If you have diabetes, the most useful thing you can do for your feet takes a few minutes: look at them every day. Take your shoes and socks off in the evening, check the tops, the bottoms and between your toes, and call the office if something has changed. The rest of this article explains why that habit matters, what to look for, and how a Southfield winter changes the routine.
Why diabetes is hard on feet
Diabetes can affect the feet in two ways, and they often happen together.
The first is nerve damage, called diabetic neuropathy. Over time, high blood sugar can damage the nerves in the feet. You may feel tingling or burning, or you may slowly lose feeling. According to the CDC, about half of all people with diabetes have some kind of nerve damage. When you can't feel pain, heat or cold well, a blister from a new shoe or a pebble in your boot can go unnoticed for days.
The second is reduced blood flow. Diabetes can lower the amount of blood reaching your feet, and that slows healing. A small sore can be slow to heal and can become infected.
Put those together and you get the reason podiatrists talk about diabetic feet so much. A foot ulcer can get infected and fail to heal well. In serious cases, an infection that doesn't respond to treatment can lead to amputation of a toe, foot or leg. The CDC is clear that early treatment greatly lowers that risk, which is why catching problems early matters.
The daily foot check
Make it part of your evening, when your shoes come off anyway. Sit somewhere with good light.
Look over every part of each foot, including between the toes. If bending is hard, use a hand mirror or ask someone at home to help. You're looking for:
- Cuts, scrapes or sores
- Blisters, even small ones
- Red spots, swelling or areas that feel warm
- Corns or calluses
- Ingrown toenails, or nails that are thick, yellow or curved
- Peeling, cracking or itching skin, especially between the toes
- Any change in the color or temperature of your feet
Check your feet even when they feel fine. With nerve damage, feeling fine doesn't tell you much.
Everyday habits that protect your feet
A few habits from the NIDDK and CDC make the daily check easier and lower the chance of trouble.
Wash and dry carefully. Wash your feet every day in warm water, not hot, and test the temperature with your elbow or hand first. Don't soak your feet, which can dry out the skin. Dry well, especially between the toes.
Moisturize, but not between the toes. A thin layer of lotion on the tops and bottoms helps keep skin from cracking. Moisture between the toes can lead to infection, so leave that area dry.
Trim nails straight across. Do it after washing, and smooth sharp edges with a file. Don't cut into the corners. If your nails are thick, curved or hard to reach, have a foot doctor trim them. Thick, discolored nails can also be a sign of fungal nails, which is worth having looked at.
Leave corns and calluses to us. MedlinePlus advises people with diabetes not to use medicated pads or try to shave or cut corns and calluses at home, and the NIDDK adds liquid corn and callus removers to that list. A small slip with a razor or a strong pad can open a wound. We treat corns in the office.
Always wear shoes and socks. That includes inside the house. Before you put shoes on, run a hand inside to feel for stones or rough spots. Shop for new shoes late in the day, when your feet are at their largest, and choose socks that fit without tight bands or thick seams.
Look after the rest of your diabetes care. The CDC calls keeping your blood sugar in your target range one of the most important ways to prevent or slow nerve damage. Smoking lowers blood flow to the feet, so if you smoke, ask your doctor for help quitting. The NIDDK also suggests putting your feet up when you sit and wiggling your toes a few times a day to help blood flow.
What changes in a Michigan winter
Southfield winters mean cold, wet feet, heavy boots and a lot of time indoors near the heat. Each of those deserves a little attention if you have diabetes.
Warm your feet with socks, not heat. Nerve damage can make it hard to feel how hot something is. The NIDDK and MedlinePlus both say not to use a heating pad or hot water bottle on your feet, and the NIDDK adds that you should keep your feet away from heaters and open fires. If your feet get cold at night, wear clean, dry socks to bed instead.
Keep feet dry. Snow and slush soak through shoes fast, so the NIDDK suggests lined, waterproof boots in winter. Change out of wet socks as soon as you can. Skin between the toes tends to stay damp, which makes infections such as athlete's foot more likely, and cracked or itchy skin is one more place for bacteria to get in.
Check your boots. Winter boots often come out of the closet once a year. Make sure they still fit, with room to wiggle your toes, and that nothing inside has worn rough. A boot that rubs on the walk from a parking lot can raise a blister you don't feel.
Limit time out in the cold. MedlinePlus recommends warm socks in cold weather and not staying out in the cold for long.
When to call instead of waiting
Some problems shouldn't wait for your next routine visit. Call the office right away if you notice:
- A cut, blister or bruise that hasn't started to heal after a few days
- Redness, warmth, swelling or pain in part of your foot
- A sore, ulcer, infected corn or ingrown toenail
- New tingling, burning or numbness
- A callus with dried blood inside it, which can be the first sign of a wound under the callus
Our office is open Monday, Wednesday and Friday. If one of these comes up when we're closed, call your primary care provider rather than waiting for us.
If an area of your foot turns black and smells bad, get care right away, at an emergency room if you can't reach a doctor. The NIDDK lists that as a possible sign of gangrene, which is serious.
How often to have your feet examined
The CDC recommends having your feet checked at every visit with your primary care provider and seeing a foot doctor at least once a year for a complete exam, more often if you already have nerve damage. That exam checks the feeling and the blood flow in your feet, not only the skin. The American Podiatric Medical Association also recommends seeing a podiatrist at least once a year if you have diabetes.
When you go in for any diabetes appointment, take your shoes and socks off so your feet get looked at too, as the NIDDK and MedlinePlus both suggest.
At StepWell, Dr. Berry Byrd, DPM, provides diabetic foot care. If it has been more than a year since anyone looked closely at your feet, or you've noticed one of the changes above, call us at (248) 559-5200. We're open Monday, Wednesday and Friday, 9:00 to 5:00, at 17515 West 9 Mile Rd., Suite 950, in Southfield. Seeing us for the first time? The New Patients page covers insurance, payment and what to expect.
Sources
- CDC, Diabetes and Your Feet (opens in a new tab)
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Diabetes and Foot Problems (opens in a new tab)
- MedlinePlus, Diabetes: taking care of your feet (opens in a new tab)
- American Diabetes Association, Foot care tips (opens in a new tab)
- American Podiatric Medical Association, Diabetes Awareness (opens in a new tab)
This article is general information, not medical advice. If you have diabetes and a foot problem, call the office or your doctor.