Diabetic Foot Care

~ Written by MGP Member, Thomas Ortenzio, DPM of OSS Health

The disease known as Diabetes Mellitus (or diabetes) affects many systems of the body and can develop in people of all ages.  When it affects the foot, the consequences can be severe.  It is crucial for people with diabetes to give special attention to their feet so that they live longer and heathier lives.

Diabetes is a disease caused when the body does not produce enough insulin, or when the body’s insulin is incapable of functioning properly.  Insulin helps turn the food we eat into energy or store it for future use.  Diabetes can cause:

• Poor immune function
• Loss of vision
• Decreased kidney function
• Nerve dysfunction resulting in decreased sensation and circulation changes

The biggest concern with your feet is prevention of those complications that arise from changes in sensation and circulation.

Inadequate blood supply/Peripheral Vascular Disease

This occurs when blood vessels become too narrow.  It is one of the most important factors contributing to infection of the lower extremities.

Warning signs:

• Pain that interrupts your rest that can typically be relieved by dangling your feet over the bed or getting out of bed to walk
• Cramps in the calf when walking
• Painful ulcers
• Skin discoloration – a blue or purple discoloration of the toes, redness of the foot to loss of color when elevating the feet
• Cold feet
• Thick and brittle toenails

Inadequate nerve supply/Neuropathy

This is a complication of diabetes that causes altered or loss of sensation of pain, temperature and joint position.  It may cause a loss of protective sensation and injury may not be realized.  This can then cause:

• Ulcerations
• Skin breakdown
• Infection
• Muscle weakness
• Toe deformities and calluses on the ball of the foot

Proper Foot Care Instructions

The American Podiatric Medical Association recommends that diabetics get regular visits to their podiatrist.  This lowers the risk for ulceration and limb loss.  These visits are essential and should be at a minimum twice per year.  It’s what you can’t feel that can harm you because of neuropathy. 

• Inspect your feet daily for any changes
• Carefully cleanse and dry your feet, especially between the toes
• Exercise regularly – walking is ideal exercise for diabetics unless there are complications. If balance is an issue, use a cane
• Avoid things that diminish circulation, such as tobacco use and crossed legs
• Avoid extremes in temperature, i.e. a hot water soak, and take extra care to avoid exposure to the cold in winter months
• Change socks daily
• Wear properly fitted shoes