For more information on foot problems, care tips, amputation risks and prevention visit our Foot Care page.
More in the Series from NDICH:
The "Prevent Diabetes
Problems" series includes seven booklets that can help you learn more about
how to prevent diabetes problems.
Free Information about Taking Care of Diabetes, National Diabetes Information Clearinghouse 1 Information
Way Bethesda, MD 208923560 Phone: 18008608747 Fax:
7037384929 Email: ndic@info.niddk.nih.gov Internet:
www.diabetes.niddk.nih.gov
National
Diabetes Education Program 1 Diabetes Way Bethesda, MD
208923600 Phone: 18004385383 Fax: 7037384929 Internet: http://ndep.nih.gov
American Diabetes
Association 1701 North Beauregard Street Alexandria, VA
22311 Phone: 18003422383 Internet: www.diabetes.org
Medical Assistance for Diabetics
Be sure to visit our Health Insurance & Assistance Programs page for information about assistance programs available to persons with diabetes and diabetes-related complications.
Read about the Medicare program for free footwear for diabetics that need therapuetic shoes.
High blood glucose can cause feet and skin
problems.
How can diabetes hurt my feet?
High blood glucose from diabetes causes two problems that can hurt your
feet:
Nerve damage.One problem is damage to nerves in your legs
and feet. With damaged nerves, you might not feel pain, heat, or cold in your
legs and feet. A sore or cut on your foot may get worse because you do not know
it is there. This lack of feeling is caused by nerve damage, also called
diabetic neuropathy (ne-ROP-uh-thee). It can lead to a large sore or
infection.
Poor blood flow.The second problem happens when not enough
blood flows to your legs and feet. Poor blood flow makes it hard for a sore or
infection to heal. This problem is called peripheral (puh-RIF-uh-rul) vascular
disease. Smoking when you have diabetes makes blood flow problems much worse.
These two problems can work together to cause a foot problem.
For example, you get a blister from shoes that do not fit. You do not feel
the pain from the blister because you have nerve damage in your foot. Next, the
blister gets infected. If blood glucose is high, the extra glucose feeds the
germs. Germs grow and the infection gets worse. Poor blood flow to your legs and
feet can slow down healing. Once in a while a bad infection never heals. The
infection might cause gangrene (GANG-green). If a person has gangrene, the skin
and tissue around the sore die. The area becomes black and smelly.
To keep gangrene from spreading, a doctor may have to do surgery to cut off a
toe, foot, or part of a leg. Cutting off a body part is called an amputation
(amp-yoo-TAY-shun).
What can I do to take care of my feet?
Wash your feet in warm water every day. Make sure the water is not
too hot by testing the temperature with your elbow. Do not soak your feet. Dry
your feet well, especially between your toes
Look at your feet every day to check for cuts, sores, blisters, redness,
calluses, or other problems. Checking every day is even more important if
you have nerve damage or poor blood flow. If you cannot bend over or pull your
feet up to check them, use a mirror. If you cannot see well, ask someone else to
check your feet.
If your skin is dry, rub lotion on your feet after you wash and dry
them. Do not put lotion between your toes
File corns and calluses gently with an emery board or pumice stone. Do this after your bath or shower.
Cut your toenails once a week or when needed. Cut toenails when they
are soft from washing. Cut them to the shape of the toe and not too short. File
the edges with an emery board.
Always wear shoes or slippers to protect your feet from
injuries.
Always wear socks or stockings to avoid blisters. Do not wear socks
or knee-high stockings that are too tight below your knee.
Wear shoes that fit well. Shop for shoes at the end of the
day when your feet are bigger. Break in shoes slowly. Wear them 1 to 2 hours
each day for the first 1 to 2 weeks.
Before putting your shoes on, feel the insides to make sure they
have no sharp edges or objects that might injure your feet.
Take off your shoes and socks so your
doctor will check your feet.
How can I get my doctor to help me take care of my feet?
Tell your doctor right away about any foot problems.
Ask your doctor to look at your feet at each diabetes checkup. To make sure
your doctor checks your feet, take off your shoes and socks before your doctor
comes into the room.
Ask your doctor to check how well the nerves in your feet sense
feeling.
Ask your doctor to check how well blood is flowing to your legs and
feet.
Ask your doctor to show you the best way to trim your toenails. Ask what
lotion or cream to use on your legs and feet.
