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If you have neuropathy that lessens your ability to feel pain in your hands or feet, you’re at increased risk of foot and skin problems. Poorly controlled blood sugar may lead to dry skin, slow healing, and decreased immune function, all of which can increase infection risk. Infections can arise from bacteria, viruses, fungus, or yeast.
Foot and skin complications often start when a minor problem becomes major. For example, you may not notice a small blister on your foot because neuropathy has dulled your ability to feel pain. If ignored, this blister can lead to a more serious infection. In addition, dry or itchy skin is susceptible to being opened up when scratched, which may allow infection to set in.
Everyone with diabetes should be screened for diabetic peripheral neuropathy. For people with type 2 diabetes, the first screening should happen at the time of diagnosis, and for people with type 1 diabetes, the first screening should happen five years after diagnosis. Screening should happen every year after that. In addition, all people with diabetes should have a yearly comprehensive foot exam.
The best way to keep your feet and skin in good health is to be very observant; check your feet daily and give your entire body a good look at least twice a week. Also, check hard-to-see areas, such as between your toes: ask a spouse, partner, or home healthcare provider to help with areas you can’t see, such as your back, or the bottoms of your feet.
Place special focus on keeping your feet clean and dry. Be sure to wash and dry between toes carefully. Wear appropriate, well-fitting footwear that cushions your feet, and comfortable, moisture-wicking socks.
Lifestyle is another cornerstone of maintaining good health, and of keeping foot and skin problems at bay. To prevent dry skin, avoid very hot showers and baths, keep your home more humid during cold, dry months, and use moisturizer. In addition, maintain blood sugar control, keep blood pressure and cholesterol levels in a healthy range, quit smoking, maintain a healthy body weight, eat a well-balanced diet, and if you're able to, engage in regular physical activity.
(Diabetes Care 2015;38:S62–S64)