What is diabetes?
Diabetes is a disease in which your blood glucose, or blood sugar, levels are
too high. Glucose comes from the food you eat. The cells of your body need
glucose for energy. A hormone called insulin helps the glucose get into your
cells. With type 1 diabetes, your body does not make insulin. With type 2
diabetes, your body does not make or use insulin well. Without enough insulin,
glucose cannot get into your cells as quickly as usual. The glucose builds up
in your blood and causes high blood sugar levels.
How does diabetes cause foot problems?
Foot problems are common in people with diabetes. They can happen over time
when high blood sugar damages the nerves and blood vessels in the feet. The
nerve damage, called peripheral neuropathy, can cause numbness, tingling,
pain, or a loss of feeling in your toes and feet. If you cannot feel pain, you
may not know when you have a cut, blister, or ulceration (open sore) of your
foot. A wound like that could get infected. The infection may not heal well
because the damaged blood vessels can cause poor blood flow in your feet.
Having an infection and poor blood flow can lead to gangrene. That means the
muscle, skin, and other tissues start to die. If you have gangrene of a foot
ulceration that does not get better with treatment, you may need an
amputation. This is a surgery to cut off your damaged toe, foot, or part of
your leg. It may prevent a bad infection from spreading and could save your
life. But there is a lot you can do to prevent a foot wound from becoming a
major health problem.
How can I protect my feet if I have diabetes?
Foot problems are common in people with diabetes. They can happen over time
when high blood sugar damages the nerves and blood vessels in the feet. The
nerve damage, called peripheral neuropathy, can cause numbness, tingling,
pain, or a loss of feeling in your toes and feet. If you cannot feel pain, you
may not know when you have a cut, blister, or ulceration (open sore) of your
foot. A wound like that could get infected. The infection may not heal well
because the damaged blood vessels can cause poor blood flow in your feet.
Having an infection and poor blood flow can lead to gangrene. That means the
muscle, skin, and other tissues start to die. If you have gangrene of a foot
ulceration that does not get better with treatment, you may need an
amputation. This is a surgery to cut off your damaged toe, foot, or part of
your leg. It may prevent a bad infection from spreading and could save your
life. But there is a lot you can do to prevent a foot wound from becoming a
major health problem.
How can I protect my feet if I have diabetes?
The best way to protect your feet is by controlling your blood sugar levels every day. This will help keep nerve and blood vessel damage from getting worse. The next step is to keep the skin of your feet healthy. Good foot care for people with diabetes includes:
Checking your feet daily. Look for cuts, redness, blisters, swelling, nail
problems or other changes in the skin. Use a hand mirror to look at the bottom
of your feet. Call our office if you notice anything.
Wash your feet daily. Make sure to dry between the toes well after washing
your feet because the excess moisture can cause an athlete’s foot fungal
infection. Do not soak your feet because that can dry out your skin.
Moisturize your feet but not between your toes. Use a daily moisturizing cream
to keep the skin from itching and cracking. But do not utilize moisturizing
cream between the toes because that could cause too much moisture and
encourage a fungal infection.
Cut toenails carefully. If you are found to have good circulation, good
sensation of your feet, and good blood sugar control, you may cut your own
toenails carefully. Cut them straight across. Do not cut toenails too short,
as this could lead to an ingrown toenail. If you have concerns about your
toenails, give us a call at the Davison or Lapeer office.
Never treat corns or calluses yourself. No “bathroom surgery” or medicated
pads. Visit your doctor for appropriate treatment.
Wear clean, dry socks. Change them daily. Consider socks made specifically for
patients living with diabetes. These socks have extra cushioning, do not have
elastic tops, and are made from fibers that wick moisture away from the skin.
Never walk barefoot. Not even at home! Always wear shoes or slippers. You
could step on something and get a scratch or cut and this can lead to an
infection or diabetic foot wound for a person with diabetes.
Wear diabetic shoes. The doctors and staff at Professional Foot & Ankle
Centers have special training to fit you for appropriate diabetic shoes. Most
insurance plans cover one pair of diabetic shoes and 3 pair of custom
accommodative insoles per year. There are certain guidelines that have to be
met to qualify for diabetic shoes and insoles and we will be able to help you
with that.
Take care of your diabetes. Keep your blood sugar levels under control. We
will typically ask your most recent hemoglobin A1c percentage at every visit
and help educate you on how well you are doing. We can also help educate you
on a diabetic diet and an exercise program.
Do not smoke. Smoking restricts blood flow in your feet and places you
at an increased risk for serious diabetic foot complications.
Why do I need a diabetic foot exam?
People living with diabetes usually need to have a complete diabetic foot exam
at least once a year to check for potential complications. However, if you
have existing foot problems from diabetes or high risk factors such as poor
circulation, peripheral neuropathy (numbness), history of a past diabetic foot
ulceration (wound), then more frequent examinations may be necessary.
Skin exam. The podiatrists at Professional Foot & Ankle Centers will examine
the skin of your feet looking for dryness, cracking, calluses, blisters,
ulcers, infections, and other “hot spots” or abnormal areas. Your toenails
will also be examined to determine if you have a fungal infection or possible
ingrown toenail.
Nerve exam. We will do a test to check your nerves and the feeling in your
feet. We will typically do a monofilament test which involves having the
patient close their eyes while the doctor brushes a soft strand of nylon (a
monofilament similar to fishing line) over your foot and toes. You will tell
the doctor when you feel the strand touching your foot. If you cannot feel the
strand of nylon, that tells us that you probably could not feel a blister, and
you are at a significantly increased risk of a diabetic foot wound
(ulceration).
Musculoskeletal exam. We will examine your feet to look for problems such as
bunions, hammertoes, bony prominences or bone spurs, and Charcot foot.
Vascular exam. We will check the blood flow to your feet by feeling the pulses
in your foot and ankle. If poor blood flow is detected we may order additional
circulation tests to better evaluate the circumstances.
What happens if I have a diabetic foot problem?
The podiatrists at Professional Foot & Ankle Centers are experts in diabetic
foot conditions. We will set up a treatment plan that works best for your
circumstances. Our goal is to help prevent diabetic foot complications with
diabetic foot examinations, patient education, and the use of diabetic shoes.
However, if a diabetic foot complication should arise we will utilize the most
up-to-date techniques to simplify your recovery.