Diabetes is the fifth leading cause of death by disease in the United States and is a major cause of vascular diseases that result in individuals having a leg or foot amputated.
High blood sugar can cause nerve damage and poor circulation which lowers the supply of oxygen and blood to the lower legs and feet. This results in a variety of problems including dry, cracked skin that doesn’t heal; nerve damage that causes sharp shooting pains; numbness or aching feet; cold feet; or abnormal toenail growth.
A person who has diabetes should take special care of their feet, including daily inspection. They should also make sure that when they have their twice-a-year checkup, the doctor or nurse looks at their feet. It is suggested that a person with diabetes remove their shoes and socks when they visit the doctor as a cue to look at the feet.
During the daily inspection, look carefully for any signs of breaks in the skin; swelling; unusually red or pale skin; hot spots; dry, cracked or shiny areas; or discolored toenails. Check the balls of the feet for ulcers. If you notice any of these problems, immediately notify your doctor.
To keep feet in good health, a person with diabetes should wash their feet daily with mild soap and warm water. Dry your feet gently but thoroughly. Apply moisturizer everywhere except between the toes. Inspect the bottom of your feet daily by using a hand mirror or having a family member help. Trim toenails immediately after bathing when they are softer, and cut them straight across.
Never go barefoot indoors or outdoors. When putting on shoes, check the inside to make sure there are no foreign particles in the shoe. Wear comfortable, loose-fitting shoes of soft leather that can mold to the shape or your feet and can breathe. Avoid pointed or open-toed shoes and never wear sandals.
It is recommended that you buy new shoes late in the day when you feet are larger. Since feet actually enlarge slightly during the day, shoes that fit in the morning may be too tight later in the day. Don’t wear new shoes for more than two hours at a time and don’t wear any shoe for more than five hours at a time. Ideally, you should have three or four pairs of shoes so you can change them two or three times during the day.
Never wear shoes without socks. Wear loose-fitting socks or hosiery that are 100 percent cotton or cotton blend. Don’t buy socks that are 100 percent synthetic because they don’t let your feet breathe. Select socks or hosiery that do not have seams or tight elastic around the top. Companies now make socks and hosiery especially designed for diabetics.
Protect your feet from extremes in temperature. Avoid situations where your feet would get extremely cold or unusually hot. If your feet are cold, don’t use a heating pad to warm them. If they get hot, don’t use cold packs. When bathing, check the temperature before you put your feet in the water. Because of the loss of sensitivity, you could burn your foot and this would result in serious complications.
If you injure your foot or leg, treat the wound immediately and see a physician to evaluate whether special medications or treatment is needed. Sores on feet and legs can easily become infected and result in gangrene and amputation.
The Lower Extremity Amputation Prevention (LEAP) program has additional information on foot care for people with diabetes. They can be contacted at www.bphc.hrsa.gov/leap or 888-275-4772.
Additional information on Healthy Aging can be found on the Colorado State University Cooperative Extension Web site at www.ext.colostate.edu. Go to online info, then select Consumer and Family and then Healthy Aging.
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by Luann K. Boyer, Family and Consumer extension agent,
Colorado State University Cooperative Extension, Morgan County