The most common reason diabetics are hospitalized in the United States is foot infections. I know that’s hard to believe, but true. Diabetes can be dangerous and devastating to your feet. The most common causes of these foot infections are improperly cut toenails and poorly fitting shoes. Yes, something as simple as a visit to the podiatrist to have your toenails cut and shoes custom fitted can avoid many amputations. Sadly, the amputation rate is trending upwards not down in the United States. Add common complications of diabetes like poor circulation and lack of feeling known as peripheral neuropathy, and you have the prescription for disaster for diabetic feet.
What is a diabetic to do to protect their feet from a sore that can lead to infection and amputation?
1. Inspect your feet daily. If you can’t see your feet, have someone else look at them every day for redness, cuts, swelling, blisters, bruising, or nail problems.
2. Wash your feet daily. Sounds simple, but many people do not bathe their feet daily. Make sure to clean in between your toes and dry them thoroughly.
3. Moisturize your feet daily. Again, a simple habit to get in to, yet most people fail to upkeep their skin every day. Diabetes can cause very dry, flaky skin, so extra moisture is needed.
4. Cut nails very carefully, and straight across. If you can see and reach your toes, be careful to cut your toenails carefully, taking time not to nick yourself or cut them too short. When in doubt, visit the podiatrist at least every 8 to 10 weeks. The podiatrist would rather cut your toenails for you than treat an infection caused by your own handiwork!
5. Never trim corns and calluses. And absolutely no corn or callus remover! The package says, “Do not use if you are diabetic” for a reason. Have the podiatrist trim them when they are thickened or red.
6. Wear clean, dry socks. And change them daily…..sounds simple, but you would not believe how many people don’t.
7. Avoid tight or bulky socks. Tight socks can reduce circulation to you feet and bulky socks can bunch up and cause a blister or sore. Check your socks before you put them on and remember that they do shrink with age. Replace them periodically.
8. Wear socks to bed. If your feet are cold, wear clean socks to bed. Never use a heating pad or hot water bottle, you can burn yourself before you realize it! You can warm the bed with a heating blanket, but turn it off before you go to sleep!
9. Shake out your shoes and inspect them before you put them on. I have taken everything from a pebble, piece of basket and a doll house chair out of the bottom of diabetic feet after they walked on them all day. Easy thing to avoid!
10. Keep your feet clean and dry. No puddle splashing or snow drifts for your feet!
11. Never, never, never go barefoot. Not even at home on carpet. You can step on something easily and get an infected puncture wound. Think tacks, sewing needles, even wiry dog hair can be a problem!
12. Take care of your diabetes! Multiple studies have shown the complications of diabetes can be diminished by keeping your sugars under control. Keep that HgA1c under 6 if you can. This is hard to do by yourself. Work with your doctor and nutritionist for optimal care. Communicate often with your medical team.
13. Don’t Smoke! Stop smoking if you do. Ever cigarette decreases the circulation to your feet and increases your chance of a non-healing wound.
14. Get periodic foot exams. The recommendations are to have a foot exam at least once a year by your doctor even if you have no foot symptioms. A trip to the podiatrist is recommended at least quarterly if you have neuropathy, a foot deformity, poor circulation, or have had a history of a foot ulcer.