Most people take their feet for granted, but if you have diabetes you can’t do that. Two complications of diabetes -diabetic nerve damage and poor circulation- make it easier for you to get feet problems such as a foot ulcer that may not heal. Non-healing ulcers lead to amputation.
What foot problems do diabetic experience?
People with diabetes have the same foot problems than people without diabetes experience: corns, calluses, bunions, ingrown toenails, arthritis, and broken bones. However, these foot problems can be more serious in people with diabetes who have diabetic nerve disease or poor circulation.
People with diabetic nerve damage lose the feeling in their feet so they may not notice an injury. Walking might cause a wound or ulcer that can get infected. Blood supplies oxygen, white blood cells that attack bacteria, and healing nutrients to the wound. But if not enough blood supply reaches your feet, the ulcer can be difficult or impossible to heal. If not treated, these foot problem will lead to amputation.
How common are diabetic feet problems?
Way too common. About half of the people who have diabetes for 10 years will have some degree of nerve damage. The older you are and the longer you have had diabetes, the more likely you are to have nerve damage, but not everybody gets it.
It is estimated that 15-25% of people with diabetes will have a foot ulcer at least once. About 70% of these ulcers will heal with good basic foot care. Up to 10% of people with diabetes will have an amputation at some time in their lives. Toe and partial food amputations are the most common, followed by below-the-knee amputations.
Experts believe that at least half of these amputations could have been prevented by good blood sugar control, better preventive foot care, and better care of foot ulcers.
What can I do to prevent diabetic foot problems?
Here are some of the things you can do to prevent feet problems:
Get your blood glucose under control.
Keep your feet clean and dry.
Check your feet every day. Touch the tops, bottoms, backs, sides and between the toes.
Get prompt medical attention if you detect any problems.
Moisturize dry skin with a good lotion.
Have corns, calluses or ingrown toenails treated by a professional.
Wear socks without a thick toe seam and made of a material that wicks moisture away from the skin such as cotton or wool blend.
Wear soft leather shoes. Always wear shoes at home.
Wear well-fitting fabric shoes to walk or run.
Have surgery to fix deformities such as bunions and hammertoes.
Does blood sugar control affect your feet?
If you control your blood sugar, you decrease your risk of diabetic complications. If you already have complications, you may prevent them from getting worse. With good blood sugar control you are less likely to develop nerve damage or poor circulation.
The Diabetes Control and Complications Trial (DCCT) studied 1,400 people with diabetes type 1. Half of the people received “conventional” care (1-2 insulin injections a day) and the other half received “intensive” care (as many injections as needed to keep blood glucose close to normal range). Patients with near normal blood sugar levels had a 40-70% reduction in the complications of diabetes. The improvement was gained regardless of the patients’ age, sec, or length of time they had had diabetes.
A healthy meal plan helps your feet
You know that achieving a good blood glucose control can help you prevent nerve damage or circulation problems. Part of managing your blood glucose is following a healthy meal plan. A meal plan that includes too many processed foods (white flour, sugars and fats) and too few fruits and vegetables leaves you with fewer weapons to fight bacteria and fungus on the skin.
Especially important are the vitamins you get from fruits and vegetables. Ask your doctor for a referral to a Registered Dietitian (RD) if you need help designing or changing your meal plan to meet your needs and to get your blood glucose under control.
The good news is that by taking good care of your feet, you can often prevent diabetic foot complications. It you take care of your feet every day and get good medical care as soon as you even suspect you might need it, you are much more likely to avoid getting infections that make amputations necessary. In fact, at least 50% of amputations in people with diabetes could be prevented.