If you’re managing diabetes, you may encounter problems with your feet and legs, two common complications of the disease. Diabetes puts you at higher risk for calluses, corns, bunions, blisters, and ulcers — and high blood sugar means these minor injuries and alterations may become gateways to potentially disabling infections.
But you can take several steps to help keep your feet in good shape, including wearing specialized footwear, having regular foot exams, and performing low-impact exercises.
Why does this complication occur in the first place? First, know that high blood sugar levels damage nerves. Researchers aren’t exactly sure how this damage happens, but they think that blood sugar may have a negative effect on the nervous system’s cells and enzymes, according to the Joslin Diabetes Center. These damaged nerves may lead to diabetic neuropathy, a condition in which you lose feeling in your feet or your hands.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, neuropathy occurs in about 70 percent of people with diabetes, and its symptoms can result in harmful infections. After all, if you can’t feel your feet, you won’t be able to notice cuts, sores, or pain. And if you can’t feel these irritations and wounds, they may lead to infection, and untreated infections can lead to gangrene, which in turn can require amputation.
Neuropathy is the cause of the dry skin experienced by many of those with diabetes: The disabled nerves in your feet can’t receive the brain’s message to sweat. Dry feet crack, which makes it possible for germs to enter the body. Nerve damage can also cause changes to the shape of your feet, which can make previously comfortable shoes hard to walk in. That friction creates calluses and bunions that can wear down and expose skin to germs. In addition, diabetes also causes the blood vessels to shrink and harden, which can make it hard for your feet to fight infection.
To help manage these symptoms, you can safely use lotion, according to the American Diabetes Association. But it’s important to make sure you don’t put it between your toes because the extra moisture in that tight space may encourage fungus to grow. In contrast, soaking your feet when you have diabetes isn’t a good idea. This approach can make already-vulnerable skin even more fragile and susceptible to infection, either through making your skin too dry or too soft.
There are a number of other solutions for the aching, sensitive feet you may encounter on your journey with diabetes. Read on for 11 tips that will help you stride on with strength and confidence while managing the disease.
Inspect Your Feet Every Day for Cracks, Wounds, and Sores
Nerve damage is a complication of diabetes that makes it hard to feel when you have sores or cracks in your feet. “Patients with diabetes are looking for any changes in color, sores, or dry, cracked skin,” says podiatrist Steven Tillett, DPM, of Portland, Oregon. Place a mirror on the floor to see under your feet or ask a friend or relative for help if you can’t see all parts of your feet clearly.
Don’t Use Your Feet to Test Hot Water
When people with diabetes develop nerve damage or neuropathy, it can be hard to tell if the bath water is too hot. “They won’t realize they are actually scalding their skin,” explains Dr. Tillett. Stepping into a bath before checking the temperature can cause serious damage to your feet since burns and blisters are open doors to infection. Use your elbow to check the water temperature before getting into the tub or shower.
Support Your Feet With Diabetes-Friendly Footwear and Socks
Shoe shopping for people with diabetes requires a little more attention to detail than you may be used to. Tillett advises looking for shoes with more depth in the toe box, good coverage of both top and bottom, and without seams inside the shoe that can rub on your foot. Likewise, seek socks without seams, preferably socks that are padded and made from cotton or another material that controls moisture.
Don’t Go Barefoot, Whether You’re Inside or Outside
Wearing shoes with good coverage outside to protect your feet makes sense to most people, but even inside your house, puttering around without shoes puts your feet at risk for small cuts, scrapes, and penetration by splinters, glass shards, and misplaced sewing needle or thumbtack. If you have neuropathy, you might not notice these dangerous damages until they become infected. It’s best to wear shoes at all times, even in the house.
Keep Your Feet Dry to Reduce the Risk of Infection
Make sure that drying your feet is part of your hygiene routine. “The space between the toes is very airtight,” says Tillett. “Skin gets moist and breaks down, leading to infection.” Prevent this by toweling off thoroughly after washing your feet and by removing wet or sweaty socks or shoes immediately. As mentioned previously, you can still use moisturizer to prevent dry, cracked skin — just avoid putting it between your toes.
See a Podiatrist Regularly to Treat Foot Problems
Even seemingly harmless calluses may become problems if you ignore them, notes Tillett. When building your diabetes healthcare team, consider including a podiatrist, a doctor who specializes in foot care, instead of heading to the pharmacy for an over-the-counter product for feet — some products are irritating to your skin and can actually increase the risk of infection even while they treat the bunion, callus, or corn on your foot.
Stabilize and Relieve Feet With Orthotic Shoes
Because wearing correct shoes is so important, orthotic footwear is a great investment in protection and comfort. Shoes made especially for people with diabetes are available at specialty stores and online, or you can visit your podiatrist for advice. Medicare Part B will cover one pair of extra-depth or custom-molded diabetic shoes a year, plus additional inserts to reduce pressure on your feet. Your doctor may recommend these shoes to you if you have an ulcer or sore that is not healing.
Go Easy on Your Feet With Low-Impact Exercises
People with diabetes benefit from exercise, but what is the best kind? While exercise for diabetes certainly isn’t one-size-fits-all, be mindful that many fitness classes and aerobics programs include bouncing, jumping, and leaping, which may not be good for your feet. This is especially true if you have neuropathy. Instead, look into programs, such as walking or swimming, that don’t put too much pressure on your feet. Just make sure you have the right shoe for whatever activity you choose.
Quit Smoking to Improve Circulation in Your Feet
The dangers of smoking run from your head to your feet. The chemicals in cigarette smoke damage and constrict your blood vessels, which means that if you smoke, you’re depriving your feet of the nutrient- and oxygen-rich blood that fights infection and keeps them healthy. “Diabetic patients already have risk factors that compromise their blood vessels. It’s never too late to stop smoking,” says Tillett.
Control Your Blood Sugar to Help Avoid Diabetic Neuropathy
“There’s a direct relationship between blood sugar level and damage to the nerve cells,” says Tillett. Out-of-control blood sugar leads to neuropathy, and the better you are at controlling your blood sugar, the healthier your feet will be over the long term. Remember, if you already have an infection, high blood sugar levels can make it hard for your body to fight it.
Check in With Your Care Team for More Help
Your doctor and your diabetes healthcare team are great sources of information if you need ideas and inspiration for taking care of your feet, quitting smoking, or staying on top of your “numbers” — your weight, blood sugar, and other measures of health, such as blood pressure. Of course, if you notice any changes in your feet that concern you, it’s a good idea to see your doctor before your next regularly scheduled check-up.