Diabetes

Did you know that according to a paper recently published in JAPMA, the odds of receiving a diabetes-related amputation have increased from three to 10 times since the onset of the COVID-19 pandemic?

Having diabetes increases the risk of developing a wide range of foot problems, often because of two complications of the disease: nerve damage (neuropathy) and poor circulation.

For those with diabetes, small foot problems can turn into serious complications, including:

• ulcers (sores) that don’t heal
• corns
• calluses
• cracked heels
• hammertoes
• bunions
• ingrown toenails

If left untreated, diabetes can lead to other conditions, such as:

Diabetic peripheral neuropathy

This condition usually develops slowly and worsens over time. Some patients have this condition long before they are diagnosed with diabetes. Having diabetes for several years may increase the likelihood of having diabetic neuropathy.

Charcot foot

This condition causes the bones of the foot to become weakened enough to fracture. With continued walking the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.

Diabetic Foot Care

Diabetes can be dangerous to your feet – even a small cut can produce serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you may not notice a foreign object in your shoe. As a result you could develop a blister or a sore. This could lead to an infection or a non-healing wound that could put you at risk for an amputation.

To avoid serious foot problems that could result in losing a toe, foot, or leg, follow these guidelines:

• Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything.
• Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily. Use only lukewarm water – the temperature you would use on a newborn baby.
• Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting, and carefully dry between the toes.
• Moisturize your feet – but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But DON’T moisturize between the toes – that could encourage a fungal infection.
• Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toe nails. If you have concerns about your nails, consult your doctor.
• Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment.
• Wear clean, dry socks. Change them daily.
• Avoid the wrong type of socks. Avoid tight elastic bands (they reduce circulation). Don’t wear thick or bulky socks (they can fit poorly and irritate the skin).
• Wear socks to bed. If your feet get cold at night, wear socks. NEVER use a heating pad or hot water bottle.
• Shake out your shoes and feel the inside before wearing. Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on.
• Keep your feet warm and dry. Don’t let your feet get wet in snow or rain. Wear warm socks and shoes in winter.
• Never walk barefoot. Not even at home! Always wear shoes or slippers. You could step on something and get a scratch or cut.
• Take care of your diabetes. Keep your blood sugar levels under control.
• Don’t smoke. Smoking restricts blood flow in your feet.
• Get periodic foot exams. Seeing your foot and ankle surgeon on a regular basis can help prevent the foot complications of diabetes.

This information is copyrighted by The American College of Foot and Ankle Surgeons.

More about diabetes and foot care here: www.apma.org/diabetes