Diabetes mellitus. How to take care of feet with diabetes?

May 3, 2024

Cukrinis diabetas. Kaip rūpintis pėdomis sergant cukriniu diabetu?

Foot care is a critically important part of daily life for people with diabetes mellitus, for several key reasons. First, diabetes disrupts normal blood circulation, especially in the limbs such as the legs. This reduces blood flow to the feet, which can slow wound healing and increase the risk of infection. Second, diabetes often causes nerve damage, known as neuropathy, which reduces sensation in the feet. As a result, a person may not notice small wounds, scratches or other damage caused by diabetes, which in turn can lead to more serious medical complications, including infections or even amputation.

Daily foot care rules for people with diabetes

Daily foot care is an essential part of health care for people with diabetes, helping to avoid complications such as infections, wounds and long-term skin and nerve damage. Here are some detailed daily foot care rules:

Check your feet regularly: People with diabetes should carefully examine their feet every day, including between the toes and the soles, looking for any skin damage such as cracks, blisters, redness or sores. Use a mirror or ask a family member for help if it is hard to see all parts of your feet.
Wash and dry gently: Wash your feet in warm, not hot, water with a mild soap. Avoiding hot water is important, as reduced sensation may stop you from noticing a temperature high enough to cause burns. After washing, gently pat your feet dry, especially between the toes.
Moisturise: After each wash, apply a moisturising cream or lotion to your feet, but not between the toes, to avoid excess moisture that can encourage fungal infections.
Wear suitable shoes and socks: Wear well-fitting, comfortable shoes without inner seams or other features that could cause friction or pressure. Socks should be seamless and made of breathable materials to reduce sweating and friction. Avoid tight shoes or high heels, which can impair circulation or put uneven pressure on your feet.
Cut your nails properly: Cut toenails straight across, without cutting them too short or rounding the corners, which can lead to ingrown nails. If cutting your nails is difficult or you notice any nail damage, it is better to see a foot care specialist.
Avoid cold and overheating: People with diabetes should avoid warming their feet for long periods on heaters or in the sun, and should protect them from frostbite in winter. Wear warm or cooling footwear appropriate to the weather.

Following these rules can significantly reduce the risk of complications such as skin infections, wounds and circulation problems. Additional foot care recommendations for people with diabetes include:

Do not self-medicate for foot pain or other problems without a doctor's advice. Some medicines can cause unwanted side effects or make the situation worse.
Avoid walking barefoot, even at home, as small foreign objects, sharp items or even rough surfaces can cause foot wounds that may be hard to heal.
Physical activity is important for managing diabetes, but choose exercises that do not put a lot of pressure on your feet. Swimming or cycling may be better choices than running or jumping. Always wear suitable sports shoes.
See a foot care specialist regularly to check for signs of developing complications and receive professional foot care. This may include a professional foot massage to improve circulation, skin treatment and nail care.

By following these recommendations, people with diabetes can avoid many serious foot-related health problems and maintain a high quality of life.

What are the most common foot problems in diabetes?

Diabetes mellitus is a chronic condition characterised by high blood sugar levels, which can cause various foot health problems known as diabetic foot. These problems result from the long-term effects of diabetes, including nerve damage (neuropathy) and circulation disorders. Here is a detailed overview of the most common foot problems in diabetes:

Diabetic neuropathy: One of the most common complications, in which damaged nerves reduce sensation in the feet. This means that minor injuries, scratches or pressure points can unnoticeably turn into more serious wounds, because the patient feels little or no pain.
Peripheral arterial disease (PAD): This occurs when arteries narrow and become blocked, reducing blood flow to the extremities, such as the legs and feet. PAD can cause pain when walking, slower wound healing and a higher risk of amputation.
Various infections: Because of reduced immune function and poorer wound healing, people with diabetes are more prone to skin, nail and soft tissue infections. These include bacterial infections as well as fungal infections such as athlete's foot.
Ingrown toenails: Improper nail care or shoes that are too tight can cause ingrown toenails in people with diabetes. This can lead to pain, inflammation and infection.
Foot deformities: Diabetic neuropathy can cause muscle imbalance and uncontrolled changes in the foot skeleton, leading to deformities such as Charcot foot. Such deformities further increase pressure on certain parts of the foot and cause wounds.
Dry skin and cracks: Reduced sweating due to neuropathy can lead to dry skin that tends to crack, especially on the heels. Cracks can become a direct route for infection.
Diabetic foot ulcers: These ulcers are very serious and common in diabetes. They usually form as a result of constant pressure or friction from unsuitable shoes or foot deformities. Because they heal slowly and carry a high risk of infection, they require intensive treatment and professional medical care. When treating diabetic foot ulcers, it is important to monitor the wound constantly and maintain strict hygiene. Various wound treatment methods are used, including modern wound care technologies such as different types of dressings that help maintain moisture balance, promote healing and protect against infection. Controlling blood sugar is also important, as stable blood sugar levels help improve healing.
Plantar fasciitis: Structural foot changes caused by diabetes and increased body weight can sometimes lead to inflammation of the plantar fascia, which causes severe heel pain. Proper foot support and therapeutic exercise can help reduce symptoms.

Treating and managing all these conditions requires a multidisciplinary approach involving foot care specialists, endocrinologists and, if needed, infectious disease specialists. In addition, regular check-ups help detect complications early and take action to prevent further health problems, including possible amputation.

Patients are advised to make daily foot care part of their routine, avoid risky activities, follow a healthy diet and lifestyle, and follow all their doctor's instructions to keep their feet healthy and maintain overall well-being.

For daily foot skin care we recommend Eubos Diabetic's Skin Care foot and leg cream – it is designed for the dry, crack-prone skin of the feet and legs of people with diabetes.