What causes diabetic foot problems?
Neuropathy and blood vessel disease both increase the risk of foot ulcers. The nerves to the feet are the longest in the body, and are most often affected by neuropathy. Because of the loss of sensation caused by neuropathy, sores or injuries to the feet may not be noticed and may become ulcerated.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), at least 15 percent of all people with diabetes eventually have a foot ulcer, and 6 out of every 1,000 people with diabetes have an amputation. Nearly three quarters of all amputations caused by neuropathy and poor circulation could be prevented with careful foot care.
Prevention of diabetic foot problems
To prevent foot problems from developing, the NIDDK recommends that people with diabetes take care of the disease and its symptoms, and follow these suggestions for proper foot care:
- Check your feet and toes daily for any cuts, sores, bruises, bumps, or infections -- using a mirror if necessary.
- Examine your shoes before putting them on to make sure they have no tears, sharp edges, or objects in them that might injure your feet.
- Wash your feet daily, using warm (not hot) water and a mild soap. If you have neuropathy, you should test the water temperature with your wrist before putting your feet in the water. Physicians do not advise soaking your feet for long periods, since you may lose protective calluses. Dry your feet carefully with a soft towel, especially between the toes.
- Wear shoes that fit your feet well and allow your toes to move. Break in new shoes gradually, wearing them for only an hour at a time at first. After years of neuropathy, as reflexes are lost, the feet are likely to become wider and flatter. If you have difficulty finding shoes that fit, ask your physician to refer you to a specialist, called a podiatrist, who can provide you with corrective shoes or inserts.
- Cover your feet (except for the skin between the toes) with petroleum jelly, a lotion containing lanolin, or cold cream before putting on shoes and socks. In people with diabetes, the feet tend to sweat less than normal. Using a moisturizer helps prevent dry, cracked skin.
- Use an emery board or pumice stone to file away dead skin, but do not remove calluses, which act as protective padding. Do not try to cut off any growths yourself, and avoid using harsh chemicals such as wart remover on your feet.
- Cut your toenails straight across, but be careful not to leave any sharp corners that could cut the next toe.
- Avoid sitting with your legs crossed. Crossing your legs can reduce the flow of blood to the feet.
- Ask your physician to check your feet at every visit, and call your physician if you notice that a sore is not healing well.
- If your feet are cold at night wear socks. Do not use heating pads or hot water bottles.
- Wear thick, soft socks and avoid wearing slippery stockings, mended stockings, or stockings with seams.
- Never go barefoot, especially on the beach, hot sand, or rocks.