By Joan Carver, DPM
Division of Podiatry
Cooper Bone and Joint Institute
What causes diabetic foot problems?
Neuropathy and blood vessel disease both increase the risk of foot ulcers. The nerves of the feet are the longest in the body and often are affected by neuropathy. When a patient with diabetes loses sensation in the feet, sores or injuries may go unnoticed until ulcers develop.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), more than half of non-traumatic lower-limb amputations in the United States occur among people with diabetes.
Prevention of diabetic foot problems
To prevent foot problems from developing, the NIDDK recommends that people with diabetes take care of the disease and its symptoms, and follow these suggestions for proper foot care:
- Check your feet and toes daily for any cuts, sores, bruises, bumps or infections — using a mirror if necessary.
- Examine your shoes before putting them on to make sure they have no tears, sharp edges or objects in them that might injure your feet.
- Wash your feet daily using warm (not hot) water and a mild soap. If you have neuropathy, you should test the water temperature with your wrist before putting your feet in the water. Physicians do not advise soaking your feet for long periods, since you may lose protective calluses. Dry your feet carefully with a soft towel, especially between the toes.
- Wear shoes that fit your feet well and allow your toes to move. Break in new shoes gradually, wearing them for only an hour at a time at first. After years of neuropathy, as reflexes are lost, the feet are likely to become wider and flatter. If you have difficulty finding shoes that fit, ask your physician to refer you to a specialist, a podiatrist, who can prescribe corrective shoes or inserts.
- Cover your feet (except for the skin between the toes) with petroleum jelly, a lotion containing lanolin or cold cream before putting on shoes and socks. For persons with diabetes, the feet tend to sweat less than normal. Using a moisturizer helps prevent dry and cracked skin.
- Use an emery board or pumice stone to file away dead skin, but do not remove calluses, which act as protective padding. Calluses should only be removed by your physician. Do not try to cut off any growths yourself, and avoid using harsh chemicals such as wart remover on your feet.
- Cut your toenails straight across, but be careful not to leave any sharp corners that could cut the next toe.
- Avoid sitting with your legs crossed. Crossing your legs can reduce the flow of blood to the feet.
- Ask your physician to check your feet at every visit, and call your physician if you notice that a sore is not healing well.
- Wear socks if your feet become cold at night. Do not use heating pads or hot water bottles.
- Wear thick, soft socks and avoid wearing slippery stockings, mended stockings or stockings with seams.
- Never go barefoot, especially on the beach, hot sand or rocks.