Friday, April 12, 2024
DIABETES Diabetic Foot Problems

Top 15 Tips for Diabetic Foot Care (From a Podiatrist)

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When you have diabetes, you may experience a lack of sensation in your feet due to neuropathy. This can place you at high risk of developing cuts, blisters, and ulcerations (open sores) due to a lack of sensation in your feet. 

What’s worse is that if you have poor blood flow in your feet, you may experience additional complications such as the inability to heal open sores. This can place you at high risk for developing a foot infection. 

This is why practicing proper diabetic foot care is so important when you have diabetes. Preventing problems such as ulceration and infection is important. Complications from diabetes can lead to amputation. It’s best to avoid foot problems from occurring in the first place. 

In this article, we’ll discuss how to properly take care of your feet to prevent complications from occurring. 

Let’s dive in…

doctor checking foot

Check Your Feet Daily

This seems like a simple statement, but when was the last time you stopped for a few minutes during the day to check the bottoms of your feet? Did you check the area in between your toes? 

When people have neuropathy, they cannot feel the bottoms of their feet. It is much easier to step on a splinter or develop a blister when wearing shoes. 

Not only that, due to being immunocompromised, diabetics tend to develop fungal infections more easily than people who are not diabetic. Fungal infections love to thrive in wet, moist environments, like in the skin between your toes. The area between your fourth and fifth toes accumulates the most sweat.

Make sure when checking your feet that you are checking the skin between your toes to check for fungus. The fungus between the toes will look white and yellow. Also, check the bottoms of your feet for fungus. It will appear scaly or itchy with red dots.

You may also notice fungal infections in the nails. Fungal infections in the nails can look yellow/white and can cause your toenails to become thick. 

You should be checking your feet regularly, preferably at least two times a day. If you cannot reach down to check your feet, have someone help you. 

Another tip is to prop a mirror against a wall and lift your feet to check the bottoms of your feet. 

washing feet

2. Wash and Dry Your Feet 

Make sure you wash your feet with hypoallergenic soaps daily. After washing your feet, make sure to dry your feet gently and thoroughly, including the area in between your toes. 

Many diabetics have hammertoes and other foot deformities. This can cause the toes to crowd together. When the space between the toes is small, debris can easily accumulate between the toes. This is why it is important to clean and dry the skin between the toes. 

If you need help wicking moisture away from the toes, place cotton or lambs wool between each of the toes until the web spaces fully dry. 

trim toenail

3. Trim Your Toenails Appropriately

Diabetics will often develop ingrown toenails. Ingrown toenails occur due to irritation against tight shoes/socks, improper trimming of the nails, and genetics.

When trimming your toenails, allow the nail to grow 2mm past the edge of your toe and then cut straight across. By doing this, you can prevent ingrown toenails. Avoid digging into the corners of your toenails.

This can cause the nail to grow abnormally into the tissue surrounding the nail. This can cause an infection. 

To read more about ingrown toenail surgery, check out this supplemental post. 

white tennis shoes

4. Wear the Right Shoes and Inserts

When you have diabetes, you must wear the right shoes and inserts. This is because the skin is sensitive, and shoes that are too constrictive or loose can cause wounds and blisters to form. 

As mentioned previously, diabetics often develop foot deformities such as hammertoes (bent toes), and bunions. This can make finding shoes difficult. 

Diabetic shoes would be a great option. They come in many different types and can accommodate foot deformities well. The inside of the shoes are soft and the soles of the shoes are rigid and supportive. 

Diabetic inserts are also important when you have neuropathy. Diabetic plastazote inserts help to prevent sheer and blisters. Not only that, your foot doctor can arrange for you to get custom diabetic inserts that can help take pressure away from certain areas in your feet. This becomes very important if you have an ulcer. Removing pressure from a sore can help it heal. 

If you cannot get diabetic shoes and inserts, make sure to go to a shoe store and have your feet measured for length and width. 

Go at the end of the day when your feet are the most swollen. The orthotist at the shoe store or your foot doctor can provide you with recommendations on shoe gear that would best fit your feet. 

Read this Detailed Guide On How Bad Shoes Can Cause Foot Pain.

protecting callus

5. Avoid Self-Trimming Corns and Calluses

Corns and calluses form from excess pressure in certain areas of the feet. When corns are present on the top of your toes, it can occur from rubbing against your shoes. Avoid the urge to self-treat your corns and calluses. Remember, the skin of diabetics is very sensitive. 

Corns and calluses should be trimmed by your foot doctor. They are trained to do this safely to prevent injury. Diabetic wounds can take a long time to heal. It’s best to avoid creating one yourself. 

However, it is possible to remove some dead tissue from your corns and calluses. Wash your feet and dry them to soften the corns and calluses. Gently use a pumice stone to remove the outer layer of dead tissue at the site of the callus/corn. Apply a moisturizer such as a coconut oil or Vaseline to soften the area. 

Offload corns and calluses appropriately using digital corn pads and donut pads. You can find these on Amazon.

Avoid corn pads that contain medications such as Salicylic acids. This can cause blister formation and ulcers to form. 

Read more about how to offload toes in this post: 7 Things You Didn’t Know That May Have Caused Your Hammertoes

walking barefoot on grass

6. Avoid Walking Barefoot

Did you know that a lot of foot ailments, such as fungal infections and warts occur from walking barefoot? Fungal infections and warts are contagious and are easily acquired in diabetics who walk barefoot. 

Check out this article for more information on foot warts: Plantar Warts on the Feet: Causes, Symptoms & Treatment of Foot Warts

Not only that, bacterial infections can occur from walking barefoot as well. Small cuts in the skin can easily become infected. Staphylococcus aureus is a very common organism present in diabetic foot infections. 

