Why is foot care important to people with diabetes?

Diabetes can cause nerve damage (called peripheral neuropathy) that reduces sensation in your feet. If you have neuropathy, you can have an injury or condition on your foot that requires medical care without even knowing it. Small injuries may become infected. Diabetes may also affect blood flow in your legs and feet, making it harder for cuts or sores to heal. Then a small infection can become very serious. Foot infection is the most common reason for hospitalization of people with diabetes. And foot ulcers and non-healing wounds are the primary causes of amputation in people with diabetes. With proper foot care, however, it is estimated that as many as half of these amputations could be prevented.

What kind of foot problems do people with diabetes have?

Just like anyone else, people with diabetes can develop the following kinds of foot conditions:

		Corns and calluses are thick layers of skin caused by too much rubbing or pressure on the same spot.
		Blisters can form if shoes always rub the same spot, or from wearing shoes that do not fit or wearing shoes without socks.
		Ingrown toenails occur when an edge of the nail grows into the skin, which can then get red and infected. Ingrown toenails can happen if you cut into the corners of your toenails when you trim them. This condition can also be caused by wearing shoes that are too tight.
		A bunion forms when the big to slants toward the small toes, and a bump forms at the base of the big toe. This spot can get red, sore, and infected. Bunions often run in the family and can also be caused by wearing shoes with pointed toes.
		Plantar warts, which form on the bottom of the feet, are caused by a virus. They tend to go away without treatment.
		Hammertoes form when a foot muscle gets weak, shortening the tendons, which then retract the toe, causing it to curl under the foot and creating a bump at the joint on the top of the toe. These areas can become sore, and hammertoes can cause problems in walking and in finding comfortable shoes.
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		Dry skin can become cracked, allowing germs to enter.
		Athlete's foot is caused by a fungus that causes redness and cracking of the skin.

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Checklist for Healthy Feet

Daily exam:

• Look for cuts or sores
• Check for warning signs: redness, swelling, warmth, pain, slow healing, dry cracks, bleeding corns or calluses, tenderness, loss of sensation

Daily care:

• Wash your feet daily and dry them carefully, especially between the toes
• Use talcum powder
• Do not cut corns or calluses - use a foot care specialist if needed
• Keep toenails trimmed and smooth
• Promptly treat dry skin or athlete's foot
• Keep blood glucose under control

Periodic foot exam by your healthcare provider:

• Once a year for everyone, every 3 - 6 months for people at high risk
• Take off shoes and socks at every doctor visit
• Check for sensation and foot pulses
• Ask for a risk evaluation

Footwear:

• Wear shoes and socks at all times
• Don't wear shoes or socks that are too tight
• Wear well-cushioned shoes
• Buy shoes that are roomy and "breathe"
• People with diagnosed foot problems may need special footwear