CONDITIONS
Diabetes and Foot Problems
Diabetes and Foot Problems
Even with the highest number of people with diabetes in the world, diabetic foot care is one of the most ignored aspects of diabetes care in India. Most people walk barefoot in rural regions due to social, religious, and rarely economic compulsions. Poverty and illiteracy lead to usage of inappropriate footwear along with late presentation of foot lesions or even completely ignoring it.
The prevalence of diabetic foot ulcers is reported to be between 3.6% and 10.4%, and resulting in 40,000 leg amputations annually. Sadly, it is suggested that in most cases, 75%–85% of diabetic foot ulcers and amputations are potentially preventable with early identification of minor lesions.
Hence, it becomes vital to make the people aware about foot problems associated with diabetes.
The reasons why diabetics are more prone to foot problems is because –
- Diabetes may damage the nerves and lessen blood flow to the feet
- Slow healing of small cuts or sores and their longer recovery make them more prone to infections, leading to longer time for recovery.
- Poorly controlled sugar causes no feeling in feet, a numbness. Thus, a person may not even realize a minor injury that happened.
- Diabetes may also cause dry skin on the feet and make heels crack.
- There is bigger risk of infection – the germs or fungus may get into small cuts or cracks that may enter the bloodstream and spread.
- Poor foot care may lead to amputation (removed by surgery) of a foot or leg to prevent the infection from spreading and to save their life.
Tips for keeping the feet healthy:
Checking the feet every day for injury such as cuts, redness, swelling, sores, blisters, corns, calluses, or any other change to the skin or nails. In case a person cannot see the bottom of the feet, ase a mirror, or ask a family member for help.
Washing feet every day in warm (not hot) water: Soaking is not recommended. Washing the feet and then dry completely and apply lotion to the top and bottom. Do not apply lotion between toes, as it could lead to infection.
Avoid going barefoot (without footwear): Shoes and socks or slippers should always be worn, even inside, to avoid injury. The lining of the shoes should be smooth and check that there aren’t any pebbles or other objects inside them.
Wearing well fit shoes: Wearing ill-fitting shoes may cause shoe bite, leading to infection. For the best fit, trying shoes at the end of the day is best since the feet tend to be largest. Always wear socks with your shoes.
Trim your toenails straight across and gently smooth any sharp edges with a nail file. Ask help from family or the foot doctor (podiatrist) to trim your toenails in case you can’t reach them.
Don’t remove corns or calluses yourself, and especially avoid using over-the-counter products to remove them as they could burn the skin.
Getting the feet checked at every health care visit: Regular check-up of the feet at the foot doctor or patient’s regular practitioner to asses feeling and blood flow in your feet is advisable.
Keeping the blood flowing: While sitting, plant the feet up, and wiggle toes for a few minutes several times throughout the day.
Choosing feet-friendly activities like walking, riding a bike, or swimming. Please consult the doctor about the best activities for you.
Wearing Diabetic Socks: If the doctor advises, diabetic socks can be worn as they:
- Improve blood flow to the feet
- Keep the feet dry
- Keep fungal infections off the feet
- Provide cushion
When should the doctor be consulted?
Experiencing any of the following symptoms requires an immediate visit to the doctor:
- Pain in legs or cramping in the buttocks, thighs, or calves during physical activity.
- Tingling, burning, or pain in feet
- Loss of sense of touch or ability to feel heat or cold very well.
- A change in the shape of your feet over time.
- Dry, cracked skin on your feet.
- A change in the colour and temperature of your feet.
- Thickened, yellow toenails.
- Fungus infections such as athlete’s foot between your toes.
- A blister, sore, ulcer, infected corn, or ingrown toenail.
Serious foot complications are preventable in most diabetes patients with regular care at home and maintaining good glucose control. The best thing to do is going to all doctor’s appointments for preventing foot problems (and stopping small problems from becoming serious ones).
References
- Shankhdhar K, Shankhdhar LK, Shankhdhar U, Shankhdhar S. Diabetic foot problems in India: an overview and potential simple approaches in a developing country. Curr Diab Rep. 2008 Dec;8(6):452-7.
- Harrison-Blount M, Hashmi F, Nester C, Williams AE (2017) The prevalence of foot problems in an Indian population. The Diabetic Foot Journal 20(2): 95–102
- Diabetes and Your Feet. Centers for Disease Control and Prevention. January 2024. https://www.cdc.gov/diabetes/library/features/healthy-feet.html
