Why is Foot Care Important?

Diabetes can contribute to foot problems in two ways, it can cause decreased feeling in the feet, so that injuries such as cuts and scrapes may go unnoticed, or it can cause decreased circulation to the feet, resulting in a reduced blood supply that may be insufficient to fight infection and heal wounds. The risks of developing foot problems can be greatly reduced if you follow the simple principles of foot care outlined here, and see your physician regularly.

Take Good Care of Your Feet

Wash your feet everyday. Use warm (not hot) water, and mild soap. Do not put your feet in the water without testing it first with your hand, elbow, or a thermometer. Do not soak your feet unless instructed by your physician. Pat your feet dry with a soft towel, making sure to dry between the toes. Do not rub the skin too vigorously. If your skin is dry, or shows evidence of cracking, use a moisturizing cream as prescribed by your doctor. Never put the cream between your toes. Foot powder, used sparingly, can help if you have a problem with excessive perspiration. Change stockings daily. Do not wear stockings that have been mended or have seams because these can injure or irritate the skin.

Footwear

Shoes that fit poorly can cause irritation and injury. Shoes should fit snugly, but not tightly. Make sure there is plenty of room for your toes. Avoid shoes made of plastic. Leather shoes allow your feet to breathe the best. New shoes should be broken in gradually. You should inspect the inside of your shoes daily for torn linings or foreign objects. Remember, diabetic patients sometimes have decreased sensation and can be unaware of something inside the shoe. Walking or running shoes may be helpful for some diabetic patients. If you have foot deformities, you may need special therapeutic shoes.

Never go barefoot, even at home. Always wear shoes or slippers, especially in the dark. Remember, an unnoticed minor cut, scrape, or burn can rapidly lead to a serious infection in a person with diabetes.

Trim Your Toenails Carefully

Be very careful to avoid injury when you trim your toenails. Trim them frequently, straight across, being careful not to cut them too short. Do not dig into the corners of the nails. Use a nail clipper, emery board, or nail file. It may help if you soften your nails by soaking them in warm water for 10 minutes before cutting them. If nails are thickened and difficult to cut, see your podiatrist.

Do not try to remove ingrown toenails. Do not use razor blades, scissors, or knives to remove calluses or corns. A minor cut can rapidly develop into a serious infection. Removal of an ingrown toenail, or a callus should be done by your physician. Your podiatric physician can also give you instructions on the use of an emery board or pumice stone for removing calluses at home.

Watch Out For Burns

Diabetic patients may have a loss of feeling in their feet, and may suffer a burn without knowing it. It is important that you check the temperature of hot water before you put your feet in it. Bath water should be a lukewarm temperature, between 85 and 90 degrees Fahrenheit. If you do not have a bath thermometer, test the water with your elbow.

Do not use a hot water bottle or heating pad. Check with your physician before you use an electric blanket on your bed. Wear socks to keep your feet warm. Wear protective footwear at the beach or around swimming pools. Do not use chemical corn or callus removers, as they can cause chemical burns.

Women should avoid tight pantyhose, panty girdles, elastic garters, and socks with elastic tops. If you see lines or indentations when you take off socks or undergarments, they are probably too tight, and may cause swelling of the feet.

Do Not Smoke

If you smoke, STOP!! Smoking narrows the blood vessels and decreases circulation to the feet. Smoking is not wise for anyone, and particularly dangerous for people with diabetes.

Warning Signs of Diabetic Foot Problems

Inspect your feet every day. Remember, any injury to the foot or break in the skin is potentially serious in a person with diabetes. Therefore, look at your feet every day, especially between the toes. If poor vision or arthritis make it hard for you to inspect your feet, have someone else do it. Notify your podiatrist if you notice:

• Puncture wounds
• Cuts or scrapes that do not heal
• Ingrown toenails
• Corns and Calluses
• Problems due to poorly fitting shoes
• Any injuries to the feet
• Discoloration, pain, redness, or swelling
• Pain in the calves during walking or exercise.

In Summary:

•  DO NOT SMOKE. It decreases the blood supply to your feet.

2. NEVER walk barefoot, neither indoors nor out

3. Examine your feet daily for redness, warmth, blisters, ulcers, scratches, cuts and nail problems from shoes or other sources. Look at the bottoms and between toes. Use a mirror or have someone else look for you.

4. Call your doctor immediately if you experience any injury to your foot. Even a minor injury is an emergency for a patient with diabetes.

5. Examine your shoes for foreign objects, protruding nails and rough spots inside before putting them on. Look and feel.

6. Buy shoes late in the day. Never buy shoes that need "breaking in." They should be immediately comfortable. Request shoes with deep toe boxes and made of leather upper material. Do not wear new shoes more than two hours at a time. Rotate your shoes. Do not wear the same ones every day.

7. Never wear thongs. They can cause irritation between the first and second toe and lead to infection.

8. Lubricate your entire foot if your skin is dry, but avoid putting cream between toes. Try Lubriderm, olive oil, vitamin E oil or lanolin.

9. Do not soak your feet. Skin can break down and won't heal well.

10. Keep feet away from heat (heating pads, hot water pads, electric blankets, radiator, fireplaces). You can burn your feet without knowing it. Water temperature should be less than 92 degrees. Estimate with your elbow or bath thermometer (you can get one in any store that sells infant products).

11. Don't use any tape or sticky products such as corn plasters on your feet. They can rip your skin.

12. Do not file down, remove or shave calluses or corns yourself. These should be taken care of by your podiatrist.

13. Do not use any chemicals or strong antiseptic solutions on your feet. Iodine, salicylic acid, corn/callus removers are dangerous.

14. Do not trim your own toenails.

15. Do not wear stockings or socks with tight elastic backs and do not use garters. Wear only white socks and do not wear any socks with holes. Always wear shoes with socks.

16. In the winter, wear wool socks and protective footwear. Avoid getting feet wet in the snow and rain and avoid letting toes get cold.

17. If the circulation in your feet is impaired, tell your medical doctor so he/she can take this into account when prescribing medication for high blood pressure or heart disease.