Tens of millions of type 2 diabetics develop diabetic neuropathy in their feet. Only hundreds of thousands of type 2 diabetics, however, suffer the kinds of injuries to their feet that eventually require surgery or even amputation. What is it that makes some type 2 diabetics especially unlucky with regard to the condition of their feet?
While we absolutely, positively urge all type 2 diabetics to keep blood sugar levels in good control and to get treatment for diabetic neuropathy, the simple fact is that the "last straw" in diabetic foot care is usually ill-fitted shoes, or failing to wear shoes at all. When diabetics don't have sensation in their feet, even a simple trip to the bathroom in the middle of the night without shoes can be occasion for a serious, and unnoticed, injury.
Most diabetics need to avoid walking outdoors without shoes, although carefully standing in place to do stretching, yoga, or meditation is likely to be OK. Walking around a swimming pool, however, requires shoes on feet, as does using a public shower. Infections are as potentially dangerous to diabetic feet as injuries.
General rules for foot care for diabetics include:
- Don't buy or wear any shoe that is uncomfortable. Your shoes should fit your feet. Don't make your feet fit your shoes.
- Always break in new shoes slowly.
- Don’t wear the same tennis shoes or canvas shoes two days in a row. Let shoes dry out so that they do not harbor bacteria or fungi that can cause infections.
- Wash your feet every day in warm water with a mild soap. Be sure to dry between your toes.
- Apply moisturizer to your feet after bathing and drying them. This keeps tiny cracks from forming in your skin that could allow infections to enter.
- Don't remove corns and calluses. They are there to protect the skin beneath them.
- Never use "corn removers." They may remove both the corn and the skin beneath them.
- Always cut toenails straight across, preferably with clippers rather than scissors. Don't cut or dig into the corners of the nail.
- Wear flats, not heels, and avoid pointed toes.