Diabetes and Your Feet

The answer is all of the above.

Peripheral neuropathy (nerve damage) of the feet, peripheral vascular disease (PVD—a circulatory condition), infections, and foot ulcers are just a few of the potential diabetic complications that can impact your feet. Treat your feet well with good preventative care, appropriate protection, and regular exams to help stop trouble before it starts.

The answer is true.

Improper toenail cutting can cause ingrown toenails, which can be painful and can lead to bigger problems, like infection, in people with diabetes.

Cut your toenails regularly, typically about once a week. Do it when they are soft from showering or bathing, and cut them to the shape of the toe—never too short. File any rough or sharp edges with an emery board. If you have problems reaching or clearly seeing your toes, let your podiatrist cut your toenails.

The answer is false.

“Tight” is the key word here. Hose or socks that are too tight can restrict blood flow to the feet and legs, causing circulation problems and making existing circulatory or neuropathy problems worse. Socks should fit well, and be made of breathable materials that wick away moisture. Seamless socks are the best bet to avoid friction blisters. The exception to the “tight hose” rule would be people who require compression stockings, also known as anti-embolism stockings or hose. These are used after surgery for patients who are confined to bed for a period of time, and they may also be prescribed for people who are at risk for deep vein thrombosis (DVT), a clotting disorder.

“Tight” is the key word here. Hose or socks that are too tight can restrict blood flow to the feet and legs, causing circulation problems and making existing circulatory or neuropathy problems worse. Socks should fit well, and be made of breathable materials that wick away moisture. Seamless socks are the best bet to avoid friction blisters. The exception to the “tight hose” rule would be people who require compression stockings, also known as anti-embolism stockings or hose. These are used after surgery for patients who are confined to bed for a period of time, and they may also be prescribed for people who are at risk for deep vein thrombosis (DVT), a clotting disorder.

Assuming you have a well-fitting pair, gym shoes win hands down. Shoes and boots that have a low heel and fit properly are also fine choices, as long as they have a closed toe and the materials they are made of breathe adequately.

Flip-flops and sandals leave too much of your foot exposed to the elements, and can result in sunburn, abrasions, blisters, or worse, if something falls on your foot or gets into your shoe unnoticed. Heels place undue strain on the ball and toes of your foot, and that added pressure can promote the formation of calluses which can lead to ulcers. If you must wear heels, try to limit your standing and walking time in them, and don’t go taller than an inch or two.

The answer is as late in the day as possible.

To get the best fit, shop for shoes at the end of the day, when your feet are bigger (they swell throughout the day). Never buy shoes that are too small with the assumption that they’ll stretch. Make sure to wear socks or stockings that allow about a half-inch between your toe and the end of the shoe when you’re standing. Always try on both shoes; most people have one foot that is larger than the other, so new shoes should feel comfortable on the larger foot.

The answer is Always moisturize after bathing, but never between your toes.

Dry skin should most definitely be moisturized regularly after bathing. Left untreated, dry skin can crack and leave you exposed to bacteria and infections. Don’t moisturize between your toes, though, because that can promote a moist environment and result in fungal infection.

Left untreated, dry skin can crack and leave you exposed to bacteria and infections. Don’t moisturize between your toes, though, because that can promote a moist environment and result in fungal infection.
While drinking water is always a good idea to keep yourself hydrated, it is not enough to treat dry skin on your feet by itself.

The answer is false.

There’s a risk of infection from the foot tub and pedicure tools if they aren’t thoroughly sterilized between customers. Additionally, a slip of the clippers, a callous trimmed too close, or a spa tub that’s too hot, could have serious consequences for someone with diabetes. Pedicurists don’t have training in the special care the diabetic foot requires. Regular foot checks and maintenance as needed from your podiatrist are always the best bet for healthy feet.

If you decide to have a pedicure, proceed with caution. Make sure the salon sterilizes all of their instruments, or allows you to bring in a personal set. Be sure that the foot tub is disinfected between customers. Instruct the pedicurist to keep the water at a safe temperature, and refrain from shaving your legs a day or two prior to your appointment. This will keep your lower legs clear of any nicks or cuts that could get infected. By all means, tell them you have diabetes, and that your feet need to be handled with care.

The answer is false.

A pedorthist is a healthcare professional who specializes in fitting shoes for people with disabilities or deformities. A pedorthist can custom-make shoes to help control the way your foot functions, or orthotics, which are special inserts for shoes. For people with diabetes, orthotics can help with foot problems, such as bunions and foot pain. They can also help improve poor circulation, a common diabetes complication.

Custom shoes may be covered by Medicare or other health insurance programs. Talk to your doctor for more information.

The answer is that it’s not safe for people with diabetes.

Barefoot on the beach may be romantic, but the potential trauma to your feet could be a nightmare. Besides the fact that the very definition of sand is finely-ground rock, there could also be broken shells, glass, nails, other sharp objects, or ocean debris hiding on the beach. You also increase your risk of getting bitten or stung by a fish or insect. These risks all open the door to potential wounds and infection.

Before your tiptoe through the sand dunes, choose and wear shoes with a sole that is strong and thick enough that a nail won’t go through it, and with enough protection that if something (or someone) were to step or fall on your toes, they’d be protected. Also make sure the shoe has a closed heel, so nothing can sneak in. If push comes to shove, have your loved one carry you across the beach. How romantic is that?

The answer is true.

Athlete’s foot is a common foot ailment, and it’s even more common in people with diabetes than in those without. Athlete’s foot is a fungus that causes itchiness, redness, and cracking of the skin. Germs enter these cracks and cause infection. High blood sugar feeds that infection.

How do you prevent athlete’s foot?

•   Manage your blood glucose to as near normal levels as possible.
• Keep your feet clean and dry. Always dry the areas between your toes.
• Don’t apply lotion or anything that could cause moisture between your toes.
• Wear shoes and cotton socks that are dry, not damp or moist. Avoid plastic shoes, since they can hold moisture in.
• Wear shoes that fit. Alternate your shoes to allow them to dry between uses. If your toes are pushed together to fit into your shoes, this increases the chance of moisture between your toes. Don’t borrow other people’s shoes or buy used shoes.
• Wear waterproof shoes when in moist environments.
• Wash your hands if your hands if you have touched your feet, someone else’s feet, or pets. Pets can carry and pass on fungal infections.
• If you have had athlete’s foot, you may need to throw away the shoes and socks you wore during the infection. Wash your bed linens, floors, rugs, and mats in hot, soapy water, and dry in a hot dryer. All of these measures help to prevent reinfection.

The measures listed above are also used in the treatment of athlete’s foot. In addition, your doctor may recommend that you use an over-the-counter, nonprescription antifungal powder, ointment, lotion, or spray. Whatever you do, if you suspect you have athlete’s foot, see your doctor to determine your best course of treatment.

Sources

American Diabetes Association. “Foot Care.” June 7, 2013. Accessed November 26, 2016. https://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html.

American Diabetes Association. “Foot Complications.” June 6, 2013. Accessed November 26, 2016. https://www.diabetes.org/living-with-diabetes/complications/foot-complications/.

National Institute of Diabetes and Digestive and Kidney Diseases. “Diabetes and Foot Problems.” February 2014. Accessed November 26, 2016. https://www.niddk.nih.gov/health-information/diabetes/preventing-diabetes-problems/keep-feet-healthy.

National Institute of Diabetes and Digestive and Kidney Diseases. “Taking Care of Your Feet for a Lifetime.” Accessed November 26, 2016. https://www.niddk.nih.gov/health-information/diabetes/preventing-diabetes-problems/keep-feet-healthy/take-care-your-feet-lifetime.