Neuropathy (damage to the nervous system) affects as many as 70 percent of those with diabetes. The first sign of danger is when there’s a loss of feeling in the feet or hands.
There is a high risk for foot problems when you have diabetes. Constant monitoring of the feet is suggested to avoid the possibility of conditions that can get so bad that amputation is the last resort. When small wounds occur in diabetic feet, such as a small blister from improper footwear or a red area on your foot, the injuries are slow to heal due to the decreased blood flow. When this happens, the chances for infection increase dramatically and the infections are more likely to spread quickly.
If you have diabetes, you should inspect your feet every day. Look for small puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. If you can’t manage this inspection by yourself, find someone who can help you or use a mirror.
Here’s some basic advice for taking care of your feet:
- Keeping your feet warm is important.
- Try to keep your feet dry, avoiding exposure to snow or rain.
- Avoid directly heating them by placing them on a radiator or in front of a fireplace.
- Don’t sit with your legs crossed, as this decreases blood supply to your feet.
- Don’t smoke, as this decreases blood flow.
- Don’t soak your feet.
- Avoid the use of antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.
- Prevent ingrown toenails by trimming them straight across and avoid cutting the corners. Use a nail file or emery board. If you have an ingrown toenail, get it look at immediately,
- Use quality lotion to keep the skin of your feet soft and moist, but don’t put any lotion between your toes.
- Wash your feet every day with mild soap and warm water.
- Wear loose socks to bed.
- Wear warm socks and shoes in winter.
- When drying your feet, pat each foot with a towel and be careful between your toes.
- Proper Footwear: 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. Don’t wear the same pair everyday. Inspect the inside of each shoe before putting it on.
- Don’t lace your shoes too tightly or loosely.
- Proper socks/hosiery: 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-toed socks will not squeeze your toes. Avoid stockings with elastic tops.
Your feet are at risk of becoming deformed when they are numb and ulcers can form, which can become infected. The bone condition is called 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. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast, CROW walker or other type of immobilization.
The shape of your foot molds exactly to the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot’s movement and supports its contours if you don’t put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is 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.
If you have diabetes and need to address problems with your feet, please contact Dr. Cruz at his offices in Brandon (813) 502-5904 or Zephyrhills (813) 782-3233 or you can also set an appointment using the form by clicking the button below.