When a person living with diabetes manages their blood sugar levels properly, they are less likely to develop complications. By adopting proper diabetes management measures, the risk of developing complications is significantly reduced. Although most people living with diabetes do not get serious foot problems, it is important to be aware of changes that can occur in their feet and what can be done to reduce risk of foot complications.

Possible complications to the feet in people living with diabetes

Poor blood supply to the feet: This occurs as a result of the narrowing of the blood vessels, leaving the feet unable to cope with cuts, infections, injuries and cold weather. It is important for people living with diabetes to keep their feet warm with quality socks, avoid extreme changes in temperature (cold to hot) and avoid using hot water bottles on their feet. Socks which have seams and shoes that press and rub against feet should be avoided as they can cause blisters. If socks have big seams, they should be worn inside out.

Neuropathy: In the early stages of neuropathy, people living with diabetes may complain of pins and needles or the feeling of walking on cotton wool or pebbles. Neuropathy makes the feet less sensitive to pain and temperature, increasing the likelihood to be unaware when blisters, cuts and infections occur. As a result, people who have neuropathy must check their feet everyday for any cuts, wounds or ulcers before it gets worse. Neuropathy may also lead to a change in the shape of the feet and toes may become clawed and rise upwards.

Dryness: Poor blood supply to the feet and neuropathy can cause dryness and loss of elasticity in the skin of the feet. This increases the risk of developing corns, calluses and fissures (splits in the feet). For this, people living with diabetes should apply a good foot cream on the top and soles of their feet (not in between toes, as it may make toes too moist).  Do not cut corns or calluses with a blade as it may cause injuries. Newly diagnosed patients of diabetes should not ignore dryness as well.

Caring for the feet

People living with diabetes need to care for their feet as a healthy circulation will keep tissues strong. This can be done by eating a healthy diet, not smoking and keeping blood sugar under control. It is also important to ensure shoes fit properly and are wide and deep enough, leaving enough room for their toes. Other tips for caring for their feet include:

Daily washing and inspection of the feet: The feet should be washed daily using mild soap and warm water. Avoid soaking your feet for a long period as it may strip the natural oils on the feet and cause soggy areas between the toes. This increases the risk of developing soft corns on the feet.

Toe nails should be cut or filed in a straight line. Any sharp corners should be filed with a nail file. Surgical spirit should be applied to white or damp areas between the toes unless there’s bleeding – for which medical attention should be sought.

For any corns, calluses (hard skin) and signs of ulcers or infections, medical attention should be sought immediately.

Reference

Understanding Diabetes by Professor Ruby Bilous, 2013

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