonly affected. This is referred to as Peripheral Vascular Disease. In people with diabetes, peripheral blood disease is made worse by other things like smoking, uncontrolled hypertension and elevated blood cholesterol levels. If they co-exist with diabetes, peripheral vascular disease ensues faster.
Diabetic neuropathy and peripheral vascular disease often co-exist in a person. This is because both are caused by uncontrolled diabetes. Diabetic neuropathy puts you at risk of injury whilst peripheral vascular disease makes it difficult for the injury to heal well. That is why control of diabetes is as important as taking care of your feet.
Other associated foot problems
Fungal infection is a common thing in diabetes. This is because fungus thrives well when blood glucose levels are high. The fungus can enter a cracked skin causing redness and itchiness of the area. It can also affect the nail causing a thick, brownish or opaque nails. The fungus will thrive well in closed shoes.
The good news is that fungal infections are treatable. Consult your doctor if you think you may be having fungal infections on your feet.
Foot ulcers commonly occur as a result of tight-fitting shoes. It sometimes occurs after a minor break in the skin which is followed by an infection. Foot ulcers is a particularly important topic in people with diabetes because of poor healing secondary to peripheral vascular disease. If not treated well or on time, these ulcers may complicate resulting in loss of the leg. That is why it is important to consult your doctor for every ulcer even if it does not hurt. Proper foot care is very critical for every person with diabetes to ensure that foot ulcers do not go unnoticed.
A callus is a thickened and hardened area of skin that builds on an area that is subjected to repeated friction and rubbing. This is the body’s way of protecting the area that is subjected to constant friction. They are frequently seen on the feet, hands and fingers.
Calluses are most commonly caused by tight-fitting shoes. They are commonly seen in people with diabetic neuropathy due to lose of sensation to pain and pressure. If not trimmed, calluses may progress to form an open ulcer.
If you have calluses, never cut them yourself as it may leave an ulcer if you cut too much into the skin. Do not remove them with chemicals; rather consult your doctor for help. Using pumice stone does help remove the dead tissue. Apply moisturizing cream or lotion every time after using the pumice stone.
A corn is a thickened small and circular area of skin that is caused by pressure or frictions. A corn is similar to a callus but is smaller, harder, and more painful, with more defined center. Corns may have a soft or hard center.
Blisters are also common in people with diabetes and are often due to friction in the feet as a result of unnoticed tight-fitting shoes. They are raised areas of skin that are filled with fluid. Always avoid popping a blister as you expose the area underneath to infections. Rather, clean the area with a disinfectant and cover with bandage.
People with diabetes are at a greater risk of complications of ingrown toenails because of the poor blood circulation associated with this condition. Ingrown toenails are common and may cause pain, tenderness and swelling around the toenail. They often caused by wearing shoes that do not fit well or cutting your toenails incorrectly.
Ingrown toenails can be avoided by wearing shoes that fit properly, keeping your nails trimmed properly and frequently inspecting your feet.
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Ensuring healthy feet
Keeping your feet healthy and preventing foot complications is a very critical aspect of care if you have diabetes. You have to be vigilant all the time and ensure that you do the following to take care of your feet:
Inspect your feet every day
Check for cuts, sores, blisters, corns, calluses, ingrown toenails or any other skin or nail changes every day. Always remember to inspect even between the toes. Set a time of the day whereby you know you will do the inspection, it may be every morning or every evening. If you cannot see the bottom of your feet, use a mirror or ask a family member to help you inspect the feet.
Daily inspection helps you spot changes in the feet early because with diabetes you may not feel the pain even when you get injured. Consult your doctor for any changes you have spotted.
Wear shoes all the time
Avoid walking barefoot even when you are indoors. Protect your feet with shoes and socks, or slippers at all times. Do not apply socks too tight as they may restrict blood flow. Always check the inside of your shoes before putting them on, to make sure that there are no objects inside.
Put on well-fitting shoes
This cannot be over stressed. Poorly fitting shoes are the root cause of many diabetes related foot complications. For best fit, try your new shoes at the end of the day when your feet are the largest. Vinyl or plastic shoes are not recommended as they do not stretch. Avoid shoes with high heels or pointed toes. Always wear socks with your shoes.
Wash feet daily
Wash your feet in warm water. Avoid hot water and do not soak your feet because it makes your skin too dry. After washing your feet, dry them completely and apply lotion. Powder between your toes is a better option than lotion as it keeps the skin there dry. Moist skin in between toes tends to be infected easily.
Trim you nails straight across
Always keep your nails short and properly trimmed. Trim them straight across and always smooth each nail with a non-sharp nail file. Do not cut into the corners of your toenail. Get help from a family member or your doctor if you can’t reach or see your feet.
Do not remove corns or calluses yourself
Always talk to your doctor if you develop corns and calluses. Do not try to remove the corn or calluses by yourself or use over-the counter products to remove them as they can burn your skin. These patches can easily turn into ulcers. Only use a pumice stone after bathing to smooth them and apply lotion after using the stone.
Improve blood flow to your feet
Physical activity improves blood flow on your body, so you have to be more physically active. Choose those activities that are easy on your feet like swimming or stretching. Avoid elastic stockings as they may reduce blood flow to the feet.
Stop smoking. Smoking causes your blood vessels to narrow and constrict, therefore lowering blood flow to many organs of the body, including your feet.
Keep your feet away from extreme temperatures
It is possible to burn your feet without noticing when you have nerve damage. That is why it is important to take the right precautions to protect your feet. Always keep your feet away from open fires and heaters. Avoid using hot water bottle on your feet. Always put your shoes on when walking outside in hot or cold weathers.
Get your feet inspected at every doctor’s visit
At every doctor’s visit, let them check your feet for any skin or shape changes. They will also check if you are developing nerve damage or peripheral vascular disease. Also do yearly visit for foot examination. It is the key to preventing foot complications like amputations. Your doctor will also continue to teach you how to take care of your feet.
It is possible for you to minimize and prevent complications of the feet that are associated with diabetes. These complications should not be taken lightly as they can result with loss of a limb.
When you control your blood sugar levels well and exercise proper foot care, complications become minimal. Always consult your doctor right away when you spot any changes in your feet.