David didn’t realize the serious nature of the blister on the bottom of his left foot. He thought the “blister” would go away, and decided not to mention it to his doctor. Unfortunately, David soon discovered that a high blood sugar level, tight fitting shoes and a blister can lead to serious consequences.
Over the course of a few short weeks, the blister continued to get larger, and he could no longer wear his shoes or sneakers on his left foot. David started to wear hiking boots during the day and walked around barefoot at home. He tried soaking his foot at night, but the blister continued to get worse.
One morning after taking a shower, David noticed that the area around the blister had a terrible odor. His left foot swelled to three times its usual size and he became very concerned. He went to the urgent care clinic, and they immediately sent him to a local hospital where he received large dosages of antibiotics. David received intravenous antibiotics for a month, and worked closely with his health care team to get his blood sugar levels under control. David is now acutely aware of the important role that proper foot care plays when it comes to managing diabetes.
Between 60 and 70 percent of people with diabetes experience a loss of sensation in their lower legs and feet known as diabetic neuropathy. This condition puts you at great risk for blisters and other foot wounds that can become infected. If the wound can't be treated, amputation of the affected toe or foot may become necessary.
If you have diabetes, here are 10 top foot care tips to help keep your feet healthy:
1. Keep your blood sugar within a target range. If your blood sugars remain elevated or out of target range, it may cause damage to your nerves and blood vessels. The circulation of blood to your feet may eventually become narrowed or blocked. Over time, high blood sugars could cause the nerves going to your feet to become inefficient, which in turn could lead to a loss of feeling for pain in your feet known as “diabetic sensory neuropathy." That's where the problems start: A cut or a blister typically causes pain. But if sensation in the feet is diminished, a blister or cut can easily go unnoticed until it gets infected. One of the best ways to prevent problems with your feet is to do your best to keep your blood sugar within target range by taking your medications and insulin as prescribed, eat a healthy diet and stay physically active.
2. Quit smoking. Poor circulation is 20 times more common in people with diabetes, and proper circulation is essential for a foot wound to heal. Add smoking into the mix, and you're looking at seriously diminished blood flow to your feet and make wounds heal more slowly. If your circulation is impaired, you will have a more difficult time healing a foot wound like a blister or a cut. Therefore, if you smoke, it’s important to quit right away. Contact your health care provider today for help to stop smoking.
3. Inspect your feet every day. Look at each foot from top to bottom and check carefully in between your toes. If you have any cuts, blisters or swelling, please contact your doctor right away. When you examine your feet, make sure you are in a well-lit room, and use a mirror to see the bottom of your feet. One trick is to put your foot across the opposite knee so you are close enough to see the top and the bottom without straining. Remember, there are no excuses for avoiding daily foot self-exams! If you can’t see the bottom of your feet, ask a family member or close friend to look for you.
4. Clean your feet daily. Keeping your feet clean is an essential part of daily foot care. Wash your feet from top to bottom every day Remember to wash the area between your toes and under your feet. This ritual will help you notice if there are any changes in your feet, too. Make sure to use lukewarm water, mild soap and a soft cloth or gentle sponge. Avoid the temptation to soak your feet in very warm or hot water. Soaking your feet may cause the cracks in your feet to open and cause an infection.
5. Always keep your feet clean and dry. After you are done washing your feet, make sure you dry them thoroughly, especially between your toes. Be gentle and don’t rub your feet vigorously when drying.
6. Slather on the moisturizer. Apply moisturizer to your feet at least once a day; if you have very dry skin, do this 3 to 4 times a day. The best moisturizers contain olive, almond, jojoba, vegetable oil or aloe vera. Always avoid moisturizer and lotions with alcohol. As alcohol evaporates it takes moisture from the skin. If you are allergic to certain scents, avoid moisturizers with perfumes and dyes. If you typically shower before bed and your feet are super dry, try this quick tip: Dry feet thoroughly, apply lotion to your feet, and put a pair of socks on. Having feet covered overnight will help the moisturizer soak in. Plus, your bed sheets stay clean.
7. Select the proper socks. Choose socks made of synthetic fibers such as Hi-bulk acrylic. These fibers draw moisture away from the skin so that it can evaporate, reducing the chance of developing an infection. Select socks without tight elastic bands, to help circulation. Toss any socks with holes and stay away from nylon stockings (as nylon is not a breathable fabric.) Always wear clean socks and change them out if they get wet from perspiration or the weather.
8. Always wear proper fitting shoes. Properly fitting shoes are essential for preventing foot problems. Make sure to purchase shoes that are comfortable, made of soft leather or other natural material and fit well. As you get older, your feet may get wider and flatter. Therefore, it’s important to be properly fitted for shoes and try them on in a shoe store. If you need more assistance (or have problems with your feet), consider working with a “pedorthist.” A Pedorthist is a professional shoe fitter, specifically trained in foot anatomy and shoe construction. They can make individualized suggestions and modifications so that your shoes fit correctly based on your needs
9. Get the blood flowing to your feet. Regular exercise will help keep your blood flowing to your feet. Try not to cross your legs for long periods of time and stay active. If you’ve been sitting on the couch every night watching TV, begin to move slowly. Exercise is great for your health, will help you manage your blood sugar levels, help manage your weight and improve the circulation in your legs and feet.
Figure out what type of physical activity you enjoy, and start moving. You’re more likely to continue to exercise if you like what you are doing. Talk with your health care provider before starting an exercise program and remember to check your blood sugar, and your feet before and after you work out.
10. Have a foot checkup at least once a year. Make sure you get a foot exam that uses a monofilament testing device at least once a year. A monofilament test measures loss of pressure sensation (diabetic sensory neuropathy) and can also help predict risk for future skin ulceration. It will help assess your ability to feel a sensation on the bottom of your foot. When you go to your doctor’s visit, take off your shoes and socks. That way you’ll remind yourself and your health care provider that the foot care exam is an essential part of your visit and diabetes assessment.