If you cannot cut your toenails or you have a foot problem, ask your doctor
to send you to a foot doctor. A doctor who cares for feet is called a podiatrist
(puh-DY-uh-trist).
What are common diabetes foot problems?
Anyone can have corns, blisters, and athlete's foot. If you have
diabetes and your blood glucose stays high, these foot problems can lead to
infections.
Corns and calluses are thick layers of skin caused by too much
rubbing or pressure on the same spot. Corns and calluses can become
infected.
Blisters can form if shoes always rub the same spot. Wearing shoes
that do not fit or wearing shoes without socks can cause blisters. Blisters can
become infected.
Ingrown toenails happen when an edge of the nail grows into the skin.
The skin can get red and infected. Ingrown toenails can happen if you cut into
the corners of your toenails when you trim them. If toenail edges are sharp,
smooth them with an emery board. You can also get an ingrown toenail if your
shoes are too tight.
A bunion forms when your big toe slants toward the small toes and the
place between the bones near the base of your big toe grows big. This spot can
get red, sore, and infected. Bunions can form on one or both feet. Pointy shoes
may cause bunions. Bunions often run in the family. Surgery can remove
bunions.
Plantar warts are caused by a virus. The warts usually form on the
bottoms of the feet.
Hammertoes form when a foot muscle gets weak. The weakness may be
from diabetic nerve damage. The weakened muscle makes the tendons in the foot
shorter and makes the toes curl under the feet. You may get sores on the bottoms
of your feet and on the tops of your toes. The feet can change their shape.
Hammertoes can cause problems with walking and finding shoes that fit well.
Hammertoes can run in the family. Wearing shoes that are too short can also
cause hammertoes.
Dry and cracked skin can happen because the nerves in your legs and
feet do not get the message to keep your skin soft and moist. Dry skin can
become cracked and allow germs to enter. If your blood glucose is high, it feeds
the germs and makes the infection worse.
Athlete's foot is a fungus that causes redness and cracking of the
skin. It is itchy. The cracks between the toes allow germs to get under the
skin. If your blood glucose is high, it feeds the germs and makes the infection
worse. The infection can spread to the toenails and make them thick, yellow, and
hard to cut.
All of these foot problems can be taken care of. Tell your doctor about any
foot problem as soon as you see it.
How can special shoes help my feet?
Special shoes can be made to fit softly around your sore feet or
feet that have changed shape. These special shoes help protect your feet.
Medicare and other health insurance programs may pay for special shoes. Talk to
your doctor about how and where to get them.
How can diabetes hurt my skin?
Diabetes can hurt your skin in two ways:
If your blood glucose is high, your body loses fluid. With less fluid in your body, your skin can get dry. Dry skin can be itchy, causing you to scratch and make it sore. Also, dry skin can crack. Cracks allow germs to enter and cause infection (especially in your feet). If your blood glucose is high, it feeds germs and makes infections worse. Skin can get dry no your legs, feet, elbows, and other places on your body.
Nerve damage decreases the amount you sweat. Sweating helps keep your skin soft and moist. Decreased sweating in your feet and legs can cause dry skin.
What can I do to take care of my skin?
After you wash with a mild soap, make sure you rinse and dry yourself well.
Check places where water can hide, such as under the arms, under the breasts,
between the legs, and between the toes.
Keep your skin moist by using a lotion or cream after you wash. Ask your
doctor to suggest one.
Drink lots of fluids, such as water, to keep your skin moist and
healthy.
Wear all-cotton underwear. Cotton allows air to move around your body
better.
Check your skin after you wash. Make sure you have no dry, red, or sore
spots that might lead to an infection.
Tell your doctor about any skin problems.
For More Information
Diabetes Educators
To find a diabetes teacher near you, call the American Association of
Diabetes Educators toll-free at 1800-TEAMUP4 (18008326874), or look on the
Internet at www.diabeteseducator.org and click on
"Find a Diabetes Educator."
Dietitians
To find a dietitian near you, call the American Dietetic Association
toll-free at 18003661655, or look on the Internet at www.eatright.org and click on "Find a
Nutrition Professional."
Government
The National Institute of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS) is part of the National Institutes of Health. To learn more about feet
and skin problems, write or call the National Institute of Arthritis and
Musculoskeletal and Skin Diseases Information Clearinghouse, 1 AMS Circle,
Bethesda, MD 208923675, 18772264267 (toll-free); or see www.niams.nih.gov on the Internet.
