Harmless Blisters Can Lead to Dangerous Diabetes Complications

A seemingly harmless blister or a minor cut can lead to a serious diabetes complication.

"People tend to overlook good foot care," says Dianne Carter, RN, CDE, a diabetes nurse educator with the University of Massachusetts School of Medicine. "For instance, sometimes you see people walking on the beach, not realizing the sand can be hot and can cause burns to their feet."

This is particularly true -- and dangerous -- for people who suffer from two diabetes complications: peripheral vascular disease (narrowing of blood vessels that carry blood to extremities) and neuropathy (damage to the nerves that can result in numbness in the feet). Initially, hot sand may not bother someone whose feet are numb. But once blisters develop on the bottoms of the feet, they can quickly escalate to open sores and, in a person whose blood sugar levels are poorly controlled, a difficult-to-control infection.

Smoking is another often overlooked danger that can cause or exacerbate foot problems in a person with diabetes.

"Smoking causes constriction of blood vessels, thereby decreasing circulation to the feet," Carter tells WebMD. In addition, smoking worsens the problem of hardening arteries, a common diabetes complication in people with poor control of the disease. Poor circulation and hardened arteries both leave people vulnerable to foot infections and less able to fight them effectively.

To ensure the best foot care possible and avoid diabetes complications, The American Diabetes Association provides the following tips:

• Always wear sturdy, well-fitted, comfortable shoes.
• Clean and check your feet daily.
• Look for calluses, particularly if you are wearing new shoes.
• Apply lotion to callused feet to keep them soft.
• Avoid walking barefoot or in open-toe shoes.
• Have all ulcers on your foot examined by your health-care provider immediately.
• Never put lotion between the toes (can breed moisture and fungus).
• Avoid smoking, which decreases blood flow to the feet and makes wounds heal slowly.
• Exercise to stimulate blood flow in legs and feet.
• Wear warm socks to keep feet warm; avoid using hot water, hot water bottles, or heating pads.

Published Oct. 29, 2004.
Medically updated March 2007.

SOURCES: Teresa Pearson, RN, CDE, president-elect, American Association of Diabetes Educators. Dianne Carter, RN, CDE, diabetes nurse educator, University of Massachusetts School of Medicine. Riva Touger-Decker, PhD, RD, associate professor, New Jersey Dental School. Sol Silverman Jr., DDS, professor of oral medicine, University of California, San Francisco, School of Dentistry. American Dental Association. American Diabetes Association.

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