Diabetes and caring for feet

Q: I recently was diagnosed with diabetes and am learning about various components of my health care that require special attention. For instance, I was told I’d need to take special care of my feet. Can you explain why foot care is so important and what is necessary? A: You’re among the millions of people in the U.S. who have diabetes. Managing your medications, adapting your diet and incorporating activity into your lifestyle are important for managing this disease. Foot care also plays a big part in maintaining your health.

Two complications of diabetes are nerve damage and restricted blood flow to the legs and feet. Both increase the risk of various foot complications. Nerve damage decreases the feeling in your feet, a condition called peripheral neuropathy. Reduced blood flow to the feet makes it harder to heal an injury or resist infection. Left untreated, even minor cuts and blisters can become serious infections that ultimately may require toe, foot or leg amputation.

This is why it’s important to have a podiatrist on your care team. Podiatrists specialize in conditions of the foot and ankle, including complications related to diabetes. Working with your podiatrist can reduce the risk of developing foot, ankle and leg issues, such as neuropathic ulcers, infections, nerve and bone damage, Charcot neuroarthropathy ( joint damage) and amputations. Studies have shown that patients with a diabetic foot ulcer who have a podiatrist on their team can reduce amputations by 36%.

If you don’t have any diabetes-related foot and ankle complications, it’s still recommended that you see your podiatrist every year. You should see your podiatrist at least every six months if you’ve been diagnosed with peripheral neuropathy or have a history of diabetes-related complications.

In addition to examinations by a health care professional, developing a daily at-home foot care routine is important.

The following fourstep routine can minimize serious infections and injuries.

Pick a time of day: Picking a specific time of day can help you form a routine. Try taking a few minutes when you get home from work or before going to bed to examine your feet.

Begin with your socks: People with peripheral neuropathy may not feel an injury when it takes place. When you take off your socks, look for any signs of infection or injury, such as dried blood or yellowish-brown drainage. Wear clean socks every day. You may want to check out socks designed especially for people with diabetes. They have extra cushioning, no elastic at the top and the fabric wicks away moisture.

Examine your feet: Next, examine your feet, including the tops and bottoms, and your toes. If you aren’t able to see the bottoms of your feet, ask a family member, friend or caregiver to help or use a long-handled mirror. Look for any cuts, scratches, ulcers, blisters, dryness, redness, warmth, swelling or pain. Check your toenails for any discoloration, thickness or ingrown borders. If you’ve developed callouses or corns, don’t try to remove or treat them yourself. Make an appointment with your podiatrist to discuss diagnoses and treatment.

Wash your feet: To reduce the chance of infections, wash your feet with a soft cloth, warm water — about the temperature you’d use to bathe a newborn baby — and soap. Dry them thoroughly when finished. It’s OK to moisturize your feet to keep dry skin from itching or cracking. But don’t moisturize between the toes, which could encourage a fungal infection.

Once you’re in the groove of your new footcare routine, it will seem like second nature. And your feet will thank you for it.

— Stephanie Kvas, D.P.M., Podiatry, Mayo Clinic Health System, New Prague, Minnesota

Mayo Clinic Q&A is an educational resource and doesn’t replace regular medical care. Email a question to Mayo ClinicQ&A@mayo.edu.

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