Diabetic Foot Problems
What causes diabetic foot problems?
Neuropathy and blood vessel disease both increase the risk of foot ulcers. The nerves of the feet are the longest in the body and often are affected by nerve injury or neuropathy. When a patient with diabetes loses sensation in the feet, sores or injuries may go unnoticed until serious ulcers develop.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), more than 60% of nontraumatic lower-limb amputations in the United States occur among people with diabetes.
Prevention of diabetic foot problems
To help keep foot problems from developing, the NIDDK recommends that people with diabetes take care of the disease and its symptoms, and follow these suggestions for proper foot care:
Check your feet and toes daily for any cuts, sores, bruises, bumps, or infections—use a mirror or ask someone to help you if necessary.
Examine your shoes before putting them on to make sure they have no tears, sharp edges, or objects in them that might injure your feet.
Wash your feet daily using warm (not hot) water and a mild soap. If you have neuropathy, you should test the water temperature with a thermometer or your wrist or elbow before putting your feet in the water. Healthcare providers do not advise soaking your feet for long periods. Dry your feet carefully with a soft towel, especially between the toes.
Wear shoes that fit your feet well and allow your toes to move. Break in new shoes gradually, wearing them for only an hour at a time at first. After years of neuropathy, as reflexes are lost, the feet are likely to become wider and flatter. If you have trouble finding shoes that fit, ask your primary healthcare provider to refer you to a foot specialist, called a podiatrist, who can provide you with corrective shoes or inserts.
Cover your feet (except for the skin between the toes) with petroleum jelly, a lotion containing lanolin, or cold cream before putting on shoes and socks. For people with diabetes, the feet tend to sweat less than normal. Using a moisturizer helps prevent dry, cracked skin. Put talcum powder or cornstarch between your toes to keep these areas dry.
Use an emery board or pumice stone to file away dead skin, but do not remove calluses using sharp instruments. Do not try to cut off any growths yourself, and avoid using harsh chemicals, such as wart remover, on your feet.
Cut your toenails straight across, but be careful not to leave any sharp corners that could cut the next toe.
Avoid sitting with your legs crossed. Crossing your legs can reduce the flow of blood to the feet.
Ask your healthcare provider to check your feet at every visit, and call your healthcare provider if you notice that a sore is not healing well.
Wear socks if your feet become cold at night. Do not use heating pads or hot water bottles.
Wear thick, soft socks and avoid wearing slippery stockings, mended stockings, or stockings with seams.
Never go barefoot, especially on the beach, hot sand, or rocks.
The American Diabetes Association (ADA) recommends that if you have a cut or break in your skin, or develop an ingrown toenail, call or see your healthcare provider. In addition, the ADA states that if your foot (or feet) change color, shape, or just "feel funny" (for example pain or loss of sensation), you should contact your healthcare provider.