|If a doctor has ever
said you had an elevated blood sugar level Ė even just once when
you were pregnant Ė you are at risk for diabetes. About 15.7
million people have the disease. Nervous system impairment
(neuropathy) is a major complication that may cause you to lose
feeling in your feet or hands. This means you wonít know right
away if you hurt yourself. The problem affects about 60 to 70
percent of people with diabetes.
Foot problems are a big risk. Like
all diabetic people, you should monitor your feet. If you donít,
the consequences can be severe, including amputation, or worse.
Minor injuries become major
emergencies before you know it. With a diabetic foot, a wound as
small as a blister from wearing a shoe thatís too tight can
cause a lot of damage. Diabetes decreases your blood flow, so your
injuries are slow to heal. When your wound is not healing, itís
at risk for infection. As a diabetic, your infections spread
If you have diabetes, you should
inspect your feet every day. Look for puncture wounds, bruises,
pressure areas, redness, warmth, blisters, ulcers, scratches, cuts
and nail problems. Get someone to help you, or use a mirror. Feel
each foot for swelling. Examine between your toes. Check six major
locations on the bottom of each foot: The tip of the big toe, base
of the little toes, base of the middle toes, heel, outside edge of
the foot and across the ball of the foot. Check for sensation in
If you find any injury -- no matter
how slight -- donít try to treat it yourself. Go to a doctor
Hereís some basic advice for
taking care of your feet:
- Wash your feet every day with
mild soap and warm water. Test the water temperature with your
hand first. Donít soak your feet. When drying them, pat each
foot with a towel and be careful between your toes.
- Use quality lotion to keep the
skin of your feet soft and moist Ė but donít put any
lotion between your toes.
- Trim your toe nails straight
across. Avoid cutting the corners. Use a nail file or emery
board. If you find an ingrown toenail, see your doctor.
- Donít use antiseptic
solutions, drugstore medications, heating pads or sharp
instruments on your feet. Donít put your feet on radiators
or in front of the fireplace.
- Always keep your feet warm. Wear
loose socks to bed. Donít get your feet wet in snow or rain.
Wear warm socks and shoes in winter.
- Donít smoke or sit
cross-legged. Both decrease blood supply to your feet.
Hereís some basic advice about
shoes and socks:
- Never walk barefoot or in
sandals or thongs.
- Choose and wear your shoes
carefully. Buy new shoes late in the day when your feet are
larger. Buy shoes that are comfortable without a
"breaking in" period. Check how your shoe fits in
width, length, back, bottom of heel and sole. Avoid
pointed-toe styles and high heels. Try to get shoes made with
leather upper material and deep toe boxes. Wear new shoes for
only two hours or less at a time. Donít wear the same pair
everyday. Inspect the inside of each shoe before putting it
on. Donít lace your shoes too tightly or loosely.
- Choose socks and stockings
carefully. Wear clean, dry socks every day. Avoid socks with
holes or wrinkles. Thin cotton socks are more absorbent for
summer wear. Square-toes socks will not squeeze your toes.
Avoid stockings with elastic tops.
When your feet lose their feeling, they are at risk for becoming
deformed. One way this happens is through ulcers. Open sores may
become infected. Another way is the bone condition Charcot
(pronounced "sharko") foot. This is one of the most
serious foot problems you can face. It warps the shape of your
foot when your bones fracture and disintegrate, and yet you
continue to walk on it because it doesn't hurt.
A doctor may treat your diabetic
foot ulcers and early phases of Charcot fractures with a total
contact cast. The shape of your foot molds the cast. It lets your
ulcer heal by distributing weight and relieving pressure. If you
have Charcot foot, the cast controls your footís movement and
supports its contours if you donít put any weight on it. To use
a total contact cast, you need good blood flow in your foot. Your
doctor monitors it carefully. The cast is changed every week or
two until your foot heals.
A custom-walking boot is an another
way to treat your Charcot foot. It supports the foot until all the
swelling goes down, which can take as long as a year. You should
keep from putting your weight on the Charcot foot. Surgery is
considered if your deformity is too severe for a brace or shoe