AND FOOT DISEASE
In a recent survey, it was found that about
86,000 lower limbs are amputated annually due to complications
from diabetes. Most people with diabetes are aware that their
condition may lead to foot numbness, foot ulcers, foot
infections and, potentially, an amputation.
What can go wrong?
If you have diabetes, you would want to
avoid serious foot problems that can lead to a toe, foot, or leg
amputation. What should be done? It's all about taking good care
of your feet.
Foot care is very important for each person with diabetes, but
especially if you have:
1 Loss of feeling in your feet.
2 Changes in the shape of your feet.
3 Foot ulcers or sores that do not heal.
Nerve damage can cause you to lose feeling
in your feet. You may not feel a pebble inside your sock that is
causing a sore. You may not feel a blister caused by poorly
fitting shoes. Foot injuries such as these can cause ulcers
which may lead to amputation.
Keeping your blood glucose (sugar) in good control and taking
care of your feet every day can help you avoid serious foot
There is a lot you can do to prevent serious problems with your
feet. Here's how.
1. Take care of your diabetes.
Make healthy lifestyle choices to help keep your blood
glucose (sugar), blood pressure, and cholesterol close to
normal. Doing so may help prevent or delay diabetes-related foot
problems as well as eye and kidney disease.
2. Check your feet every day.
You may have serious foot problems, but feel no pain. Check
your feet for cuts, sores, red spots, swelling, and infected
toenails. Find a time (evening is best) to check your feet each
day. Make checking your feet part of your everyday routine. If
you have trouble bending over to see your feet, use a plastic
mirror to help. You also can ask a family member or caregiver to
help you. Make sure to call your doctor right away if a cut,
sore, blister, or bruise on your foot does not begin to heal
after one day. If your toe looks blue or dusky, beware it may be
3. Wash your feet every day.
Wash your feet in warm, not hot, water. Do not soak your
feet for too long, because your skin will get dry.
Before bathing or showering, test the water to make sure it is
not too hot. You can use a thermometer (90° to 95° F is safe) or
Dry your feet well. Be sure to dry between your toes. Use talcum
powder or cornstarch to keep the skin between your toes dry.
4. Keep the skin soft and smooth.
Rub a thin coat of skin lotion, cream, or petroleum jelly on the
tops and bottoms of your feet.
Do not put thick lotion or cream between your toes, because this
might cause an infection.
5. Smooth corns and calluses gently.
If you have corns and calluses, check with your doctor or foot
care specialist about the best way to care for them. If your
doctor tells you to, use a pumice stone to smooth corns and
calluses after bathing or showering. A pumice stone is a type of
rock used to smooth the skin. Rub gently, only in one direction,
to avoid tearing the skin. Do not cut corns and calluses.
Don't use razor blades, corn plasters, or liquid corn and callus
removers -- they can damage your skin.
Make sure to call your doctor right away if a cut, sore,
blister, or bruise on your foot does not begin to heal after one
6. Trim your toenails each week or when
needed. Trim your toenails with clippers after you
wash and dry your feet.
Trim toenails straight across and smooth them with an emery
board or nail file.
Don't cut into the corners of the toenail.
If you can't see well, if your toenails are thick or yellowed,
or if your nails curve and grow into the skin, have a foot care
doctor trim them.
7. Wear shoes and socks at all times.
Wear shoes and socks at all times. Do not walk barefoot -- not
even indoors -- because it is easy to step on something and hurt
your feet. This may be hard to do in Singapore, if you feel it
is not possible to wear shoes and socks all the time, be extra
Choose clean, lightly padded socks that fit well. Socks that
have no seams are best.
Check the insides of your shoes before you put them on to be
sure the lining is smooth and that there are no objects in them.
Wear shoes that fit well and protect your feet.
8. Protect your feet from hot and cold.
Wear shoes at the beach or on hot pavement. Keep your feet
away from radiators and open fires. Do not put hot water bottles
or heating pads on your feet. Wear socks at night if your feet
get cold. Lined boots are good in winter to keep your feet warm.
Check your feet often in cold weather to avoid frostbite. In
Singapore, people are fond of doing the "pebble" walk to massage
their feet. This is not advisable if you have diabetes!
9. Keep the blood flowing to your feet.
Wiggle your toes for 5 minutes, 2 or 3 times a day. Move your
ankles up and down and in and out to improve blood flow in your
feet and legs.
Don't cross your legs for long periods of time.
Don't wear tight socks, elastic or rubber bands, or garters
around your legs.
Don't smoke. Smoking reduces blood flow to your feet. Ask for
help to stop smoking.
Work with your health care team to control your HbA1c, blood
pressure and cholesterol.
10. Be more active. Ask your
doctor to help you plan a daily activity program that is right
for you. Walking, dancing, swimming, and bicycling are good
forms of exercise that are easy on the feet. Avoid activities
that are hard on the feet, such as long-distance running and
Always include a short warm-up and cool-down period.
Wear athletic shoes that fit well and that provide good support.
11. Be sure to ask your doctor to check
the sense of feeling and pulses in your feet.
This should be done at least once a year.
What can I do
about the numbness in my feet?
Some patients have persistent tingling or
numbness or even pain in their feet. This may be due to nerve
damage (neuropathy). Be sure to tell your endocrinologist. New
medications like gabapentin have been found to be helpful for