10 Steps to Better Diabetic Foot Care

As a diabetic, you can have a loss of sensation (neuropathy) and/or poor circulation. Some patients are not even aware of these issues. Chronic nerve damage (neuropathy) can cause dry and cracked skin, which provides an opportunity for bacteria to enter and cause infection. The lack of feeling and poor blood flow can allow a small blister to progress into a serious infection in a matter of days. The consequences can range from hospitalization for antibiotics to amputation of a toe or foot.

For people with diabetes, careful, daily inspection of the feet is essential to overall health and the prevention of damaging foot problems. You need to be aware of how foot problems can arise from disturbances in the skin, nails, nerves, bones, muscles, and blood vessels. There is plenty you can do much to prevent amputation by adhering to the following important steps:

Follow the proactive measures discussed below and see your Facaros Foot & Ankle physician regularly.
It is imperative that your medical doctor strictly manages your disease and any/all concomitant vitamin deficiencies and other metabolic conditions. For these reasons, it is important the patient follows some simple foot care preventative measures. Below are recommendations for close monitoring of the diabetic foot:

1. Control your diabetes
   Work with your healthcare team to keep your blood sugar within a good range, as well as all other medical illnesses.

2. Inspect your feet daily
   Look at your bare feet every day for scratches, cuts, blisters, open wounds, red or warm spots, and swelling. If one foot is swollen or warmer than the other, that represents a potential urgent medical condition, and should contact a your foot and ankle physician. Use a mirror to check the bottoms of your feet or ask a family member for help if you have trouble bending your leg or seeing.

3. Wash your feet well daily, particularly in between your toes
   Wash your feet in lukewarm water, not hot, and with mild bath soap. Test the water temperature with your hand first. Do not soak your feet. Dry your feet well, particularly in between the toes.

4. Keep your skin soft and smooth
   Rub a thin layer of skin lotion over the tops and bottoms of your feet, but not between your toes. You should never trim or smooth corns and calluses yourself, nor cut your own toenails. Following evaluation by your foot and ankle physician and if your feet are at low risk for problems, you may be allowed to use a pumice stone or emery board to smooth corns and calluses, but it is IMPERATIVE you do not rub the skin too vigorously.

5. Be aware of ingrown toenails
   If you have an ingrown toenail, especially if it has turned red, hot, and swollen, see us at Facaros Foot and Ankle. Following evaluation by the doctor and if cleared to do so, toenails should be cut straight across. Never dig into the corners. Wear comfortable shoes that fit well and protect your feet. Walking or running shoes may be helpful for some diabetics.

6. Select the right footware
   When purchasing new shoes, always do so at the end of the day when your feet have natural swelling and are typically larger. Check how your shoe fits in width, length, back, bottom of the heel, and sole. Have your feet measured every time you buy new shoes because your foot does change shape over the years. Wear new shoes for only 2 hours or less at a time. Do not wear the same pair every day. Feel inside your shoes before putting them on each time to make sure the lining is smooth, and there are no objects inside, such as a small pebble or foreign object. Do not lace your shoes too tightly or loosely.

7. The right socks matter
   Choose socks and stockings carefully. Wear clean, dry socks every day and avoid socks with holes or wrinkles. Avoid stockings with elastic tops. Seamless socks are available for those with neuropathy. Therapeutic compression stockings are recommended if your feet and legs swell often. Wear socks at night if your feet get cold.

8. Protect your feet in the elements and over the counter remedies
   Wear protective footwear at the beach, swimming pool, or on hot pavement. Do not use strong antiseptic solutions, drugstore over-the-counter medications, heating pads, or sharp instruments on your feet. Do not put your feet on or near radiators, nor too close to a fireplace or heating lamp.

9. Stay active
   Keep active, promoting muscle strength and good blood flow to your feet. Wiggle your toes and move your ankles up and down for 5 minutes, 2-3 times per day. Stay aware on long walks to remember periodically remove your shoes and socks, checking for signs of redness or bruising.

10. Stop smoking
    If you smoke tobacco products, you MUST stop. Smoking damages blood vessels by decreasing the ability to deliver oxygen to your skin. When combined with diabetes, it significantly increases your risk of amputation.