Diabetic Foot Care: Easy Steps to Healthier Feet
At a diabetes education appointment, we talk about a lot of things. Typically, the patient guides the appointment, and we cover the topics that are important to them, while still focusing on certain key issues, such as checking blood sugar levels, getting exercise, and identifying carbohydrates, for example.
I’ll often ask, “So, how are your feet?”
Some of the patients will know right away where I am going with this question because their physician has already gone through the importance of checking their feet and daily foot care. Others look at me, dumbfounded, and say, “They’re fine. Why do you ask?
So, let’s talk about it.
Why Diabetic Foot Care is Important
Did you know diabetic foot complications account for up to 25 percent of all diabetes-related hospital admissions?
That’s a large high number. This is because when blood sugar levels become out of control, they can wreak havoc on your body, causing a myriad of complications in the lower extremities (not to mention in other areas of the body).
For example, nerve damage, also known as peripheral neuropathy, can lead to decreased nerve sensation. This can then cause decreased circulation.
These two conditions coupled together are a disaster – if you can’t feel your extremities, you may not know that you have a wound, and if you don’t have adequate blood flow to the wound, it won’t heal as quickly as it should.
Daily Foot Checks
Now that you know why it is so important to take care of your feet, let’s discuss how to check your feet!
Follows these steps systematically each time you check your feet:
- Your feet should be bare so that you can examine the entire foot. A good opportunity to perform the exam is before or after showering, or before putting on socks.
- Examine the entire foot – the top of the foot, the bottom of the foot, the sides, the heels, and in between each toe.
- Use a hand-mirror if you can’t see the entire foot, or enlist a friend or family member for help.
- You are looking for anything out of the ordinary – scrapes, bruises, blisters, redness, or cuts. Contact your physician if you notice anything. It may not be anything to worry about, but it is better to err on the side of caution.
Watch out for Common Foot Conditions
Not everyone will experience problems with their legs and feet, but the following two complications are relatively common among people with diabetes:
- Diabetes peripheral neuropathy (DPN). This condition causes damage to the nerves in the feet. The tingling sensation is annoying, but it becomes dangerous when you can no longer feel the pain of scrapes and cuts, since neglecting treatment can lead to major infection.
- Peripheral arterial disease (PAD). This disorder interferes with the circulation of blood and fluid, which can numb the legs and feet. Without proper circulation, your body is not able to heal cuts or bruises as quickly or effectively.
Tips for Washing
The first step to good diabetic foot care is washing your feet properly, which also means knowing what ingredients and techniques to avoid.
Washing your feet seems like a pretty straightforward chore, but there are some things to keep in mind to avoid an unwelcome aftermath. You can stay free of infection, injury, and discomfort if you:
- Maintain water warm: It’s vital that your water remains lukewarm since hot water can irritate or burn your skin without you realizing it. If you have nerve damage, your feet may not be able to sense the heat, so use your elbow to test the water – the temperature should be appropriate for a baby’s bath.
- Use mild soap: Fragrances, exfoliating beads, and ultra-moisturizers are too much for your sensitive skin, so keep your soap natural and fragrance-free. Look for plant-based ingredients, and avoid harsh chemicals like Triclosan (an antibacterial compound), sodium laurel sulfate (SLS) and parabens.
- Dry thoroughly: Damp feet can be a breeding ground for bacteria, plus they will be more prone to cold (which further decreases circulation). Use a soft, absorbent towel to pat your feet dry, paying extra attention to the spaces between toes and any cracks or scratches. Be sure to bandage up cuts or scrapes right away, before they can become infected.
- Don’t soak: It’s fine to dip your feet in a tub for a few minutes, but the longer they soak, the more your skin softens. Once it begins to break down, your skin is much more prone to infection.
Daily Foot Care
So you now know how to perform a foot check on your feet. Let’s discuss how to care for your feet, which is also of the utmost importance!
First of all, your feet should be kept clean. Wash your feet daily with soap and water. You do not need to use a special soap to keep your feet clean – in fact, harsh soaps can damage the skin, and damaged skin can allow in infections. The water temperature should be warm as opposed to hot, especially if you have peripheral neuropathy.
It is important that your feet be kept clean because cuts and abrasions are openings for infection and clean skin can prevent infection.
After washing your feet, it is important that you dry your feet completely with a towel. Putting socks on wet feet can allow moisture to build, and infection can breed in moist areas.
Keep skin supple by applying lotion. Dry skin can crack, cracked skin can become infected.
Here are some other habits to adopt:
- Do not walk barefoot. Shoes and slippers act as a barrier between you and obstacles that may hurt your feet.
- Take steps to prevent your feet from heat extremes.
- If you have warts, corns, and calluses, see your physician or a podiatrist to remove them. Do not attempt to remove them on your own.
How to Develop a Good Foot Hygiene Routine
Although it’s an essential element, washing is only one part of a healthy diabetic foot care routine. To catch problems before they turn into emergencies, develop a regular and holistic approach to your foot health:
- Close observation: Get in the habit of looking at your feet often: check all sides and surfaces for scrapes, blisters or ingrown toenails, and use a hand-held mirror to help you see the soles of your feet. The sooner you spot a problem, the easier it is to deal with it, and the less likely you’ll be faced with an infection. While you’re at it, keep your toenails well-trimmed to avoid breakage or undue pressure on the nail bed.
- Frequent care: Wash your feet at least once a day. It’s a good idea to begin your morning routine with a foot wash, and end your evening with another right before you go to bed. Be sure to dry them carefully, especially between the toes.
- Moisturize your heels and soles: Apply lotion everywhere except between the toes. This will help prevent cracks in your skin, which could lead to infection. Use a lotion suitable for sensitive skin, and be sure to wipe off any excess that isn’t absorbed.
- Wear socks and shoes that fit well: Clean, white socks will reveal any blisters, cuts or other drainage issues, and comfortable, well-fitting shoes will let your feet breathe and distribute pressure evenly.
- Keep your feet and ankles active: Draw circles with your legs, wiggle your toes and flex your feet throughout the day to promote circulation. Regular, moderate exercise will keep your legs in good working order, so try to walk, swim, bike or practice yoga at least a few times each week.
- Monitor the overall look and feel of your feet: Check out your feet daily, and compare them for changes or imbalances in size and temperature. Sometimes a change in one foot can signal a more serious issue in that side of the body.
- Know when to see a doctor: Whether it’s something obvious, like an ingrown nail, or a more subtle change, like a blister, it’s always better to be safe than sorry when it comes to your feet. Bleeding and blistering demands a trip to the doctor right away, but even bruising or changes in sensation can spell trouble.
It can be helpful to keep a foot care checklist in the bathroom, so you don’t forget an important step or overlook a troublesome transformation. Write down changes in appearance (yellowing toenails, dry skin, corns), as well as changes in feeling (itching, sore scratches, blisters, warmth).
Relay any concerns to your doctor right away, but in any case, be sure to have your feet examined at your next scheduled appointment.
Tips for Treating Foot Injuries
Keeping your feet clean and dry is the best way to deal with a minor injury, but visit your primary care physician or podiatrist (foot disorder specialist) for more severe problems. If you find a wart, corn or other new growth on your foot, consult your doctor before trying to treat it at home. Steer clear of tight-fitting bandages, heating pads and foot soaks, too – they can worsen symptoms or cut off circulation.
Once your feet are back on track, connect with a pedorthist (orthotic and footwear specialist) for help and advice on how to prevent future foot issues, so you can stay active and comfortable for years to come.