Diabetes is a group of conditions that affect how your body uses sugar for fuel. It can also impact different areas of the body, with one of the most common areas impacted being the feet. Diabetics can have problems with nerve damage and blood flow that can harm their feet. The two primary foot conditions that patients with diabetes have are diabetic peripheral neuropathy and peripheral vascular disease.
Diabetic peripheral neuropathy
According to the American Diabetes Association, about half of all patients with Type 2 diabetes have some form of neuropathy, or nerve damage. The most common type is peripheral neuropathy which is when the nerve damage is in the hands, feet, legs and arms.
People with diabetes should check their feet daily and regularly visit the primary care provider for a foot check. But patients should let their health care provider know if they get any new symptoms or have ones that get worse.
Symptoms could include:
- Tingling feet or the sensation of pins and needles
- Pain, increased sensitivity to touch or changes in temperature
- Numbness or weakness which can make you less steady on your feet or make you not able to feel sores on the feet
- Sores or ulcers that heal very slowly
“It is important to manage your blood sugars well as that can delay diabetic nerve damage,” says Carl Gibson, M.D., an endocrinologist with Riverside Endocrinology and Diabetes Specialists. “And, it’s very important for diabetic patients to take good care of their feet, including checking both feet daily and making sure they are wearing shoes that fit well.”
Peripheral vascular disease
A second major cause of foot problems in patients with diabetes is poor circulation. Diabetes can cause the vessels in your feet and legs to narrow and harden. This leads to impaired blood flow.
Poor blood flow can make your feet feel cold, but as you may have difficulty sensing the heat it would be easy to burn them with hot water or a heating pad. The best way to warm your feet is to wear warm socks. The blood flow problems can also cause leg pain in the calves when walking, known as claudication.
To maintain healthy blood flow, you should:
- Not smoke
- Exercise regularly to help blood flow through the legs
- Wear sturdy, well-fitting shoes that don’t constrict or rub your feet
“Diabetes can affect blood flow throughout your body,” says Dr. Gibson. “Without proper blood flow, any wounds, cuts or sores you get can take longer to heal.” This is why patients with diabetes are at an increased risk for getting ulcers or gangrene (tissue death that can lead to the need for amputation). Caring for your feet and checking them daily can help prevent problems and catch them before they worsen.
Caring for your feet to avoid problems
If you have diabetes, there are several measures you can take in your daily life to reduce your risk of having foot problems. You should:
- Manage your diabetes. Check your blood sugar levels regularly and take your diabetes medication as prescribed. Keep your regular appointments, including seeing a podiatrist (foot doctor), as needed.
- Perform daily home care. Each day wash your feet in lukewarm water and then dry them. Apply lotion to your feet, but not in between your toes as it can encourage a fungal infection. After you’ve cleaned your feet, check for new wounds or sores, so you can care for them before infection is a risk. You should try to elevate your feet when sitting or lying down to keep your blood flowing.
- Perform weekly self-care. Check your toenails for things that look different – such as changes in color or texture – weekly. Aim to clip your toenails straight across once per week, or more often as needed. Toenails that grow too long can risk becoming ingrown.
- Wear proper footwear. To protect your feet and toenails, you should wear closed-toe shoes or slippers with socks or stockings at all times. Wear comfortable, well-fitting shoes. Shake your shoes out before wearing them as you may not be able to feel a pebble or other irritant inside them. Also be sure to wear clean, dry socks and change them daily.
- Get periodic foot checks: Be sure to see your primary care provider or podiatrist for regular checks of your feet.
- Do not smoke: If you are a smoker, talk to your physician about resources to help you quit as smoking restricts blood flow in your feet.
- Manage your diabetes: Work to keep your blood sugars under control to help prevent nerve damage and hardening of vessels.
Make an appointment
If you have diabetes, you should see your provider regularly to make sure your diabetes is in check and do regular foot checks. If needed, your primary care doctor may refer you to a podiatrist or vascular specialist for more specialized care. If you do not have a primary care provider, call 757-534-5352 to make an appointment with aRiverside Primary Care practice near you. To make an appointment with Riverside Endocrinology and Diabetes Services, call 757-534-5909. To consult a vascular surgeon, call 757-534-5340 to make an appointment with Riverside Vascular Specialists.
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