Perhaps on account of all the ways diabetes affects physical health and lifestyle choices, it is easy to overlook the intertwining relationship between the disease and feet – but doing so would be a huge mistake!
Even for healthy individuals, foot health can be an indication of overall health. This also holds true when diabetes is in the picture. Further, diabetic issues that arise in feet play a role in overall health and safety as well.
For these reasons, it is simply essential for you to have a diabetic foot care plan in place if you are living with this disease. These plans are based on measures taken to prevent problems from developing and to identify issues at the earliest possible opportunity for professional intervention. There are four areas used to achieve those key goals – protection, inspection, lifestyle choices, and professional care.
Foot Health Risks from Diabetes
To help you best understand why protection and early intervention is so important, let’s start by looking at two very serious medical conditions that can develop when diabetes is in the picture – diabetic foot ulcers and Charcot foot.
Both of these conditions arise on account of systemic damage from the disease. The core problem with diabetes is the damage elevated blood sugar (glucose) levels does to body systems, including the nervous, circulatory, and immune (endocrine) systems.
Your nervous system has two components – the central nervous system (basically, your brain and spinal column) and peripheral nervous system (nerves extending from the central nervous system and branching throughout the body).
Problems start when peripheral nerves—the ones that enable you to feel physical sensations—are damaged from excess sugar. This can cause painful sensations, but it’s even more concerning when the nerves are damaged to the point they do not provide any sensation at all (neuropathy). With this numbness, it is entirely possible to sustain a small cut, have a toenail become ingrown, or experience any other injury or condition without even knowing about it.
Given that you don’t know about issues like those, you won’t likely take measures to address problems when they develop. This is worrisome because an impaired circulatory system means that the damaged area will not receive an adequate blood supply to heal in a normal fashion. A nonhealing wound is known as an ulcer – and this is a serious matter.
Ulcers allow microscopic contaminants to enter the body. Once in, the compromised immune system is unable to fight them off effectively. Infected tissue continues to break down and can become gangrenous.
Charcot foot is another very serious medical condition that can develop. These two issues are not mutually exclusive. In fact, Charcot foot increases your risk for ulceration.
So what is Charcot foot? This is a severe deformity that happens on account of peripheral neuropathy and weakened foot bones.
Impaired circulation keeps bones in the feet from receiving the nutrients they need to be strong. Since foot bones endure tremendous force loads, weakness is a problem. When there is also lack of sensitivity from neuropathy, you may be unaware of bones breaking from the physical strain.
Since you cannot feel this, you will likely keep performing normal tasks and activities (unless you discover a problem during your daily foot inspection!).
Continuing normal activities leads to further damage, and this cycle can continue until a foot is severely misshapen.
Protecting Diabetic Feet
Clearly, there are major problems that can develop in feet on account of diabetes. So, what can you do about this?
Well, a key step of your diabetic foot care plan is to protect your feet.
Some areas of protecting your feet may seem more obvious than others, but they are all essential components for keeping you safe and healthy.
Diabetic shoe choices. Without wearing proper footwear, your feet are at risk of blisters, bunions, or other injuries. For people with diabetes, this is a greater danger and health risk. At HFAA, we equip you with the type of shoes needed to support your lifestyle and your health. Talk to us about orthotics that will help you feel better when you walk and reduce your risk of serious complications.
Nail care. We offer nail care services to help you prevent ingrown toenails. With our help, you can maintain healthy toenails without risk of open cuts or infection from a nail that does not grow back properly.
Cleanliness. Protect yourself from the threat of infection by washing your feet daily. Use a mild soap and warm water. Avoid hot water, since neuropathy may prevent you from realizing when you are burning your skin. Afterwards, be sure to dry your feet thoroughly.
Skin care. Excessive dryness can lead to cracks and fissures that enable microorganisms to enter your body. After cleaning your feet, apply lotion to the heels, tops, and bottoms of your feet. Avoid the areas between your toes as this can create an ideal environment for bacteria to thrive.
Inspecting Diabetic Feet Daily
Feet spend a lot of time covered and are the farthest points on the body, which means it isn’t always easy to see problems or abnormalities that have developed. On top of that, diabetic neuropathy can take away your ability to feel injuries—and especially ones an otherwise healthy individual would consider to be minor (there is no such thing as a “minor” injury with diabetes!)—when they happen.
Since visual cues and physical sensation are not likely going to clue you in to an existing or developing problem, you need another approach. This is where a daily foot inspection comes into play.
What this means is you need to carefully inspect all areas of your feet every day. And by “all areas,” we mean ALL AREAS – tops, bottoms, sides, and between the toes.
In the event you are unable to see the bottoms of your feet or check between your toes, you might need to use a mirror or enlist the help of a loved one.
The best time to do this thorough foot check is before going to bed at night. This way you can catch any problem that might have come up during the day at the earliest opportunity.
When you perform your inspection, make sure you check for:
Blisters, corns, calluses, warts, and other growths. Any abnormality that you note on your feet has the potential for leading to a dangerous infection. A blister that bursts or callus that cracks can open the door for a microorganism to enter your body.
Cuts, scratches, and scrapes. When you discover these, wash the affected area carefully and apply an antibiotic cream recommended by our office. If there is redness, oozing, or foul-smelling discharge, call us as soon as possible.
Ingrown or discolored toenails. Ingrown toenails dig into the soft skin flanking them and increase the risk of infection, but our foot specialists can help. Discolored nails are a sign of fungal infection and need professional treatment.
Skin issues. Keep your feet from becoming too dry, which can ultimately lead to fissures and cracking. Itching and redness are possible signs of infection and need to be treated right away. Blue or black coloration are indications of circulation issues and you must seek emergency care immediately.
Whereas these are some specific issues you might discover, it is important to keep in mind that ANYTHING out of the ordinary could be cause for concern. If you have signs of an infection, you need to seek immediate medical care.
Whether you have diabetes or not, smoking is simply a poor choice for your physical health. When you do live with this disease, though, it becomes an even bigger detriment to your body. Smoking constricts your blood vessels, which is less than ideal for someone who already has circulation issues due to diabetes.
Not all lifestyle choices entail “do not,” and a prime example is exercise. You can actually help fight some of the problems that accompany diabetes with physical activity. Low-impact exercises, like walking and swimming, are great ways to promote better circulation and lose weight, but without putting excessive pressure on your feet. Let us help you create an exercise plan!
Professional Diabetic Foot Care
In addition to the steps you take yourself, an important component of diabetic foot care is setting up regular appointments with our office. By coming in every 2 or 3 months, we can catch issues before they become serious. Also, this enables you to ask questions and see if there is anything else you should be doing to manage your condition.
When you first visit the Heartland Foot and Ankle Associates offices, we’ll perform a Comprehensive Diabetic Foot Exam (CDFE). During this exam, our team will evaluate important indicators of your foot health, including:
The health of your nerves
Signs of ulcers
Risks of developing sores or an infection
Having a CDFE done regularly will help keep your feet as healthy as possible.
Contact Heartland Foot and Ankle Associates today to set up a diabetic foot care plan. Call us at (309) 661-9975 or use our online form to request an appointment at our Bloomington, IL office.