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If You Have Diabetes—Prevention is the Key!

By: Dr. Laura Willson

If you have diabetes and have not had your feet checked, make an appointment. You do not need to have any current problems with your feet, but it’s a good idea to have them checked out at least once or twice a year by a podiatrist.

If your glucose levels are fluctuating, nerve and vascular damage will often occur causing:

  • a loss of sensation or feeling (neuropathy) in which you may or may not feel heat, cold, something foreign in the shoe, or pain from an infection that’s developing.

  • poor blood flow, causing difficulty in healing (which then increases the risk for ulcers and gangrene).

North Shore Podiatry recommends:

  1. DAILY INSPECTION OF YOUR FEET: Check for redness, sores, blisters, calluses, ingrown nails, numbness or open sores, cold to the touch or discoloration to your toes, loss of hair on toes and feet.

  2. CLEAN YOUR FEET EVERYDAY: Wash with mild soap and WARM (not hot) water. Dry well, especially between the toes but don’t be aggressive – just blot; never soak your feet as this can increase dryness. Lightly apply lotion or moisturizer to feet but NEVER between the toes. Check your toenails once a week and cut them straight across.

  3. ALWAYS WEAR SHOES AND SOCKS: This will serve to protect your feet from hot, cold, and foreign objects. Wear white natural fiber (cotton or wool) socks. Soft, padded, seamless diabetic socks will help to avoid blisters and sores. The top band of socks should fit comfortably and not cause indentations in your legs. Have your shoes professionally fit or evaluated by your podiatrist. Wear sturdy, supportive shoes that fit well in length, width and have a deep (high) toe box. Change your shoes once a day to alter pressure points. Check your shoes daily for foreign objects or pebbles. Put your feet up when sitting to decrease any swelling. Wiggle your toes and move ankles periodically to increase blood flow. Do NOT cross your legs for long periods of time. Never go barefoot!

Most Important Things to Focus On:   • Control Blood Sugar Levels • Exercise Everyday • Take Medication as Prescribed

Common Diabetic Foot Problems

Bunions – Progressive change in alignment of the toe joint. Base of toe extends beyond the normal profile of your foot

Callus – Area of thickened skin, produced by pressure or friction. Cracking can allow entry of bacteria, causing infection. These are usually precursors to ulcerations.

Corn – (Hammer toe) – Caused from external pressure in a small defined area. Bones in contracted toes putting pressure against skin and causing a focal hardened area on toe.

Toenails – Ingrown toenails result when the toenail grows into the flesh of the toe. Tissue around the nail becomes infected. Nails that are infected with a fungus may become discolored, thick and brittle, and may separate from the rest of the nail. In some cases, the nail may crumble.

Dry Skin – If blood glucose levels are high, fluid is lost and dehydration can lead to dry skin on the legs, feet, or elbows. Dry skin cracks and is easily infected.

Ulcer – Can occur anywhere on foot, often at site of injury or pressure. Loss of sensation (neuropathy) makes many diabetics vulnerable to this. If blood glucose levels are not controlled, ulcerations don’t heal and this can lead to amputations.

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