They may be our greatest supporters but, all too often, it’s only when our feet kick up a fuss that we pay attention to their needs. If we take the recommended 10,000 steps a day, over a lifetime, we’ll have walked roughly the equivalent of five times around the globe – in the region of 200,000 kilometres. If lots of these steps are taken barefoot, or in thongs or toe-crushing high heels, it’s little wonder if we’re left with a legacy of pain, disfigurement and poor mobility as the years march on.
Having diabetes can compound existing foot problems, especially if it’s poorly controlled. The combination of long-term diabetes and elevated BGLs increases the likelihood of complications with your feet.
Why poor blood glucose control is risky for your feet:
As your feet are the furthest body parts from the heart, they are particularly vulnerable if damaged blood vessels starve them of oxygen-rich blood and nutrients – these are vital for keeping tissue healthy and also aid in healing. Impaired blood flow also means antibiotic treatment is less successful in circulating and reaching infection sites.Nerve damage
Known as ‘peripheral neuropathy’, this condition is a loss or reduction in the ability to feel in the feet and lower legs. As a result, a person doesn’t often sense pain from a trauma, injury or infection. Some common sensations include burning, sharp stabbing and tingling pains, but they’re not always present with nerve damage.
Poor circulation and nerve damage can fast-track minor foot issues into major health problems – without due care, a scratch can turn into an ulcer, with infection leading to amputation in the worst-case scenario. Keeping BGLs well controlled will prevent or, at least, delay the development of diabetes complications, including foot problems. Keeping pace with changes in the way your feet look, feel and behave is a vital step in keeping complications at bay.
Here are simple ways to care for your feet – and most of them can be part of your daily routine.
Toe the line
Even if you’ve only recently been diagnosed with diabetes, your feet need to be checked. You may already have signs of wear and tear, such as cracked heels, corns and calluses, or blisters that require attention and that can lead to problems. You also need to know how to care for your feet, understand any specific problems that may affect them, as well as how diabetes affects them. See a podiatrist or attend a Diabetes Centre near you.
keep a look out
Pain is a protective mechanism that alerts you to discomfort from corns, calluses, bunions and trauma. You may be unable to sense pressure, sharpness, heat and cold. If you’ve lost the ability to feel, you need to use your eyes to detect problems instead of relying on the nerves in your feet.
Go to the expert
Whether you attend a specialist foot clinic for people with diabetes or you see a private podiatrist, placing your feet in the hands of a qualified podiatrist is a must.
Be familiar with your feet
Include your feet in your daily routine. Wash, dry and inspect them so you can pick up anything new or something that wasn’t there yesterday. Keep a light-coloured cloth for cleaning the feet and, that way, you’ll notice any blood if trauma has occurred.
Hail hairy toes
You might think that they’re unsightly, but hairy toes are often a sign of reasonable circulation. Keep an eye on how quickly your nails grow because, with decreased blood flow, they will often be slower to grow and your hair will be more sparse.
Know exactly where your feet stand
Understand whether your feet are at a high or low risk of developing problems. Low-risk feet have normal sensation and good blood flow. High-risk feet have nerve damage and/or poor blood flow. See your podiatrist and talk feet.
Book in for a service
Your feet should be serviced twice a year, just like your car. Ask your podiatrist to check the circulation and nerve function in your feet to keep them finetuned and healthy. With a close eye, changes will be picked up sooner and you’ll sleep easy knowing your feet are properly maintained.
Sock it right
Wear socks that are made of cotton, wool or a combination of fibres to absorb any sweat and allow your feet to breathe. Avoid socks with tight tops or those that are knee-high, as they can hinder the blood flow. Make sure the seams aren’t too bulky as they can rub and cause blisters. (Try Karma Soles predominantly cotton, seamless socks, which come with compression for the foot and leg and a loose-fitting top).
Smooth rough edges
Joint stiffness and clawing of the digits is a classic diabetic foot problem, which changes the mechanics of the foot. Your toes can become rigid and deformed, forcing pressure onto the ball of the foot as you walk. This leads to a build-up of protective skin, known as a callus. It is important to get prompt treatment or there is a risk that the tissue beneath the hard skin will break down into a wound, which will be far tougher to manage.
Turn down the heat
Avoid putting anything hot, such as wheat packs and hot water bottles, directly onto your feet, and steer clear of the heater, too. These can all cause serious burns to your skin without you noticing or feeling any pain or discomfort. Make sure you test the water with your elbow rather than your tootsies before having a bath or taking a shower for the same reason.
Look good in shoes
Your feet need to be protected with good shoes. Look for styles that are deeper and broader at the toes. Having shoes properly fitted at a specialist shop, such as The Athlete’s Foot, makes obvious sense. Some private health funds will contribute to the cost. Speak with your podiatrist about the options and ask them to check out your shoes.
Cut it fine
If your podiatrist says that it’s okay for you to cut your own nails, make sure you cut them straight across. Cutting them down the sides can create ingrown nails and and cause an infection. Also, don’t cut them too short and use a nailfile to file any sharp bits.
Keep some dressings handy in case of a foot injury. Even if it’s a minor cut, flush the area without soaking your feet. Then apply a non-adhesive dressing, which can be changed daily. If there’s no improvement or signs of infection occur, see your podiatrist or doctor immediately.
An area on your foot that is red, hot to touch and swollen can often indicate an infection or, in some cases, a fracture. Don’t delay in getting this checked out because, with impaired blood flow, the ability to heal and the slow delivery of antibiotics can keep it hanging around for longer. And, the longer the duration, the higher the risk of complications. Bear in mind that with poor circulation your feet can often feel cold and the signs may not be evident. If you’re unsure, it’s best to see your podiatrist or doctor straightaway.
Exercise is great for improving circulation, weight loss, fitness and blood glucose control. If you’re walking, make sure you have good shoes that your podiatrist has checked so you don’t cause any foot injuries. If you’re doing water sports or walking on the beach, wear a pair of soft surf shoes
for protection. Also consider other options such as swimming and aquarobics. Discuss your exercise ideas with your diabetes healthcare professional.
Damp or sweaty feet can cause skin breaks, and excess moisture between the toes increases the risk of fungal infections. Breaches between the toes and tinea are the most common entry sites for cellulitis – a serious bacterial infection. Dry well between your toes after washing and don’t put cream between them. Wear socks or stockings with your shoes to absorb any sweat.
With nerve changes, your skin becomes dryer, so moisturise your feet daily to keep your skin soft and supple. Use sorbolene, and if this doesn’t feed the thirst, try an urea-based heel balm. Remember to avoid putting moisturiser between your toes.
If you have diabetes, bare feet should be a thing of the past. Thongs and strappy sandals offer little support or protection. A stub to the toe is sometimes the initial insult to cause a potentially dangerous wound. Reduce your risk of injury by keeping your tootsies covered and safe.
Leave it to the professionals
Don’t take matters into your own hands and cut off calluses or corns with blades or other sharp objects, as you may inflict a wound. Putting your feet in a podiatrist’s hands should help prevent the problem from recurring. Likewise, corn removal pads contain acids that often inflict burns to the skin and can cause a wound. See your podiatrist to pare the corn.
Aim for optimum diabetes control as well as good overall health to reduce your risk of complications, including those with your feet. Eat a healthy balanced diet and eliminate risk factors such as smoking.