Diabetes

Keeping Diabetics' Feet and Toes Healthy

Apart from people who have injuries, diabetes is the leading cause of amputation.

Diabetic neuropathy occurs when the body is not able to manage the sugar levels in the blood properly. Having high concentrations of glucose can cause secondary problems for the blood vessels that provide nutrients and oxygen to the nerves. When the nerves of the feet and legs are exposed to these high glucose levels, they begin to lose their ability to function properly. The resulting pain, tingling, numbness or combinations of all three, is called diabetic neuropathy.

Some of the problems people with diabetic neuropathy may develop include:

Nerve damage
Circulation problems
Infections

Foot Problems Cause by Diabetic Neuropathy

The problems listed above can cause serious foot ailments for people with diabetes. Poor circulation combined with a lack of feeling makes it very easy for a diabetic to injure his or her foot and not even realize it.

Cuts or blisters can easily turn into decubitus ulcers, also known as pressure sores or bed sores, which become infected and have difficulty healing. An open sore such as an ulcer leaves the body vulnerable to:

Cellulitis - a painful infection of the connective tissue in the skin
Gangrene - rotting flesh that frequently results in amputation
Sepsis - an infection spreading to the blood stream and other organs causing rapid shock and widespread organ failure

Prevention and Check Ups

Constant inspection can help prevent damage from this condition. People with diabetes should have their doctor check their feet once a year with a special tool to make sure they have feeling. There are also several self-examinations or checkups that could help you:

Control your blood sugar - It is very important that you get your blood sugar under control as this is the only way to stop the progression of this complication of diabetes. Controlling the sugar level is crucial, as it could help prevent neuropathy and other diabetic complications. This is also the best way to evade any amputations.

Inspect your feet every day - Look for any signs of injury or any changes in color, shape, or feeling in your feet, and report them to your doctor immediately. Your feet could lose sensitivity and go numb so it is important to check for feeling. For example when you wash your feet, test the water to be sure it's not too hot.

Protect your feet - Wear good fitting socks and shoes every day. Check your shoes and socks before putting them on to make sure there are no foreign objects that might cause injury. Finally make sure you do not walk barefoot at home, wear slippers, sneakers or sandals when home.

Trim your toenails - Keep your toenails trimmed if you can do it yourself or, if not, get someone to help you. This will help you from getting any cuts that could lead to infections.

Get the Help You Need

Have someone at home inspect your feet daily for areas of redness or irritation especially on the bottom of the foot and over the tops of the toes. Make sure they also to check between each toe as sometimes the web spaces can become too moist causing the skin to break down. It is a good idea to see a podiatrist or other foot care specialist who can provide much more specific advice for keeping your feet in good shape.

What to Do If You Develop a Sore or Blister

If you or someone else notices a sore or blister on your foot, see a foot care specialist immediately as this type of mild injury can progress fairly rapidly. If you are in good health you can follow the following plan:

Do not remove the top of the blisters as they serve as a natural bandage.
Make sure you clean the area at least daily with mild soap and water and apply a topical antibiotic ointment such as Neosporin or Betadine and cover with a sterile bandage. A Band-Aid is fine.
Make sure that you do not wear shoes that are too tight.

Pay attention to the pain and rest when it is sore. The extra padding from the Band-Aid should help some with the discomfort however remember that pain is the only way your body has to tell you that something is wrong. Listen to it and take it easy for a few days until the pain subsides and you are able to walk comfortably again.

Hope Through Research - You Can Be Part of the Answer!

Many research studies are underway to help us learn about diabetes complications. Would you like to find out more about being part of this exciting research? Please visit the following links:

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Go to the Diabetes health topic, where you can:

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Last Reviewed: Oct 04, 2011

Jeffrey M Robbins, DPM
Clinical Assistant Professor of Surgery
School of Medicine
Case Western Reserve University