Diabetic Foot Problems

What causes diabetic foot problems?

Neuropathy and blood vessel disease both raise the risk for foot sores (ulcers). The nerves of the feet are the longest in the body. They often are affected by nerve injury (neuropathy). When a person with diabetes loses sensation in the feet, they may not notice sores or injuries until serious ulcers develop.

Preventing diabetic foot problems

To help keep foot problems from developing, the American Diabetes Association (ADA) advises people who have diabetes to take care of the disease and its symptoms. They suggest the following for correct foot care:

Check your feet and toes daily for any cuts, sores, bruises, bumps, or infections . Use a mirror to look at the bottom of your feet. Or ask someone to help you.

Check your shoes before putting them on. Make sure they have no tears, sharp edges, or objects in them that might harm your feet.

Wash your feet daily with warm (not hot) water and a mild soap. If you have neuropathy, test the water temperature before putting your feet in the water. You can do this with a thermometer or your wrist or elbow. Health care providers don't advise soaking your feet for long periods. Dry your feet carefully with a soft towel, especially between the toes.

Wear shoes that fit your feet well and let your toes move. Break in new shoes gradually. Wear them for only an hour at a time at first. After years of neuropathy, as reflexes are lost, the feet are likely to become wider and flatter. If you have trouble finding shoes that fit, ask your primary health care provider to refer you to a foot specialist (podiatrist). A podiatrist can help you get corrective shoes or inserts.

Before putting on shoes and socks, cover your feet (except between the toes) with petroleum jelly, a lotion containing lanolin, or cold cream. For people with diabetes, the feet tend to sweat less than normal. Using a moisturizer helps prevent dry, cracked skin. Put talcum powder or cornstarch between your toes to keep these areas dry.

Use an emery board or pumice stone to file dead skin, but don't remove calluses using sharp tools. Don't try to cut off any growths yourself. Don't use harsh chemicals, such as wart remover, on your feet.

Cut your toenails straight across. But be careful not to leave any sharp corners that could cut the next toe.

Don't sit with your legs crossed. Crossing your legs can reduce the flow of blood to the feet. Don't smoke. Raise your legs when you are sitting. Wiggle your toes several times a day to keep the blood flowing.

Ask your provider to check your feet at every visit. Call if you notice that a sore is not healing well. Take your shoes and socks off while you are waiting for your appointment to start.

Don't use heating pads or hot water bottles if your feet become cold at night. Wear socks instead.

Wear thick, soft socks. Don't wear slippery stockings, mended stockings, or stockings with seams.

Never go barefoot, especially on the beach, hot sand, or rocks.

The ADA also recommends that you call or see your health care provider right away if you have a cut or break in your skin, an ingrown toenail, wounds that don't start to heal in a few days, or signs of infection. Also call your provider if your foot or feet change color, shape, or just "feel funny." This might be pain or loss of feeling. If the pulses in your feet are weak, your provider may may have the pulse in your arms and legs tested. This is to see if you have any blockages or narrowing in the arteries to your feet.