FOOT PROBLEMS

Avoiding Foot Problems

Since most foot problems begin with an unnoticed injury to the skin, many things can be done to prevent more serious problems, including:

• regular foot and footwear checks by a professional
• daily self-inspection of the feet
• never walking barefoot
• nail care only by professionals
• understanding why diabetes causes foot problems

With good education, good diabetes care, and proper footwear and foot care, people with diabetes can avoid many of the disease’s serious consequences for the feet.

What You Can Do:

• Control your diabetes. Your risk is decreased by good control of the disease.
• Wash your feet daily. Dry carefully between the toes.
• Apply a moisturizer to feet lightly after bathing. It is important for you to keep your skin soft and supple.
• Do not cut toenails too short. The corners of the nails should always be visible. If you have difficulty reaching or seeing your feet have someone else cut your toenails.
• Stop smoking. Smoking reduces blood circulation and increases your risk of amputation.
• Wear comfortable, well-fitting shoes.
• Examine feet every day for cuts, blisters, dry blood, redness or swelling. Call your podiatrist immediately if you notice a problem. Hours can make the difference between saving your foot and losing it.
• Inspect the inside of shoes for foreign objects.

What You Should NOT Do:

• Never use hot water bottles or heating pads. These can cause serious burns.
• Don’t walk barefoot, even indoors.
• Don’t trim corns or calluses with any type of blade. An emery board can be used safely if necessary.
• Don’t use corn removal pads, liquids or wart treatments. These products contain acids that can cause an ulcer or hole in the skin.
• Don’t wear open-toed shoes, particularly sandals with thongs between toes.

What Your Doctor Can Do:

• Educate you regarding diabetes and foot complications.
• Care for areas that are at risk for ulceration.
• Consult nerve and vascular specialists where appropriate.
• Make protective insoles to decrease pressure on problem areas.
• Perform surgery to reduce the risk of ulcer and infection.
• Perform wound care for ulcers.

Foot Complications of Diabetes mellitus

• Diabetic ulcers – the loss of skin and subcutaneous tissue over areas of pressure
• Neuropathy – loss of sensation due to damage to peripheral nerves
• Charcot joint disease – Severe destructive joint changes to the neuropathic foot
• Diabetic osteolysis – the resorbtion of bone, especially of the forefoot bones
• Osteomyelitis – infection of bone, usually from an overlying skin ulcer
• Amputation of foot or leg due to severe infection