Diabetes Health Guide - Diabetic Foot Care

1. Nerve damage. One problem is damage to nerves in your legs and feet. With damaged nerves, you might not feel pain, heat, or cold in your legs and feet. A sore or cut on your foot may get worse because you do not know it is there. This lack of feeling is caused by nerve damage, also called diabetic neuropathy (ne-ROP-uh-thee). It can lead to a large sore or infection.
2. Poor blood flow. The second problem happens when not enough blood flows to your legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral (puh-RIF-uh-rul) vascular disease. Smoking when you have diabetes makes blood flow problems much worse.

These two problems can work together to cause a foot problem.

For example, you get a blister from shoes that do not fit. You do not feel the pain from the blister because you have nerve damage in your foot. Next, the blister gets infected. If blood glucose is high, the extra glucose feeds the germs. Germs grow and the infection gets worse. Poor blood flow to your legs and feet can slow down healing. Once in a while a bad infection never heals. The infection might cause gangrene (GANG-green). If a person has gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

To keep gangrene from spreading, a doctor may have to do surgery to cut off a toe, foot, or part of a leg. Cutting off a body part is called an amputation (amp-yoo-TAY-shun).

What can I do to take care of my 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 shoes or slippers 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 1 to 2 weeks.
• Before putting your shoes on, feel the insides to make sure they have no sharp edges or objects that might injure your feet.

How can I get my doctor to help me take care of my feet?

• Tell your doctor right away about any foot problems.
• Ask your doctor to look at your feet at each diabetes checkup. To make sure your doctor checks your feet, take off your shoes and socks before your doctor comes into the room.
• Ask your doctor to check how well the nerves in your feet sense feeling.
• Ask your doctor to check how well blood is flowing to your legs and feet.
• Ask your doctor to show you the best way to trim your toenails. Ask what lotion or cream to use on your legs and feet.
• If you cannot cut your toenails or you have a foot problem, ask your doctor to send you to a foot doctor. A doctor who cares for feet is called a podiatrist (puh-DY-uh-trist).

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