Diabetics often experience significant foot problems that can lead to difficulties in walking or even the risk of amputation. These conditions often start out very small but, due to complications associated with neuropathy or lack of feeling in the feet, they can escalate rapidly into potentially life threatening health concerns. Careful foot care that starts with routine foot examinations is absolutely essential to treat minor foot issues before they become serious.
Changes You Can See:
Most diabetics will notice changes on the skin of their feet. This can include darker patches, known as dermopathy, which are not serious but are an outward sign of narrowing of the blood vessels. This in turn indicates a reduced volume of blood flowing to the lower legs and feet. Lower amounts of blood to the tissues of the feet means that the skin on the feet, particularly the surface layers, can become very dry and scaly. There may be deep cracks that form on the soles of the feet and the heels which are problematic for infections.
To help keep the surface of your feet moisturized avoid soaking your feet for long periods of time as this can cause increased drying. Instead wash your feet with warm water and an exfoliants scrub or a pumice stone to remove dead skin. Dry, then apply unscented foot lotion, Vaseline or petroleum jelly or a good quality non-perfumed hand lotion or cream. Then, to add extra protection and comfort, wear a heavy pair of cotton socks or stockings to help moisturize the skin and retain the benefits of the cream or lotion. A properly fitting pair of diabetic footwear will also help to maintain a bounce in your step.
Calluses can also be problematic for a diabetic. This is a thick, hard and raised area of skin that is typically found on the pressure points of the feet. If not trimmed and removed the calluses may actually ulcerate and lead to open wounds that are very slow to heal. The pumice stone in the shower or bath along with moisturizing the feet regularly will help prevent the skin from building up. Any existing calluses should be removed by your doctor to prevent infections or skin damage that can occur with over the counter products or self-treatment.
Ulcers are open wounds on the feet that do not heal. Often they are caused when a smaller skin wound, perhaps a callus or blister, is constantly irritated by your footwear. Since neuropathy causes a decrease in the pain sensation in the feet ulcers, particularly on the bottom of the foot, can often become very severe before they are noticed.
Most ulcers will require medical attention. According to the American Diabetes Association it essential to have your physician examine the ulcer to make sure it has not caused a deep infection that can cause damage to the bones of the feet and toes. Dead tissue will need to be surgically removed and, if there is very poor circulation in the feet, vascular procedures may be required to prevent further ulcers from forming. Most people will also be put on a drug therapy that includes antibiotics to help treat the ulcer as quickly as possible.
Damage to the nerves in the feet due to low blood circulation can lead to a wide range of foot problems. Neuropathy can cause the feet to turn and twist or actual deformities of the bones of the feet and toes. If you do have poor sensation in the feet or any abnormality in the shape of the foot it is important to have shoes custom made that avoid adding pressure to the feet that may result in skin lesions, blisters, calluses or ulcerated pressure points.
As with all aspects of diabetes good foot care starts with controlling your blood sugar. With managed blood sugar there is less damage to the blood supply and less chance of developing conditions of the feet typically associated with diabetes.