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3 Ways to Protect Your Feet if You Have Diabetes

How to Decrease Your Chances of Diabetic Foot Complications

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Updated October 24, 2011

Diabetes is a serious chronic disease that can lead to complications involving the feet. Diabetes can cause neuropathy (or nerve damage) that results in decreased or absent feeling in the feet. If neuropathy develops, a diabetic may be unable to feel pain associated with injury to the skin, and this can lead to a diabetic wound or ulcer. Two other possible complications of diabetes include diminished blood supply to the feet and a weakened immune response, which can hinder wound healing and the ability to fight infections. All of these factors result in an increased risk of limb amputation.

In addition to regular medical care and lifestyle changes to help keep blood sugar under control, here are three important steps that every diabetic should take to minimize the risk of diabetic foot complications:

1. See a Podiatrist

Regular foot care at a podiatrist has the benefit of helping to identify potential problems and prevent them from occurring. A visit to a podiatrist for routine foot care is recommended about every two months and involves screening for neuropathy and diminished blood supply to the feet. Possible problem areas such as calluses, corns and ingrown toenails are treated so as to avoid the potential for them to become wounds. Orthopedic problems such as bunions are also identified and treated if necessary.

It has been shown that even if a diabetic foot complication such as an ulcer does occur, having podiatric care along with other medical intervention decreases the likelihood of limb amputation.

2. Check Your Feet Daily

One of the most important ways to prevent diabetic foot problems is to inspect your feet daily for wounds and other problems. It is not uncommon for a patient with diabetic neuropathy to have a foot infection or injury, such as a puncture wound, and be unaware of it. This is because of the loss of pain sensation in their feet that is characteristic of neuropathy. The earlier any trauma or infection is identified and treated, the better the chance it has of being resolved with minimal complication.

When inspecting your feet, be sure to thoroughly check all areas including between the toes and on the soles. If any wounds, rashes, irritated skin, swelling or other changes to the skin are observed, make an appointment with a podiatrist or your primary care physician as soon as possible. If you have difficulty reaching your feet or are unable to have someone inspect them for you, there are foot examination mirrors that are hand-held and extendable. Foot examination mirrors can be found online or in many pharmacies where diabetic products are sold.

3. Use Protective Footwear

It is especially important for a diabetic to avoid poor-fitting shoes. Foot wounds can easily occur from rubbing against a tight or loose-fitting shoe. To protect your feet, it is best to have your feet sized to ensure a proper fit and choose styles that give adequate room for the toes, avoiding shoes that are too narrow.

Extra-depth shoes are a style of shoe that is often prescribed or recommended for diabetics. Today, there are more stylish and versatile options for extra-depth shoes, anything from sneakers to dress styles. These can be purchased online or at a specialty shoe store. Under certain conditions, Medicare and some commercial insurances will cover the cost of one pair of podiatrist-prescribed diabetic shoes per year. Ask your podiatrist about insurance-covered prescription shoes and insoles to see if you qualify.

In addition to diabetic shoes, orthotics or arch supports can help to accommodate any orthopedic foot problems. For example, a bone prominence on the bottom of the foot may increase the risk of an ulcer. Arch supports or orthotics will help offset this pressure and cushion the foot.

Sources:

Caputo, Wayne J., DPM, FACFAS. "Surgical Management of the Diabetic Foot." Wounds.2008;20(3):74-83.

Litzelman, MD MA, Debra K., et. al., "Reduction of Lower Extremity Clinical Abnormalities in Patients with Non-Insulin-Dependent Diabetes Mellitis." Annals of Internal Medicine. 1993;119(1):36-41.

Sloan, Frank A., Feinglos, Mark N., and Grossman, Daniel."Receipt of Care and Reduction of Lower Extremity Amputations in a Nationally Representative Sample of U.S. Elderly." Health Services Research. 2010;45(6p1):1740-1762.

Turina, Matthias, MD; Fry, Donald E. MD; Polk, Hiram C. Jr MD. "Acute hyperglycemia and the innate immune system: Clinical, cellular, and molecular aspects". Critical Care Medicine. July 2005 33: 1624-1633.

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