For diabetics, smart foot care is crucial

When people have diabetes, there’s rightly a lot of concern about managing blood sugar. A second hot topic is taking good care of one’s feet.

How do diabetes and foot health go together? In my practice, I help many people whose diabetes has caused nerve damage known as neuropathy. This condition leaves the nerves in their feet with limited or no sensitivity to pain. Calluses, small foot cuts and scrapes can quickly become dangerous wounds and infections.

My most important advice to diabetics, or anyone who suffers from neuropathy, is to have someone inspect their feet daily. A second set of eyes that can clearly see the side, bottom and toenails of each foot means we can catch a minor issue before it becomes infected. The key is to stay on top of any concerns before they get serious. Even normal calluses on a diabetic person’s foot can cause serious problems to the soft skin underneath.

Diabetes also damages a person’s blood vessels and this can mean a person’s feet do not get enough blood and oxygen. This makes it harder for foot injuries to heal if a sore or infection sets in, and serious cases can even lead to amputation.

Secondly, I recommend all my diabetic patients invest in high quality-diabetic shoes. They are wider and deeper than average shoes to help a person’s feet move freely without rubbing up against the inside of the shoe. They tend to be constructed with seamless interiors and designed to facilitate good blood and air circulation.

Remember the old-fashion shoe stores where the salesperson helped measure your feet and fit your shoes? Well, you’re in luck. Go to a specialty shoe store where the staff has been specially trained to assess the style and fit of the diabetic shoes you need. Remember, if you have neuropathy, you won’t really be able to tell if a shoe fits you properly. You’ll need someone to help you. Your doctor or pharmacist can recommend where to buy diabetic shoes and advise you about possible Medicare coverage.

Speaking of shoes, I know it’s almost summer, but flip flops and sandals should be worn very little or not at all. They leave your feet exposed to debris on the ground, stubbed toes and other dangers that can cut or infect your skin. And if you’re thinking about going barefoot around the house, think again. It is essential that people with diabetes protect their feet all the time. This means slippers at home, too.

Beyond footwear, I counsel my patients with diabetes to establish and keep these healthy foot care habits:

Keep your diabetes well managed. People with high glucose levels tend to have dry skin and less ability to fend off harmful bacteria. Both conditions increase the risk of infection.

Get medical attention for any calluses that form on the feet. Ulcers can form under a seemingly-normal callus and cause a significant wound or infection.

Wash your feet every day. Dry them carefully, especially between the toes.

Keep your skin soft and smooth. Scratching dry or itchy skin can open it up and allow infection to set in. Rub a thin coat of skin lotion over the tops and bottoms of your feet, but not between your toes. Moist skin between your toes is an ideal place for foot fungus to grow.

Treat cuts right away. Wash minor cuts with soap and water. Only use an antibiotic cream or ointment if your doctor says it's okay. Cover minor cuts with sterile gauze. See a doctor right away if you get cut, burn, or infection that does not immediately heal on its own.

Protect your feet from hot and cold. This means wearing shoes even at the beach.

Don’t use hot water bottles, hot foot soaks, heating pads, or electric blankets because you can burn your feet without realizing it.

Check inside your shoes before wearing them. Make sure there are no objects inside that can puncture your skin. I’ve have found some interesting things in patients’ feet (not just their shoes), including a sewing needle, glass, and even a toothpick!

Buy good quality diabetic socks because they are designed to be non-binding to encourage circulation. The fabric helps wick away moisture to reduce the risk of infection.

If you can see and reach your toenails, trim them when needed. Trim your toenails straight across and file the edges with an emery board or nail file. If you have a hard time reaching or seeing your feet, go to an area foot care clinic staffed by specially-trained foot care nurses. Many people find them relaxing, too.

Your health care provider should perform a complete foot exam annually and more often if you have foot problems. If your doctor says, “Take everything off and put on this gown, but you can leave your socks on,” remember you should take your socks off! This will remind both of you to check your feet.

A person’s healthy feet take them where they need to go, especially if they are carefully managing their diabetes: the grocery store, the farmer’s market, on a bike ride, or brisk walk. Take care to build a healthy lifestyle from the ground up. Go feet first.

Dr. Gregory Kirwan is an orthopedic foot and ankle surgeon with ThedaCare Orthopedic Care in Appleton. He can be reached at 920-831-5050.