Why? The short answer involves both nerves and circulation.
Diabetes is linked to progressive nerve damage (or neuropathy), which can take away your ability to “feel” injuries and cuts on your feet. It’s also linked to poor circulation, which reduces your ability to fight infections and close wounds.
Put them together, and you have a recipe for chronic foot ulcers that just won’t heal. And according to the APMA, as many as one quarter of diabetic patients who develop foot ulcers will one day require part of their foot or leg to be amputated due to wound infection.
By far, the best way to escape this fate is to avoid getting diabetic foot wounds in the first place. Fortunately, they are very preventable—if you know what to do and what to watch for.
Here are some of the most important components of an effective prevention strategy.
Manage Your Diabetes
The underlying conditions that lead to wounds—neuropathy and poor circulation—both develop gradually over time due to exposure to high blood sugar levels. The worse these conditions get, the greater your risk for developing a foot ulcer—and the more likely that ulcer will develop a dangerous infection.
As a result, carefully monitoring and managing your blood sugar levels and controlling your diabetes through diet and exercise is extremely important.
Keep Your Feet Clean
Poor hygiene will increase your risk of skin breakdown, and also of those wounds becoming infected.
Wash your feet at least once per day, using warm water and mild soap. Since nerve damage can make it difficult to tell when the water is too hot or cold using your feet or hands, test the temperature with a thermometer (or an unaffected body part, such as your elbow) first.
Do not allow your feet to soak too long, since this can also cause skin breakdown. Dry thoroughly after washing your feet—don’t forget the space between your toes! Once you’re done, apply your favorite moisturizer and then put on a clean pair of socks.
Trim your toenails weekly with a toenail clipper, straight across. Do not round the corners.
Give Yourself a Diabetic Foot Self-Exam Every Day
If you have diabetes, you may not be able to trust that the nerves in your feet will tell you that you’ve hurt yourself. If neuropathy is severe, you might walk on a cut, blister, or even broken bone for hours (or days!) before you recognize any problem.
Because of this, you should take just five minutes every day to give yourself a comprehensive diabetic foot self-exam. Do it at a regular time—say right after dinner or right before bed—so you don’t forget.
Sit upright in a well-lit room and use a hand mirror (or ask a loved one) to help you if you aren’t able to fully examine all sides of both feet on your own. During the visual inspection, you should carefully check and record any changes you notice to your feet. This not only includes obvious cuts, cracks, blisters or sores, but also things like swelling, redness, or the early signs of a bunion or hammertoe.
Also, use your hands to feel your feet and note any unusual bumps, temperature changes, or cracks that you didn’t detect during your visual inspection.
If you notice any existing wounds or sores, any budding foot deformities, or any other problem that doesn’t clear up (or gets worse) within a few days, please give us a call.
Get a Diabetic Foot Checkup At Least Once Per Year
Even if you’re checking your own feet every day, there may be additional problems hiding under the surface.
During your diabetic foot checkup, your doctor (that’s us!) can test the health of your circulation and nerves. Unfortunately, the nerves can be damaged quite extensively (and irreversibly) before symptoms become obvious, so these tests can help ensure you get adequate treatment before you experience a significant and permanent decline in your quality of life.
We will also provide whatever routine foot care and assistance you require, whether that’s helping with toenails, skin problems, corns and calluses, etc. Having a podiatrist care for these problems safely and regularly helps keep your feet as healthy and safe as possible.
If you have a history of foot problems or diabetic wounds, you may need to see us more often than once a year. That’s certainly something we can discuss at your next appointment.
Protect Your Feet with Appropriate Footwear
People with diabetes should not go barefoot in public places, or sometimes even at home (depending on your symptoms). Footwear not only protects your feet from scrapes and injuries (for example, a puncture wound from stepping on a rock), but also from indirect fungal and bacterial infections.
We can help you determine what kind of footwear is appropriate. In most cases, a good pair of comfortable socks and well-fitting walking shoes will serve you well. However, those who are at greater risk for wounds may benefit from wearing socks and shoes specifically designed for diabetes.
Diabetic socks are typically made from breathable and moisture-wicking fabrics that resist harboring fungi and bacteria. Other common features include built-in padding, gentle compression to encourage circulation, and a seamless design to minimize skin irritation.
Diabetic shoes, meanwhile, are built with a little extra depth so that they can easily accommodate custom orthotics. They also have high standards for cushioning and support to reduce the risk of skin breakdown and improve mobility. They are prescribed and fitted by a qualified professional such as Dr. Patel, and can be covered by Medicare (along with many insurance plans).
Always check the insides of your shoes before you put them on. They may be hiding small rocks or other foreign objects that can scratch or puncture your skin.
Quit Smoking and Avoid Excessive Use of Alcohol
Smokers are at high risk of developing foot ulcers, since smoking has a negative effect on blood flow to your feet. If you’re a smoker, quitting as soon as possible is one of the best decisions you can make for a wide variety of health reasons, including foot health.
Alcohol abuse is also dangerous, as it can poison nerves and deplete your body of essential nutrients needed for nerve health and wound healing.
Is It Time for Your Appointment?
If you have diabetes and you’re experiencing any foot pain, you notice any foot problems—or it’s just been too longer since your last comprehensive checkup—give us a call today. You can schedule with us in either Milford or Hamden, CT by calling (203) 876-7736.