Diabetes and your feet: Disease management must focus on head-to-toe health

Diabetes affects 25.8 million people, or 8.3% of the U.S. population. It is a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.

About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage that may result in impaired sensation or pain in the feet or hands. In 2008 alone, more than 70,000 people with diabetes had a leg or foot amputated. While diabetes can lead to serious complications and premature death, by taking steps to control the disease, including being extra aware of foot health, people with diabetes can manage the disease and lower their risk for complications, including lower-extremity amputations.

Why diabetes affects the feet

Diabetes has the potential to harm your feet because blood flow is reduced to certain areas of the body, especially limbs such as the legs. This makes it harder injuries to heal. Also, diabetes-related nerve damage may cause you to no longer feel pain in your feet, and you may not realize you have a wound or injury that needs treatment.

Typical warning signs of nerve damage in the feet include:


pain in your legs or cramping in your buttocks, thighs, or calves during physical activity

tingling, burning, or aching in the feet

lost sense of touch or unable to feel heat or cold well

a change in the shape of your feet over time

loss of hair on your toes, feet, and lower legs

dry and cracked skin on the feet

thick and yellow toenails

fungal infection between your toes

blisters, sores, ulcers, infected corns, and ingrown toenails

Protecting Your Feet

Over half of diabetes-related amputations can be prevented with regular exams and patient education which includes the following simple tips from the Centers for Disease Control and Prevention.

Have your doctor check your feet at least four times a year.

Check your feet each day. Because you may not feel foot pain, look at the tops and bottoms of your feet and toes every day to check for scratches, cracks, cuts or blisters. If you cant see well, ask a family member or friend to help. Call your doctor if you have any sores.

Wash your feet daily. Dont soak your feet, as it can dry out your skin, which can lead to infections. Be sure to dry your feet carefully, especially between the toes. Rub a doctor-recommended lotion on the tops and bottoms of your feetbut not between your toes; moisture between the toes will allow germs to grow that could cause infection.

Trim your toenails carefully. After washing and drying your feet, trim your toenails. Trim the nails to follow the natural curve, but dont cut into the corners. If you cant see well, or if your nails are thick or yellowed, get them trimmed by a foot doctor or another healthcare provider. If you see redness around the nails, see your doctor immediately.

Never cut or use a razor on corns or calluses. Ask your doctor how to use a pumice stone to rub them.

Protect your feet from heat and cold. Hot water or surfaces are dangerous to your feet. Test your bath water with your elbow and wear shoes and socks when you walk on hot surfaces. In summer, use sunscreen on the tops of your feet, and in the winter, wear socks and warm footwear to protect your feet.

Always wear shoes and socks. Never walk barefooteven indoors.

Wear shoes that fit well and protect your feet. Dont wear shoes that have plastic uppers, and dont wear sandals with thongs between the toes. New shoes should be comfortable when you buy them. Always wear stockings or socks made of cotton or wool to help keep your feet dry.

Be physically active. Physical activity helps increase the circulation in your feet. If you are not able to walk, ask your doctor about seated or reclining exercises for your feet and legs.

To learn more about diabetes management or prevention, visit PottstownMemorial.com, choose the Health Resources tab and type Diabetes in the search box. You will find an array of videos and podcasts, health tips, a risk assessment and more. If you or a loved one has diabetes, Pottstown Memorial Medical Center offers a diabetes education class once a month.