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If you have type 1 or type 2 diabetes, you may be at risk for nerve damage, a condition called neuropathy. The high blood sugar levels that may result from diabetes can lead to neuropathy, especially in the feet, which in turn can lead to a loss of feeling. For this reason, taking care of your feet is particularly important.
If you have diabetes, our guide for keeping your feet in tip-top shape can get you pointed in the right direction. In addition, it is recommended that all patients with diabetes receive an annual, comprehensive foot examination from a doctor.
Inspect daily. Set a time to examine your feet at least once a day. Look for bruises, cuts, red spots, and tender areas. If you find any of these issues, contact your doctor for advice on how best to care for them. If your doctor has given you the go-ahead to self-treat minor problems, use an appropriate ointment or cream, such as antibiotic ointment, and bandage the area as needed to protect it from further damage. For more serious injuries, do not self-treat; get to the doctor, urgent care clinic, or emergency room as soon as possible. And if minor problems persist, make an appointment with your doctor.
Wash and moisturize regularly. Wash and dry your feet carefully at least once a day. Make sure to dry between your toes. Keep your feet moisturized to minimize cracking and calluses. For a person with diabetes, cracked foot skin can increase infection risk. Try a lotion developed specifically for foot care, which tends to be thicker, and better suited for softening the tough skin on the bottoms and sides of the feet. Rub the lotion everywhere except between your toes.
Be shoe savvy. Always wear proper-fitting, comfortable footwear that is right for your planned outing. Even if you’re a fashionista, if you’re going to be walking a lot save the dress shoes for special occasions and wear sneakers. Consider specialized inserts for dress shoes if you must wear them more frequently to meet a work dress code, or for important meetings.
Save your soles. To avoid injury and infection, never go without shoes. For summer activities, a pair of “water shoes” or sandals with canvas straps and a rubber bottom will let your toes feel the open breeze, without the risk to your feet. You can go into the water with less worry about unseen sharp objects in lakes or the ocean. And be sure to wash and carefully dry your feet, especially between the toes, after these activities.
Shop your socks. Pick socks that are appropriate to the temperature and your activities. Overly hot feet can mean extra moisture, which increases risk of blisters and foot abrasions. If your feet are cold, you risk frostbite or other damage from cold exposure. Thinner socks work best for summer and thicker for winter. Natural fibers breathe better than synthetics, though socks made with wicking materials containing some synthetic fibers may work better than 100% cotton. Carry an extra pair if you’re going to be out for a long period of time and change your socks if they get damp. Choose white or another light color so it's easy to spot if a sore weeps or bleeds.
Protect from the extremes. Protect your feet from hot and cold temperatures. Wear shoes at the beach, and when walking across hot pavement. Never use a hot water bottle or heating pad on your feet, and avoid electric blankets. Always test the temperature of water before you put your feet into it. Wear properly fitting, warm, waterproof shoes or boots in the winter.
Keep them moving. Regular physical activity, even a daily 15-minute walk around the block, can keep the blood flowing to your feet. Plus it can help keep your blood sugar levels in a healthy range. If you are unsure of how to start, ask your doctor to guide you on how much, and what type of physical activity is right for you. While you’re sitting during the day, frequently wiggle your toes and roll ankles around to keep your feet healthy.
Request a referral. If you have chronic foot problems, ask your physician for a referral to a podiatrist, a doctor who specializes in foot care. A podiatrist can evaluate your gait and how your feet hit the ground, and can identify and correct problems such as when your feet roll inwards or outwards excessively. The podiatrist can order specialized shoes or shoe inserts, and help you develop an appropriate long-term foot care program.
Nail it. Pay special attention to your toenails. Keep them trimmed straight across, and don’t allow them to grow too long. Ask your doctor or nurse for help if you’re uncertain how best to prevent ingrown toenails or other nail problems. Your healthcare provider can trim your toenails for you if you cannot see or reach them. And skip the pedicures—unless you are absolutely certain that the person giving you a pedicure has experience working on the feet of clients with diabetes, it’s best to avoid salon foot care.
Check foot temperature. An infrared dermal thermometer can measure foot surface temperature—areas that later develop problems can be up to four degrees warmer than surrounding areas, even before those problems appear. These thermometers are available for purchase, but can be pricey. If this option doesn’t fit your budget, run your hands slowly over all portions of your feet during your daily foot inspection. If any area feels warmer than surrounding areas, watch it carefully for blister or ulcer development. Ask your doctor if you should protect that area with a bandage or cushioning product to prevent further issues.
(“Prevent diabetes problems: Keep your feet healthy,” NIH, http://www.niddk.nih.gov/health-information/health-topics/Diabetes/prevent-diabetes-problems/Pages/keep-feet-healthy.aspx)