Published on January 04, 2021

Foot Care in Diabetes- Its all about loving your feet

Komal MotwaniThe New Year is a time for new resolutions. It is a time for new hopes, promises and effort; a time to love yourself a little bit more, and hence an absolutely perfect time to begin loving your feet. After all, we need them very much to help us walk tall in the year ahead of us.

Foot care is an integral part of diabetes management.  Diabetes is known to be the leading cause of non-traumatic lower leg amputations.  All feet, especially diabetic feet deserve tender, loving care.  This involves washing feet daily, wearing comfortable footwear and clean dry sweat-soaking socks, examining feet daily including between toes, bottom (using mirror if needed) and top, trimming toenails and seeking immediate care in case of any cuts, wounds, ulcers, blisters or signs of infection (warmth, pain, redness and swelling).

Of the various organs that poorly controlled diabetes can affect, nerves of the body is a common one.  Patients can often lose sensation in the feet, which along with poor blood circulation, makes them prone to wounds.  Feet are usually affected more commonly than hands, because we tend to see and care for our hands better.

There have been instances where patients walking barefoot on the beach did not realize how warm the surface was when they were walking and ended up burning their feet.  Similar episodes have happened where patients were using heater close to their feet to keep themselves warm, failing to realize when the temperature rose too much.  Hence, it is highly recommended not to walk barefoot even around the house.

Unfortunately, once nerves get affected, patients often have to live with it.  It is usually irreversible, and can continue to progress if the diabetes is not controlled.  Many medications for treating painful neuropathy or nerve damage also relates to many side effects, and often give only half the relief in the symptoms, which can include numbness, tingling, burning, sharp and shooting pains in the hands and feet.

Eventually, having good control of diabetes from the beginning of diagnosis is the most effective way of preventing the progression to nerves or any other organ damage.  The changes that occur in the body can start long before Type 2 Diabetes is diagnosed, hence patients need to be examined for any complication from their very first year of diagnosis.  Annual foot exam by a healthcare provider is highly recommended for every diabetic patient as well as daily self-care routine.

Most amputations begin with foot ulcers.  It is vital to seek urgent care in case of any foot ulcer, infection or wound, calluses or corns.  Patient should not try to remove calluses or deal with other foot injuries on their own, rather see a podiatrist. It is not uncommon for an infection to worsen, as high blood sugar leads to poor healing and serve as a breeding ground for infection.

In addition to controlling diabetes early on, patients should also keep a good control on your blood pressure, avoid smoking, and keep up with regular follow-up with their providers.  Healthy lifestyle, low-carbohydrate diet and exercise will all help in maintaining vitality. With good care and understanding, organ damage is highly preventable.

Wish you all a wonderful, happy-feet, year ahead!

(References: mayoclinic.org, cdc.gov)

Dr. Komal Motwani specializes in endocrinology, diabetes and metabolism at UNC Health Southeastern’s Southeastern Medical Specialists clinic.