If you are overweight, there is a high probability that you also have diabetes.  For diabetics, personal care and hygiene are of utmost importance (really, this is important for everyone) because seemingly innocent infections could cause greater health issues. Many doctors will spend a lot of time with diabetics in ensuring that they are taking care of their disease but also of their body and the feet are one of the most important parts (though not the only important area).

Why feet?

It’s easy to wear shoes too small for your feet, or stub your toe which could result in an infection setting in and the possible amputation of your toe(s) or even feet or foot.

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. Nerve damage can lead to a sore or an 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 vascular disease, also called PVD. Smoking when you have diabetes makes blood flow problems much worse.

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. 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.

You DON’T want to loose your foot/feet/toe(s) or parts or all of your leg.

What can I do to take care of my feet?

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• 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 slippers or shoes to protect your feet from injuries.
  Always wear slippers or shoes to protect your feet.
• 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 few weeks.
• Before putting your shoes on, feel the insides to make sure they have no sharp edges or objects that might injure your feet.

What are common diabetes foot problems?

Anyone can have corns, blisters, and other foot problems. 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. You can also get an ingrown toenail if your shoes are too tight. If toenail edges are sharp, smooth them with an emery board.
• 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. Pointed 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. Diabetic nerve damage may cause the weakness. 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. Cracks allow germs to enter and cause infection. If your blood glucose is high, it feeds the germs and makes the infection worse.
• Athletes foot is a fungus that causes itchiness, redness, and cracking of the skin. The cracks between the toes allow germs to get under the skin and cause infection. 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.

Taking care of your feet is very important – one of the simplest steps to start with is ensuring that your shoes are the right size. If you wear a 12 wide, make sure you always buy a 12 wide — don’t buy something too small or normal width because you will feel it in your feet.

Once you have the right shoes make sure you check your feet regularly for any signs of corns, blisters or other foot problems.  The sooner you catch these problems, the sooner you can deal with them and prevent an infection which could cost you parts of your feet or an entire foot.

I highly recommend that you visit http://diabetes.niddk.nih.gov/complications/index.htm for extensive and detailed information on diabetes, diabetics and the complications that arise from diabetes.

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