Diabetes can mean double trouble for your feet. First, diabetes can reduce blood flow to your feet, depriving your feet of oxygen and nutrients. This makes it more difficult for blisters, sores, and cuts to heal. And second, the diabetic nerve damage called peripheral neuropathy can cause numbness in your feet. When you can't feel cuts and blisters, you're more likely to get sores and infections.
If you don't notice or treat the sores, they can become deeply infected, and lead to amputation.
Diabetic peripheral neuropathy can also cause sharp pain in your feet. You may become excruciatingly sensitive to the lightest touch, like the sheets on your bed.
Fortunately, a little TLC goes a long way in preventing foot problems from diabetes.
1. Check both feet daily.
Look over both feet carefully every day, and be sure you check between all of your toes. Blisters and infections can start between your toes, and with diabetic neuropathy, you may not feel them until they've become irritated or infected.
If a physical challenge keeps you from checking your own feet, ask a family member to help.
2. Wash with warm -- not hot -- water.
Wash both of your feet briefly each day with warm -- not hot -- water. You may not be able to feel heat with your feet, so test the water with your hands first. Avoid soaking too long in water, since waterlogged sores have a harder time healing.
Dry your feet right away, and remember to dry gently between all of your toes.
3. Make sure your shoes fit well.
It's an investment worth making. Even the slightest rubbing or misfit shoe can cause a blister that turns into a sore that becomes infected and never heals.
Buy better-fitting shoes, or try different socks, even at the most minor signs of redness or irritation, since you may not be able to feel when it's getting worse. Before buying or putting on the shoes check your shoes for rough seams, sharp edges or other objects that could hurt your feet. And break your shoes in gradually.
4. Skip the barefoot look.
Always wear shoes or slippers. Always wear socks with your shoes, since leather, plastics, and manmade shoe materials can irritate your skin and quickly bring on blisters.
While you might prefer the look of hose, nylon knee-highs, or thin socks, you may find that these don't give your toes or heels enough protection. Wear thicker socks to pad your feet and cushion any calluses or sore spots.
5. Speak up.
Nerve damage can be unpredictable. Tell your doctor about any changes in sensation in your toes, feet, or legs. Speak up if you notice pain, tingling, a pins-and-needles feeling, numbness, or any other unusual signs -- even if it seems trivial to you. There's nothing small-potatoes about a potential foot amputation.
6. Stay soft, but dry.
Your skin may be dry and cracked because of high glucose levels, and cracked skin means it's easier for bacteria to get under your skin and harder for infections to heal. Use a small amount of skin lotion daily, but be sure your feet feel dry, not damp or sticky, afterward. Try not to get the lotion in between your toes.
Keep your toenails trimmed and filed smooth to avoid ingrown toenails. You may find it easier to trim your nails after using lotion, when your cuticles are softer.
Use a pumice stone after showering or bathing to softly file corns or calluses.
7. Try non-impact exercise.
8. Fix bunions, corns, and hammertoes.
If your big toe slants sharply in toward your other toes, with a big bump on the knuckle of your big toe, you've got a classic bunion. Corns are spots of thick, rough skin, where the tissue builds up on toes constantly barraged by too much rubbing or pressure. A buckled-under toe, called a hammertoe, can result from muscle weakness caused by diabetic nerve damage. All of these make it hard to fit shoes comfortably.
A good podiatrist can help you fix these problems and take better care of your feet.
9. Consider fitted orthotics.
A podiatrist can also fit you with shoe inserts called orthotics to support your feet if you have diabetic nerve pain or the muscles have become weak from nerve damage. If pain or weakness is so severe that it's too painful or even impossible to walk, a foot brace or orthopedic shoes might help. A podiatrist is your best source for these devices.
10. Control your blood sugar.
The best prevention for nerve pain, ultimately, is to manage your diabetes well. In fact, a 2006 study by the National Institute of Diabetes and Digestive and Kidney Diseases showed that strict blood glucose control with intensive insulin therapy lowered the chances in people with type I (insulin requiring) diabetes of having symptoms of peripheral neuropathy -- tingling, burning, and pain -- by 64%. These results have also been shown to hold true in type II diabetes, too.
The two most important determinants of whether you get diabetic neuropathy are how many years you have had diabetes and how well you control your blood sugar. Other factors, including controlling blood pressure and blood fats (cholesterol and triglycerides) and not smoking are also important to prevent diabetic neuropathy.
Controlling your blood glucose also helps reduce the symptoms of diabetic nerve pain. So the good news is that controlling your glucose levels with diet, exercise, and if needed, medications can not only help prevent diabetic peripheral neuropathy, but they can also help ease its effects.
Protect Your Feet
Your feet are your source of independence, or at least its foundation. Give your feet a little tenderness, a little loving care, each day. And be sure to have your doctor take a good look at your feet during each of your diabetes checkups in case you've missed anything.