Diabetic Foot Care
Diabetes Foot Care Recommendations
Taking care of your feet is crucial if you have diabetes, as even a small cut can lead to serious issues. Diabetes can cause nerve damage, which may make it hard to feel injuries in your feet. It can also reduce blood flow, slowing healing and increasing infection risk. For example, you might not notice a small object in your shoe, which could cause a blister or sore. If untreated, this could turn into an infection or a wound that won’t heal, potentially leading to amputation. To prevent these problems and protect your toes, feet, or legs, follow these simple guidelines.
1. Check your feet every day. Look for cuts, blisters, redness, swelling, or nail issues. Use a magnifying hand mirror to inspect the bottoms of your feet. Alternatively, ask a caregiver or family member to help you inspect your feel daily, especially if experiencing vision problems commonly linked to diabetes. If you spot any signs of infection, contact our office immediately.
2. Wash your feet with lukewarm water. Keep your feet clean by washing them daily with water that’s cool or comfortably warm—not hot. Patients who suffer from diabetic neuropathy can accidentally sustain a burn to the feet from water that is too hot, due to lack of sensation to the feel.
3. Be gentle when cleaning your feet. Use a soft washcloth or sponge to wash your feet daily. Pat or blot them dry, making sure to carefully dry between your toes.
4. Moisturize your feet, but skip between the toes. Apply a moisturizer daily to prevent dry, itchy, or cracked skin. Avoid putting lotion between your toes to help prevent fungal infections. If over the counter moisturizers fail to relieve areas of cracked skin or excessive dryness, contact our office for evaluation and treatment. Areas of skin fissuring in the feet and heels can often lead to infections and advanced complications.
5. Trim nails with care. For diabetic patients, it’s recommended that nail care be performed by a trained professional. However, if trimming your toenails cut them straight across and smooth the edges with a file. Avoid cutting them too short to prevent ingrown toenails. If you’re unsure about your nails, check with your doctor.
6. Don’t treat corns or calluses on your own. Avoid home remedies or medicated pads. Instead, visit your doctor for safe, proper treatment.
7. Wear clean, dry socks every day. Change your socks daily to keep your feet fresh and comfortable. White socks are recommended. When wearing white socks, patients will be alerted with there is a bleeding wound or infection, if stains are noted on the sock upon removal.
8. Choose socks designed for diabetes, if possible. Look for socks with extra cushioning, no tight elastic tops, and moisture-wicking fibers. These are often ankle-high or taller for added comfort.
9. Inspect your shoes before wearing them. Shake out your shoes and feel inside to make sure there are no pebbles or objects that could harm your feet, as you may not feel them.
10. Try an antiperspirant for sweaty feet. If your feet sweat a lot, applying an antiperspirant to the soles can help keep them dry.
11. Never go barefoot. Always wear shoes or slippers, even at home, to avoid stepping on something that could cause a cut or scratch. Patient with diabetes often suffer from peripheral neuropathy which limits sensation to the feet. This loss of sensation can hinder a patients ability to know if they have sustained a skin injury to the feet, thereby leading to possible infection.
12. Manage your diabetes. Keep your blood sugar levels in check to prevent diabetes related complications such as peripheral neuropathy, peripheral vascular disease and diabetic dermopathy leading to skin fragility.
13. Avoid smoking. Smoking can reduce blood flow to your feet, which can lead to complications. Long term nicotine use can cause the small blood vessels that feed the skin to begin clotting off, leading to complications including ulceration, plaque formation and difficulty healing cuts.
14. Get regular foot checkups. Visit a foot and ankle specialist regularly to catch and prevent any diabetes-related foot issues early.
Diabetes and Foot Health: Preventing Complications and Amputation
Living with diabetes can increase the risk of foot and leg problems due to two main complications: nerve damage (neuropathy) and poor circulation. These issues can turn small injuries into serious complications, sometimes even requiring amputation. However, with proper care, regular checkups, and proactive steps, you can protect your feet and reduce these risks.
Diabetes can lead to:
• Nerve Damage (Neuropathy): This reduces feeling in your feet, making it hard to notice pain, injuries, or irritation. A small cut or blister might go undetected and worsen.
• Poor Circulation: Reduced blood flow slows healing, making it difficult for even minor wounds to recover and increasing the risk of infection.
These factors make people with diabetes more prone to foot problems that, if untreated, can become severe.
Common Diabetes-Related Foot and Leg Problems
Here are some issues to watch for and why they’re serious:
• Infections and Ulcers (Sores): Small cuts or blisters can turn into deep sores (ulcers) that may reach the bone. Poor circulation and neuropathy make these sores slow to heal and prone to infection, which can lead to serious complications, including amputation.
• Corns and Calluses: Neuropathy can prevent you from feeling pressure from ill-fitting shoes, leading to corns or calluses. If not treated properly, these can develop into ulcers.
• Dry, Cracked Skin: Poor circulation and neuropathy can dry out your skin, causing cracks that may become infected sores.
• Nail Problems: Ingrown toenails or fungal infections may go unnoticed due to loss of feeling, leading to infections if untreated.
• Hammertoes and Bunions: Nerve damage can weaken foot muscles, causing deformities like hammertoes or bunions, which may lead to ulcers if not addressed.
• Charcot Foot: This severe condition occurs when nerve damage hides the pain of a broken bone, leading to further damage as you walk on it. It can cause significant foot deformity and may require surgery or, in rare cases, amputation.
• Poor Blood Flow: Narrowed blood vessels below the knee reduce blood flow, slowing healing and potentially causing tissue death.
How a regularly seeing a foot & ankle surgeon can play a key role in preventing and treating complications.
Dr. Ortiz employed advanced techniques, like joint reconstruction and specialized wound care to help heal wounds and prevent amputation. Routine visits allow early detection of problems, keeping small issues from becoming serious. Dr. Ortiz works with other healthcare providers to manage diabetes-related complications effectively. As the program director of the Foot & Ankle Surgical residency at Bethesda Hospital, Dr. Ortiz works closely with a team of surgical residents, vascular surgeons and hospitalist to provide comprehensive limb saving care.
Proactive Steps to Protect Your Feet
You can significantly reduce your risk of complications by taking these steps:
1. Inspect Your Feet Daily:
• Check for cuts, scrapes, redness, swelling, bad odor, rashes, or changes in nails (e.g., discoloration, thickening, or deformities).
• Look for signs of a fracture, like swelling, redness, heat, or changes in foot shape or size. If you notice these, contact your foot and ankle surgeon immediately.
• If your vision is poor, ask someone to help with inspections.
2. Don’t Ignore Pain:
• Leg pain at night or during light activity may signal a blocked artery. Seek medical care right away.
3. Proper Nail Care:
• If you have nail issues or reduced feeling in your feet, have your toenails trimmed by a professional to avoid complications.
4. Avoid “Bathroom Surgery”:
• Never trim corns or calluses yourself or use over-the-counter medicated pads, as these can cause harm.
5. Keep Floors Safe:
• Ensure floors are free of sharp objects like needles or insulin syringes.
6. Wear Shoes and Socks:
• Never go barefoot, even indoors, to protect your feet from injury.
• Check shoes for objects before putting them on and ensure socks are smooth, not bunched up.
7. Test Circulation and Sensation:
• Have your foot and ankle surgeon regularly check your circulation and sensation to catch problems early.
Take Control of Your Foot Health
By staying vigilant, seeking regular care from a foot and ankle surgeon, and following these preventive steps, you can reduce the risk of serious foot complications from diabetes. If you notice any changes or problems, don’t wait—contact Dr. Ortiz immediately to keep small issues from becoming major ones.
