Diabetic Foot Problems
Diabetes can damage the nerves in your feet, as well as lead to blood vessel disease. These conditions make it harder to notice when you injure your foot or develop a sore.
The Mass General Diabetes Clinical Center is one of the oldest outpatient centers in the country dedicated to the comprehensive treatment of persons with diabetes, pre-diabetes, and associated disorders.
Diabetic Foot Problems
What causes diabetic foot problems?
Neuropathy and blood vessel disease both raise the risk for foot sores (ulcers). The nerves of the feet are the longest in the body. They often are affected by nerve injury (neuropathy). When a person with diabetes loses sensation in the feet, they may not notice sores or injuries until serious ulcers develop.
Preventing diabetic foot problems
To help keep foot problems from developing, the National Institute of Diabetes and Digestive and Kidney Diseases recommends that people with diabetes take care of the disease and its symptoms. They suggest the following for correct foot care:
Check your feet and toes daily for any cuts, sores, bruises, bumps, or infections . Use a mirror to look at the bottom of your feet. Or ask someone to help you.
Check your shoes before putting them on to make sure they have no tears, sharp edges, or objects in them that might harm your feet.
Wash your feet daily with warm (not hot) water and a mild soap. If you have neuropathy, test the water temperature with a thermometer or your wrist or elbow before putting your feet in the water. Healthcare providers don't advise soaking your feet for long periods. Dry your feet carefully with a soft towel, especially between the toes.
Wear shoes that fit your feet well and let your toes move. Break in new shoes gradually. Wear 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 trouble finding shoes that fit, ask your primary healthcare provider to refer you to a foot specialist (podiatrist). This healthcare provider can give you corrective shoes or inserts.
Except for the skin between the toes, cover your feet with petroleum jelly, a lotion containing lanolin, or cold cream before putting on shoes and socks. For people with diabetes, the feet tend to sweat less than normal. Using a moisturizer helps prevent dry, cracked skin. Put talcum powder or cornstarch between your toes to keep these areas dry.
Use an emery board or pumice stone to file dead skin, but don't remove calluses using sharp tools. Don't try to cut off any growths yourself. Don't use 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.
Don't sit with your legs crossed. Crossing your legs can reduce the flow of blood to the feet. Don't smoke. Elevate your legs when you are sitting. Wiggle your toes several times a day to keep the blood flowing.
Ask your healthcare provider to check your feet at every visit. Call your healthcare provider if you notice that a sore is not healing well. Take your shoes and socks off while you are waiting for your appointment to start.
Wear socks if your feet become cold at night. Don't use heating pads or hot water bottles.
Wear thick, soft socks. Don't wear slippery stockings, mended stockings, or stockings with seams.
Never go barefoot, especially on the beach, hot sand, or rocks.
The American Diabetes Association (ADA) recommends that if you have a cut or break in your skin, or develop an ingrown toenail, call or see your healthcare provider. The ADA also says to contact your healthcare provider if your foot or feet change color, shape, or just "feel funny." This might be pain or loss of feeling. If the pulses in your feet are weak, your healthcare provider may send you for a test of the pulses in your arms and legs. This is to see if you have any blockages or narrowing in the arteries to your feet.
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