Foot care is essential for any person living with type 1 or type 2 diabetes. High blood sugar levels put you at risk of developing these 10 diabetes-related foot problems which can lead lower limb amputation in the worst cases.
Fortunately, most of us stay away from serious problems following these 3 essential rules:
1 – Keeping diabetes under control. With an HbA1c below 7%, you are not at greater risk of developing foot problems than the general population.
2 – Observing a flawless foot care routine. Taking extra care of your feet is a crucial part of your daily fight against diabetes.
3 – Wearing appropriate footwear. Poor quality unfit footwear is responsible for most foot conditions. Here’s how to know if your feet need specialised diabetic footwear.
In this article, we’re dealing with n*2: observing a flawless foot care routine. And here’s how!
We’ve seen in other article that 2 main diabetes complications can affect our feet: diabetic neuropathy and peripheral artery disease. The first one damages our nerves, causing a decreased sensation in our feet. The second one impacts our blood flow which reduces oxygen brought to our feet.
Along with a proper diabetes management, it is absolutely essential that diabetics observe a strict daily foot care routine at home. Following these routine checks should take you no more than 5 minutes a day and can save your feet and legs.
The possible decreased sensation in your feet and legs caused by diabetic neuropathy can lead to cuts and wounds staying unnoticed. That’s why you have to visually inspect each side of your feet and toes everyday.
Check for redness, blisters, cuts, swelling, nail problems, bruises, calluses, or any other problems. Don’t forget to check in between your toes and under your feet. If you’re physically unable to do so, you can use a mirror. Never try to treat a foot problem by yourself when you have diabetes. If you notice anything unusual, always call your doctor for advice before.
A flawless foot hygiene is obviously fundamental when one wants to avoid diabetes-related foot problems. This is how you should proceed:
High blood sugars may cause dehydration which can affect your skin. Dry skin can peel, crack down, or itch, causing further problems such as infections or foot ulcers.
If the skin of your feet is dry, apply a good moisturiser after your daily wash. Do not apply between your toes as it could encourage fungal infection.
Be careful what products you put on your feet. Poor quality moisturisers and foot products can be harmful. Not only won’t they be efficient, but they often contain chemicals that are too aggressive to your skin. We strongly recommend you choose foot creams that are recommended by diabetes professionals.
Only use moisturiser if you have dry skin. If your skin does not feel rough or dry, you do not need to use any moisturiser. Simply wash and dry your feet every day.
It may seem insignificant, but bad toenail trimming can lead to foot problems such as ingrown toenail that easily get infected. You should check your toenails at least once a week. Here’s how to properly trim them:
Here’s a useful Podiatrist’s video guide on how to properly cut your toenails:
Your feet’s skin needs to stay moist, but your feet need to stay dry! Fungal and bacterial infections tend to develop in moist areas. Be cautious not to let your feet stay wet for too long after being under rain or snow. Use waterproof shoes when necessary.
If you live in hot weather, choose appropriate diabetic socks for summer (for men here, for women here). They’ll help wick the moist away.
If you have excessive feet sweating, consider using an antiperspirant such as Carpe’s antiperspirant foot lotion. Change your socks whenever they are wet, be it from water or from sweat.
Socks too have their role to play in diabetes foot care. Change them daily, and even more if your feet sweat a lot. Your socks should always be dry.
It’s important to keep your feet warm. So wear socks at night if you usually have cold feet when sleeping. But be careful they’re not too tight and don’t compress your feet.
Most important feature in socks for diabetes is that they have a soft elastic or no elastic at all. It helps stimulate better blood flow. Good blood flow is key to staying away from infections.
Consider getting socks specially designed for patients living with diabetes. They have extra cushioning. They’re made from materials that allow your feet to breathe. And they do not have elastic tops that could block your blood flow.
Last but not least: diabetic shoes and insoles. We’ll never insist too much: if you have diabetes-related foot problems, you should wear shoes designed to address these specific problems.
Diabetic shoes take into account every little factor that can impact your feet’s comfort: shape, fabric, extra depth, deeper toe box, etc. You can find good quality diabetic shoes from certified orthotic shoe brands at prices starting around $80. If you qualify, your medical insurance can even pay for them (Medicare does it!). Diabetic insoles are cheaper (from $8 to $30) but won’t protect your feet as much.
As we like to say it: diabetic shoes are not for diabetic people, but for diabetic problems. So if you do not have any specific foot problems, and if your diabetes is properly managed, you probably don’t need diabetic footwear. But you do need at least some well-fitted proper quality shoes for prevention.
We’ve written a complete article to help you decide whether or not you need diabetic footwear and which one would best suit your feet.
We all make common mistakes thinking we’re doing good to our feet. But avoiding these few things would really help:
If you daily follow these do’s and don’ts of diabetes foot care, there’s no reason you should get serious foot problems. One more decisive thing is to get your feet checked by a professional at least once a year. This is called a diabetic foot exam, and it’s usually covered by medical insurances.
It’s imperative you follow the above mentioned diabetes foot care routine at home. But you are not a doctor. Even the most conscientious of us could miss some symptoms of diabetes complications or some foot problems. Every one with diabetes should get a complete foot check by a health professional at least once a year.
In the US only, around 100,000 adults have lower extremity amputations relating to diabetes each year. Most of these amputations originate from common foot problems. Then you understand the point of having your feet checked.
Diabetic foot exam is a totally risk-free and painless series of medical tests performed by a health professional. You do not need to prepare for it. You will only be asked to take off your shoes and socks.
Such exam should be performed by either your GP, or a foot specialist known as a podiatrist. Although they play a key role in diabetes management, nurses are not competent enough to run this exam.
All diabetic foot exams follow about the same procedure by which your health professional is looking for two main things: foot/legs problems, and symptoms of diabetic neuropathy or peripheral artery disease, the two main diabetes complications affecting our feet.
What you can expect from a full diabetic foot exam:
To complete our explanation, here’s a very informative video by DIABETES UK about what to expect when having a diabetic foot exam. You can most probably expect the same wherever you live in the World:
If you’ve been diagnosed with diabetes, chances are your national or private medical insurance covers the cost of one diabetic foot exam per year. Think about it this way: your diabetic foot exam will cost your insurance company a few dozens of dollars vs thousands of dollars if you get serious foot problems. It’s prevention for yourself as much as for your insurance!
In the USA, Medicare covers most of diabetes medical costs and even diabetic shoes when the patient qualify for it. It is expressly stated on Medicare.gov that Medicare “covers foot exams every 6 months if you have diabetic peripheral neuropathy and loss of protective sensations, as long as you haven’t seen a foot care professional for another reason between visits.”
For UK residents, the National Health Services (NHS) entitles everyone with diabetes to at least one annual foot check. It’s free.
Here’s pretty much as far as we can go about diabetic foot care. We are not health professional either. Never forget that any tiny blister can turn into a severe problem when living with diabetes. If you ever feel anything is wrong, do not wait for your annual diabetic foot exam and call your doctor immediately.