High blood glucose levels from diabetes causes two problems that can work together to hurt your feet:
- Nerve damage (diabetic neuropathy). Diabetes can damage the nerves, resulting in numbness. This means the person may not feel pain, heat, or cold in the legs or feet. A sore or cut on your foot may occur without the person knowing it is there.
- Poor blood flow. Poorly controlled diabetes can also damage the blood vessles and result in poor blood flow. This problem is called peripheral vascular disease, also called PVD. Smoking when you have diabetes makes blood flow problems much worse. Peripheral vascular disease causes wounds to heal more slowly
A person may get a blister from shoes that do not fit and not know it because of the nerve damage. Next, the blister gets infected due to the poor blood flow. If blood glucose is high, the extra glucose feeds the germs. Germs grow and the infection gets worse and leads to deep wound called foot ulcerations. In some cases, surgery may be required to repair deep wounds or to cut off part of the extremity.
Steps to Take Care of Your Feet
- Wash your feet in warm water every day. Make sure the water is not too hot by testing the temperature with your elbow. Do not soak your feet. Dry your feet well, especially between your toes.
- Look at your feet every day to check for cuts, sores, blisters, redness, calluses, or other problems. Checking every day is even more important if you have nerve damage or poor blood flow. If you cannot bend over or pull your feet up to check them, use a mirror. If you cannot see well, ask someone else to check your feet.
- If your skin is dry, rub lotion on your feet after you wash and dry them. Do not put lotion between your toes.
- File corns and calluses gently with an emery board or pumice stone. Do this after your bath or shower.
- Cut your toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board.
- Always wear slippers or shoes to protect your feet from injuries.
- Always wear socks or stockings to avoid blisters. Do not wear socks or knee-high stockings that are too tight below your knee.
- Wear shoes that fit well. Shop for shoes at the end of the day when your feet are bigger. Break in shoes slowly. Wear them 1 to 2 hours each day for the first few weeks.
- Before putting your shoes on, feel the insides to make sure they have no sharp edges or objects that might injure your feet.
What are common diabetes foot problems?
Anyone can have corns, blisters, and athlete’s foot. If you have diabetes and your blood glucose stays high, these foot problems can lead to infections.
Corns and calluses are thick layers of skin caused by too much rubbing or pressure on the same spot. Corns and calluses can become infected.
Blisters can form if shoes always rub the same spot. Wearing shoes that do not fit or wearing shoes without socks can cause blisters. Blisters can become infected.
Ingrown toenails happen when an edge of the nail grows into the skin. The skin can get red and infected. Ingrown toenails can happen if you cut into the corners of your toenails when you trim them. If toenail edges are sharp, smooth them with an emery board. You can also get an ingrown toenail if your shoes are too tight.
A bunion forms when your big toe slants toward the small toes and the place between the bones near the base of your big toe grows big. This spot can get red, sore, and infected. Bunions can form on one or both feet. Pointed shoes may cause bunions. Bunions often run in the family. Surgery can remove bunions.
Plantar warts are caused by a virus. The warts usually form on the bottoms of the feet.
Hammertoes form when a foot muscle gets weak. The weakness may be from diabetic nerve damage. The weakened muscle makes the tendons in the foot shorter and makes the toes curl under the feet. You may get sores on the bottoms of your feet and on the tops of your toes. The feet can change their shape. Hammertoes can cause problems with walking and finding shoes that fit well. Hammertoes can run in the family. Wearing shoes that are too short can also cause hammertoes.
Dry and cracked skin occurs because the nerves in your legs and feet do not give the proper signals to the sweat gland that keep the skin moist.
Dry skin can become cracked and allow germs to enter, leading to an increased risk of infection.
Athlete’s foot is a fungus that causes itchiness, redness, and cracking of the skin. The cracks between the toes allow germs to get under the skin. If your blood glucose is high, it feeds the germs and makes the infection worse.
The fungal infection can spread to the toenails and make them thick, yellow, and hard to cut. Tell your doctor about any foot problem as soon as you see it.
Special Shoes to Help Your Feet
Special shoes can be made to fit softly around your sore feet or feet that have changed shape. These special shoes help protect your feet. Medicare and other health insurance programs may pay for special shoes. Talk with your doctor about how and where to get them.
Reference: The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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