Wearing shoes to protect your feet when you have diabetes is so important. Make sure you wear sandals if you are in communal areas such as swimming pool floors and locker rooms. 

woman walking through forest path

7. Increase Your Activity

If you can, try to walk more. The American Heart Association recommends adults perform 150 minutes of moderate-intensity activity per week in addition to moderate- to high-intensity muscle-strength training 2 days per week minimum.

Walking can help reduce swelling in your legs. The muscles in your legs pump the blood flow back to your heart. This becomes very important especially during hot weather when swelling in the legs increases. 

Read more about why your feet swell in hot weather in this supplemental article. 

If your legs and feet become too swollen, this places you at higher risk for developing wounds and sores. Not only that, swelling can feel uncomfortable and even painful. 

woman drinking water

8. Drink More Water

It’s important to stay hydrated when you are a diabetic. A large number of the population is chronically dehydrated. 

Adults who perform mild to moderate activities should aim to drink 2.5L-3.5L of water a day. When you are dehydrated, your feet and legs will swell. Drinking more water can help flush excess fluid out of the body.

Read more about foot swelling from dehydration in this supplemental post.

moisturize feet

9. Moisturize Your Feet

A daily application of moisturizer to your feet is essential. The skin of diabetics tends to be drier due to autonomic effects on the body. This can cause dry cracks in the skin. 

Diabetics tend to also develop heel fissures. If the dry skin is not addressed, the fissures can deepen and get infected. 

Simple moisturizers such as Vaseline and pure coconut oil can be beneficial. Apply it to your feet at night time. You can also cover your feet using saran wrap to lock in the moisture for a few minutes. 

If you need something stronger, you can try Urea 40% cream. You can find this on Amazon. Urea is a keratolytic that breaks down the hard keratin in the skin. 

To read more about how to manage cracked heels check out this post: 6 Interesting Reasons Why Your Feet Crack (With Helpful Tips)

socks

10. Wear the Right Socks

Socks can irritate the feet when they are too tight. In addition, certain materials can cause your feet to sweat more. Try wearing diabetic socks. They provide an extra cushion with a light amount of compression to help with swelling. 

You can also choose socks that help prevent sweating. Merino wool socks are a great option to help prevent sweaty feet. 

To read more about why your feet sweat and how to treat it, check out this supplemental post.

soaking feet

11. Soak Your Feet in Lukewarm Water

Avoid soaking your feet in water that is too hot or too cold. Diabetics who have severe neuropathy often cannot feel the difference between hot and cold temperatures. Use your fingers or elbow to check the water temperature before you put your feet in the water. 

Avoid soaking in harsh chemicals like peroxide. Soak your feet only in water. Epsom salt soaks are okay as well. 

person holding cigarette

12. Quit Smoking

Did you know that smoking can impact wound and bone healing? When you smoke daily, wound healing can be delayed. This can be detrimental in people with diabetes who are trying to heal their foot wounds. This can lead to increased infections. 

Not only that, smoking can impact how quickly your body can heal after surgery. If you undergo an incision and drainage procedure to evacuate a pus pocket, smoking can delay the healing of your wound.

female feet

13. Assess Your Skin Temperature

Do your feet feel cold? Have you noticed hair loss in your toes? Do you notice cramping in your legs and feet that is relieved when you sit down? This could be a sign of peripheral vascular disease. 

Check to see if you can feel your dorsalis pedis and posterior tibial pulse. These are the two major pulses that supply blood flow to the feet. 

Here’s a video demonstrating how to check pedal pulses properly. 

Check capillary refill time to the toes. Push on the tips of your toes and see how quickly the blood flow returns to the toes. If it takes longer than 3-4 seconds for the blood flow to return to your toes, then you may have peripheral vascular disease. 

If you have any of these symptoms, make sure to contact your foot doctor. Your doctor may order arterial testing to assess the blood flow in your feet. Your doctor may refer to a vascular surgeon if there is severe blockage in the blood flow to your feet. 

bunion

14. Offload Foot Deformities

If you have a bunion that is rubbing against your shoe and you cannot get another pair of shoes, get a bunion donut pad to help offload the bunion. This can help prevent sores. I prefer Dr. Jill’s 1/8″ bunion felt donut pads. You can purchase them on Amazon.

If you have hammertoes and have painful corns, use Dr. Jill’s digital corn pads. You can apply them on the top of your toes and this will prevent your shoes from rubbing against your toe. They stick well and are disposable.

If you have a corn between your toes, you can use digital corn pads or toe spacers. This will prevent your toes from rubbing against each other.

If you prefer using a toe spacer, get gel toe spacers with digital sleeves. The added sleeves help to prevent your toe spacer from sliding when you are walking.

Simple offloading modalities can go a long way in preventing sores. 

doctor holding i pad

15. Make an Appointment With a Podiatrist

If you have diabetes, you should get a diabetic foot exam done by a Podiatrist. Depending on your level of risk, your doctor may recommend you follow up every 3 months to 6 months. If you are at high risk for developing ulcers and infections, your doctor may suggest you follow up sooner. 

Your foot doctor will alert you about any problems they may notice with your feet and what you can do to solve these issues.

If you notice any signs of infection in the feet such as redness, swelling, or pus in your feet, you should contact your doctor immediately. If you cannot see your doctor, you should go to the Emergency room. 

Related articles: Diabetic Neuropathy in the feet- A Simple Treatment Guide

How often do you get your feet checked? I would love to hear your thoughts! Leave a comment below!

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Vaishnavi Bawa
Dr. Vaishnavi Bawa is a Podiatrist who specializes in treating foot and ankle pathology. LifesLittleSteps mission is to educate the public about foot health in an easy-to-understand manner using evidence-based medicine.
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