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Diabetes: Best Foot Care

Our experts tell you how to protect your feet if you have diabetes.
By Stephanie Stephens
WebMD the Magazine - Feature

For most people, a blister, cut, or scrape on the foot is no big deal -- an "ouch!" and a hurriedly applied bandage, and it's over. Not so if you have diabetes; meticulous daily foot care is as important as monitoring blood glucose, cholesterol, and blood pressure levels.

"Unfortunately, diabetes foot-health awareness doesn't have a colored ribbon or national voice," says foot care expert James Wrobel, DPM, of the University of Michigan Medical School. "If you don't manage them early, small problems that start in the feet can cause really big ones."

Show your hardworking feet some love by preventing ulcers -- open sores that can lead to serious complications like infection and even amputation. According to a report co-written by Wrobel, people who develop diabetic foot ulcers have a higher risk of dying within five years than people with some types of cancer, including prostate cancer, breast cancer, and Hodgkin's lymphoma.

Remember that what you can't feel might really hurt you later, especially if infection sets in. Uncontrolled glucose levels can lead to nerve damage called diabetic neuropathy, a numbness or tingling that may affect balance and prevent you from feeling hot, cold, and even pain. Nerve damage can also compromise your body's ability to sweat, which means skin on the feet can get dry and crack, opening the body's natural infection barrier. The foot's pressure-absorbing fat pads also harden and thin out, creating ideal conditions for foot ulcers to develop.

When cholesterol and blood pressure levels aren't controlled, narrowing or poor function of blood vessels in the arms and legs, called peripheral vascular disease, can reduce blood flow and circulation. Narrower vessels mean the feet get less oxygen and vital nutrients that fight infection and heal wounds. When tissue dies (a condition called gangrene), amputation may follow.

Diabetes Experts' Tips on Foot Care

The lifetime risk that a person with diabetes will develop a foot ulcer may be as high as 25%. To lower your chances of having this happen and to keep your feet in tiptop shape, Wrobel recommends taking these steps.

Take care. Wash feet daily with warm water and soap, dry well, then soften with lotion, cream, or petroleum jelly, avoiding the areas between toes. Trim or file toenails into a shape that's almost square but with no corner points to break skin or cause ingrown toenails.

Be sure the shoe fits. Indoors or out, wear properly fitting, closed-toe shoes to protect feet from stubs and bangs. After age 40, when feet get wider, consider prescription orthopedic footwear for better balance and stability. Never go barefoot.

Wear socks. Clean, light-colored, and lightly padded socks will show blood or draining wounds so you can easily spot problems. Avoid slow-drying, 100% cotton socks in favor of synthetic blends that wick moisture away and discourage fungus.

Is This Normal? Get the Facts Fast!

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If the level is below 70 or you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

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