From checking your feet for ulcers to looking after dry skin on your legs, good foot health is essential when you have diabetes. Use these tips to reduce the risk of infection, protect your feet and prevent diabetic foot.
How does diabetes affect your feet and legs?
If you have diabetes, you may face foot and leg problems – two common complications of the disease. Diabetes puts you at greater risk of calluses, bumps, blisters and ulcers – and high blood sugar means these small injuries and changes can become gateways to infection. However, there are several things you can do to help keep your feet in good condition, including wearing specialised footwear, checking your feet regularly and doing gentle exercise.
Why does this complication occur? First of all, high blood sugar damages the nerves. Researchers are not entirely sure how this damage happens, but they believe that blood sugar levels can negatively affect cells and enzymes in the nervous system, according to the Joslin Diabetes Center. These damaged nerves can cause diabetic neuropathy – a condition in which you lose sensation in your feet or hands.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, neuropathy affects about 70 percent of people with diabetes, and its symptoms can lead to serious infections. After all, if you cannot feel your feet, you will not notice cuts, sores or pain. And if you cannot feel these irritations and wounds, they can become infected, and untreated infections can lead to gangrene, which in turn can lead to amputation.
Neuropathy is the reason many people with diabetes have dry skin: the damaged nerves in your legs cannot receive the signals from the brain to sweat. Dry feet crack, allowing germs to enter the body. Nerve damage can also change the shape of your feet, so shoes that were once comfortable may become hard to wear. This friction causes calluses and bunions (painful swelling on the big toe joint), which can break open and allow germs to spread. In addition, diabetes causes blood vessels to narrow and harden, making it harder for the feet to fight infection.
According to the American Diabetes Association, you can safely use a moisturising cream or lotion, such as Eubos foot and leg cream, to help manage these symptoms. But it is important not to apply it between your toes, as the extra moisture in that tight space can encourage fungal growth. On the other hand, soaking your feet is not a good idea when you have diabetes. It can make already vulnerable skin even more fragile and prone to infection by making it too dry or too soft.
There are many other ways to care for painful, sensitive feet when you have diabetes. Read on for 11 tips to help you stay steady and confident on your feet.
Check your feet every day for cracks, wounds and sores
Nerve damage is a complication of diabetes that makes it hard to feel ulcers or cracks on your feet. "Patients with diabetes should look for any changes in colour, sores or dry, cracked skin," says podiatrist Steven Tillett, MD, of Portland, Oregon. Place a mirror on the floor to see the soles of your feet, or ask a friend or relative for help if you cannot see all parts of your feet clearly.
Do not use your feet to test hot water
When people with diabetes develop nerve damage or neuropathy, it can be hard to tell whether the bath water is too hot. "They won't realise they are actually scalding their skin," explains Dr Tillett. Stepping into the bath before checking the temperature can seriously injure your feet, as burns and blisters are an open door to infection. Before getting into the bath or shower, check the water temperature with your elbow.
Support your feet with diabetes-friendly footwear and socks
Buying shoes when you have diabetes requires a little more attention to detail than you may be used to. Tillett advises looking for shoes with extra depth in the toe area, good coverage on both the top and bottom, and no seams inside that could irritate the feet. Also look for seamless socks, preferably padded and made of cotton or another moisture-wicking material.
Do not walk barefoot, whether indoors or outdoors
Most people understand the need to wear good-quality shoes to protect their feet outdoors, but even at home, going barefoot puts you at risk of small cuts, scrapes, splinters and glass shards. If you have neuropathy, you may not notice these dangerous injuries until they become infected. It is best to wear shoes at all times, even at home.
Keep your feet dry to reduce the risk of infection
Make drying your feet part of your hygiene routine. "The space between the toes is very tight," Tillett says. "The skin becomes moist and prone to tearing, which leads to infection." You can avoid this by drying your feet thoroughly with a towel after washing and by removing wet or sweaty socks and shoes straight away. As mentioned earlier, you can still use a moisturising foot cream to prevent dry, cracked skin – just avoid applying it between your toes.
See a podiatrist regularly to deal with foot problems
Even seemingly harmless calluses can become serious problems if ignored, Tillett notes. When building your diabetes care team, consider including a podiatrist – a doctor who specialises in foot care – instead of going to the pharmacy for an over-the-counter foot product: some products irritate the skin and can actually increase the risk of infection, even while they treat a bunion or calluses on your feet.
Stabilise and take the pressure off your feet with orthotic shoes
Because wearing the right shoes is so important, orthotic footwear is a great investment in protection and comfort. Shoes made specifically for people with diabetes are available in specialist shops and online, or you can visit your podiatrist.
Go easy on your feet with low-impact exercise
Exercise is good for people with diabetes, but what kind is best? While no single type of exercise suits everyone, keep in mind that many fitness classes and aerobics programmes involve a lot of jumping, which may not be good for your feet. This is especially true if you have neuropathy. Instead, consider activities such as walking or swimming that do not put too much strain on your feet. Just make sure you have the right footwear for whatever activity you choose.
Quit smoking to improve circulation in your legs
The dangers of smoking run from head to toe. The chemicals in cigarette smoke damage and narrow your blood vessels, which means that if you smoke, your legs do not get enough blood rich in the nutrients and oxygen needed to fight infection and keep them healthy. "Patients with diabetes already have risk factors that damage their blood vessels. It is never too late to quit," Tillett says.
Control your blood sugar to prevent diabetic neuropathy
"There is a direct link between blood sugar and nerve cell damage," Tillett says. Uncontrolled blood sugar leads to neuropathy, and the better you control your blood sugar, the longer your feet will stay healthy. Remember that if you already have an infection, high blood sugar can make it harder for your body to fight it.
Contact your care team for further help
Your doctor and diabetes care team are a great source of information if you need ideas and inspiration on looking after your feet, quitting smoking or keeping your "numbers" – weight, blood sugar and others such as blood pressure – in check. Of course, if you notice any changes in your legs or feet that worry you, it is a good idea to see your doctor before your next scheduled visit.
For daily care of the skin on your feet we recommend Eubos Diabetic's Skin Care Foot & Leg Cream – developed for the dry, crack-prone skin on the feet and legs of people with diabetes.
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