Diabetic Foot Care
Diabetes causes a number of physical side effects that conspire to create the potential for serious foot problems for diabetic patients. Diabetic foot care is a very important part of keeping healthy when you have diabetes. Peripheral neuropathy causes numbness in the extremities, so you may not notice if you stub your toe or injure your foot in some way. Dry skin is not only easily injured, but can crack or split on its own, creating an opportunity for infection to set in. Poor blood circulation to the extremities means the injured foot can not heal as quickly as it should. All of these things combine to create on of the most notorious side-effects of diabetes: foot ulcers and gangrene that, if not treated promptly, can lead to amputation. Proper diabetic foot care can not only prevent many diabetes-related injuries and infections, but ensures that you will notice any injuries or problems early enough to have them treated promptly.
Good diabetic foot care starts with regular cleaning and moisturizing of your feet. A heated foot spa helps make regular foot care more enjoyable and relaxing. After washing your feet (anti bacterial soap may be a good choice), dry them thoroughly with a soft towel, and then use a high-quality lotion to keep your skin moisturized. Some companies make special diabetic foot lotions and creams, designed specifically for the needs of diabetic dry skin. While you are going through your wash & lotion routine, you should examine your feet for any signs of cracked skin, bruising or abrasions. Does it look like your shoes may be squeezing or rubbing your feet? Are your socks leaving marks from the toe seams? Anything out of the ordinary should be noted, and looked after. If any sign of infection sets in, go to your doctor immediately!
Many companies manufacture special socks and shoes for diabetics also. These are also an important part of proper diabetic foot care. Soft, cushioned socks with no seams at the toes help prevent chafing injuries to the skin. Comfortable, properly fitted shoes, with extra-cushioned orthotic insoles won’t pinch your feet, and help prevent pressure injuries to the soles of your feet. While diabetic shoes and socks may be more expensive than regular footwear, taking proper care of your feet is much less expensive than paying for a hospital visit to treat an advanced infection (or even an amputation!). Good diabetic foot care is a very worthwhile investment for anyone with diabetes.
There are many products that aren’t even designed specifically for diabetic foot care that can be very helpful anyway. “Spa” gel moisturizing socks, designed to be worn while you sleep, help keep your skin soft and healthy. Foot massagers and massage slippers can help improve blood circulation, especially important to help heal existing injuries. “Natural” shoe companies, like Earth Shoes, Birkenstock and Haflinger, with contoured foot beds in their shoes, and shoes that are shaped to feet your left and right feet separately, are good for diabetic patients. Gel shoe insoles can add an extra layer of cushioning to any pair of shoes. There are many options on the market today that will help you create and maintain your own personal diabetic foot care regimen.
Diabetic shoes may cost more than normal shoes, but they are worth it. One of the most dreaded side-effects of diabetes is amputation of the lower extremities, due to gangrenous ulcers of the feet and lower legs. Good quality diabetic shoes can go a long way towards preventing the foot injuries that can lead to eventual amputation. If that is not a good reason to invest some extra money in your foot wear, I don’t know what is!
A good pair of diabetic shoes will have plenty of room inside – ie they will be ‘comfort fit’ rather than ‘tight’. However they must not be too loose either. Overly tight shoes can cause “pressure ulcers” in a diabetic patient, and such ulcers are one of the most difficult types of foot injuries to treat and heal. Be especially careful that your shoes have enough room around the toes and ball of the foot. On the other hand, overly loose fitting shoes can slip and chafe, causing blisters and friction burns, which greatly increase the risk of skin infection in a diabetic patient.
Many companies specialize in the manufacture of diabetic and other “special needs” shoes. It is worthwhile to ask your doctor for a list of recommended brands, and research your options. Diabetic shoes generally share the following features:
- Roomy, contoured toe boxes. Your toes should have room to wiggle without rubbing against the inside of the shoe.
- Seamless, or near-seamless inner linings. While regular shoes often have ‘lumps’ or seams near the ball of the foot and/or around the heel, diabetic shoes should have seamless and cushioned linings to prevent chafing.
- Extra-thick contoured insoles. The soles of the feet are especially prone to pressure ulcers, so diabetic shoes and diabetic insoles are usually extra thick, and have extra-cushiony padding materials often at the heels and balls of the feet.
- Good “breatheable” ventilated designs. Diabetics are susceptible to fungal infections and cracked skin, both of which can be prevented by keeping the feet dry and well-ventilated.
- Elastic fit features. To ensure the fit of the shoe stays snug across the top of your foot, but never too tight, many diabetic shoes feature elastic inserts in the ‘uppers’.
Some shoe companies sell ‘regular’ shoes that are fairly well-suited for diabetics as well. Shoes designed for people who stand on their feet all day (such as nurse’s shoes) often meet most of the requirements for diabetic shoes. Other “natural” shoe companies design their shoes with roomy, contoured toe areas, and orthopedically “correct” footbeds. Many of their shoe designs could be ‘converted’ to acceptable diabetic shoes with the simple addition of extra insole padding. However, until you are very familiar with diabetic shoes and their special features, it is probably advisable to shop with the specialty diabetic shoe manufacturers, as their designs take the guesswork out of shoe shopping for you!
Some of the most common complications of diabetes concern the feet, and diabetic socks are a good way of minimising the problems. Whilst using diabetic socks will not prevent every problem, it will help with many of the problems. Special supportive diabetic socks will assist in preventing blood from collecting in your feet and lower legs, which, if it happens, will lead to infection and injury in the diabetic person.
Diabetic socks designed to cushion the feet and protect them from scuffing against the inside of your shoes, will also help avoid pressure ulcers and blisters. Look for thick, cushioned socks, with extra-thick knitting on the bottoms of the feet. Thick wool socks have been a favorite for cushioning the feet for centuries, but many modern diabetic socks are also made with cotton and cutting-edge synthetic fibers as well. Your doctor may be able to provide catalogs of special diabetic care products, including specialty diabetic socks.
Most diabetic socks are designed with zero seams which prevents friction burn injuries as well. Any abrasive toe seams can cause problems for a diabetic, as blisters are often very slow to heal, and cause gretly increased risk of ulcers on the foot. Seamless socks are a great help in avoiding such problems. When you try on a pair of socks, pay attention for anything that feels like a “lump” against your foot, because that will be a point where a blister or diabetic ulcer could form later. But if your favorite pair of socks have toe seams, you don’t necessarily need to throw them away. Turning them inside-out can minimise chafing from the seams.
Diabetic Socks which absorb moisture and also keep your feet warm will help stop fungal infections and assist with good blood circulation. Although dry skin is often a problem for diabetics, natural fiber socks and diabetic socks designed to absorb moisture and keep your feet dry are important in preventing infections and especially in allowing any existing injuries to heal. Many people swear by wool socks, but modern synthetic fabrics can do an admirable job as well.