Diabetes is a growing concern in America, affecting more than 34 million people. In the last 2 decades, the population of diagnosed Americans has more than doubled. Type 2 diabetes is the most common, accounting for up to 95% of all cases. When we think of diabetes, blood sugar most often comes to mind and, indeed, keeping levels within a normal range is a chore in and of itself. One thing you may not know, however, is that foot health is of huge importance to diabetics as well.
What does blood sugar have to do with feet?
Diabetes is a progressive disease, which means it can worsen over time, especially if not managed properly. About half of all people with diabetes have nerve damage, especially in the feet and legs. When nerves are damaged, it can be difficult to feel pain, temperature or anything “off” on that part of the body. For instance, someone with diabetes could cut their foot and not even realize it.
When you add this to the poor circulation caused by the progression of this disease, it can be a deadly combination. Think infections and a body that may not heal very quickly if at all. Extreme cases can result in amputation to save the rest of the body from becoming infected or even eventual death.
Now that we have your attention
Hancock Health nurse practitioners Megan Bradshaw and Barb Pescitelli have special training to support and counsel patients who have diabetes. Both women are affiliated with Hancock Internal Medicine in Greenfield. They each repeat the same three steps to their diabetic patients over and over again, in hopes that it will stick. “Check your feet every day; don’t go outside without shoes on; and wear shoes in the house.”
Bradshaw even suggests that her diabetic patients change the way they move through day-to-day activities to protect their foot health. “Sometimes I’ll tell patients to check water temperatures with their hand or elbow instead of their foot,” she says.
Nerve damage means no pain, and although this may sound like a blessing, it is a danger. Our nerves are important in telling us when something is wrong. Therefore, diabetics should have a daily foot check routine, and every doctor’s appointment should involve a foot and shoe inspection.
According to the American College of Foot and Ankle Surgeons, there are several things diabetics and caregivers need to know about treating feet.
- Inspect every day. Check for any injuries, redness, swelling or nail issues. Use a magnifying glass to inspect the soles.
- Wash gently but daily. Use only lukewarm water, never hot! Use a soft washcloth or sponge and dry by blotting, not rubbing. Thoroughly pat dry between toes.
- Don’t moisturize toes. Using a moisturizer is fine but avoid toes as it could lead to a fungal infection.
- Cut nails carefully. Cut them straight across and gently file edges.
- Change into clean, dry socks every day. Wear them to bed, too.
- Invest in diabetes-specific socks. They have extra cushioning, no elastic tops and are made from moisture-wicking material.
- Inspect inside shoes before wearing. Small pebbles or foreign objects might not be felt by nerve-damaged feet.
- Keep feet warm and dry. Always.
- Consider using an antiperspirant on the soles of your feet. This is helpful if you have excessive sweating of the feet.
- Never walk barefoot. Not even at home!
- Don’t smoke. It restricts blood flow in your feet.
- Get periodic foot exams. Every doctor visit should include a foot exam.
Diabetics should also know that they’re eligible for special footwear through their insurance company. Specially designed shoes can help with proper support and increased blood flow to the toes. A common problem with regular shoes is that they may put pressure on the toes or cut off circulation all together. Without properly functioning nerve endings, it’s difficult to tell when something is happening. Pescitelli mentions that footwear options have grown over the years. “What the shoe is like depends on what they need,” she says of the importance of getting the right type of shoe for the patient.
A diabetic’s No. 1 concern is managing blood sugar and, if this is done properly through medications, diet and exercise, chances are they will be able to maintain foot health. However, it’s always important to both inspect and protect your feet if you have diabetes, especially if you suffer from nerve damage. Make sure to take time every morning or evening to go through a simple inspection process and report anything unusual to your doctor right away. Prevention is key in managing the side effects that can come with this difficult disease.