My Diabetes Project – Foot complications
Diabetes information and services in Europe
- Skin changes—the skin on your feet can become very dry and maybe even peel or crack because the nerves that control the oil and moisture in your feet no longer work. You can help fight this by coating feet with plain petroleum jelly, unscented hand cream, or similar products after bathing. You should not put these oils or creams between your toes (because they can cause infection) or soak your feet (this will just dry them out more).
- Calluses—they build up faster on the feet of people with diabetes, and therapeutic shoes and inserts can help with this problem. Use a pumice stone to help keep calluses in check and put on lotion right afterward. Calluses should be trimmed, otherwise they can get very thick, break down, and turn into ulcers. You should not try to do this yourself or use chemicals to break them down, but instead let a health care provider trim them for you.
- Foot ulcers—they are usually found on the ball of the foot or the bottom of the big toe, and even if they don’t hurt, you should go to your doctor right away to get it checked out. If you neglect the ulcer it can lead to infection and maybe even the loss of a limb. Your doctor has some options when it comes to treating the ulcer: they can take x-rays to make sure the bone isn’t infected, they can clean out dead and infected tissue, culture the wound to find out what type of infection you have, or refer you to a vascular surgeon. It’s really important that you stay off your feet and avoid walking while your ulcer is being treated, as this can make the ulcer bigger and push the infection deeper into your foot. Your doctor may prescribe an antibiotic or suggest special shoes and braces to help with the healing process and prevent the ulcer from returning.
- Poor circulation—this can prevent your foot from fighting infection and slow down the healing process because the blood vessels in your feet and legs narrow and harden. You can help your circulation by not smoking and keeping your blood pressure and cholesterol under control. If your feet are cold, warm them by wearing socks and avoid using hot water or heating pads because reduced feeling in your feet can make it easy to burn yourself. If you feel pain in your calves while walking (a problem called intermittent claudication), you should stop and rest and the pain will go away quickly. But this does mean you must stop smoking and start some sort of walking program, while your doctor can check if any medications will help improve your circulation. Exercise if you’re able, and make sure you’re wearing sturdy, comfortable shoes that fit well.
- Amputation—because many people with diabetes have peripheral arterial disease (PAD), which basically means they have reduced blood flow to the feet, combined with nerve disease that reduces sensation in the feet, they are more likely to get ulcers and infections that can lead to amputation. But these are almost always preventable if you take care of your feet and wear the right shoes. Like we mentioned above, smoking can cause a lot of problems because it decreases blood flow to the feet, making it harder for them to heal.