Are you at risk for diabetic foot ulcers?
If you have the tingling, burning, or numb sensation in your feet caused by diabetic neuropathy, chances are, you are. But there is a great deal you can do to avoid diabetic neuropathy progressing to diabetic foot ulcers.
Here are some easy but important tips, including a few that I personally learned the hard way.
To prevent diabetic ulcers, diabetics who have neuropathy in the feet, and diabetics in general, should:
Inspect feet and toes every day for any bruises, bumps, cuts, contusions, scrapes, or infections, including fungus infections like athlete’s foot. If you can’t look at your feet yourself, it is very important to find someone who can look at your feet for you.
Of course, if you are diabetic, you already know that part. But what you may not know to be on the lookout for is dryness on your shins, calves, and ankles. Dry skin tend to crack. When it cracks, it can invite infection. Diabetics tend to be especially susceptible to nasty infections like Klebsiella, which are easy to pick up on hospital floors and in emergency rooms.
Only use warm water, not hot, and mild soap (no Lava), to wash your feet. Test the temperature of the water by using your wrist before you immerse your heat. This will help prevent burns. And only spend as much time in the water as you need to get clean. Sorry, no hot tub soaks for you if you have diabetes.
Dr. Robert Bernstein cautions against soaking your feet if you have diabetes. Too much exposure to water may loosen protective calluses. Dry feet carefully with a soft towel, and don’t forget to dry between your toes. It’s a good idea to wash your feet every day.
Before you put on your socks, make sure your feet are dry, but then moisturize with a foot cream, cold cream, lanolin, or petroleum jelly. Moisturize will keep the skin on the foot from cracking and letting infection in. I'm personally partial to moisturizing with sea buckthorn oil, which reminds me of the hair care commercial from the 1950's (yup, I'm that old) about a "little dab 'll do ya,'" but less expensive products in larger quantities will also work.
And you don't want tight-fitting socks. Specially designed "diabetic socks," that don't leave grooves on your calves and ankles when you take them off, are both better for circulation and a lot more comfortable. Diabeticsocks are pricey, you can find a wholesale diabetic sock section at most WalMarts throughout North America. Medipeds Diabetic Socks are also available at K-Mart and Sears and occasionally for as little as US $1.50 a pair on eBay.
Be picky about your shoes. Make sure you get shoes with firm heels that support and stabilize. There should be plenty of room for your toes. Break news shoe in gradually, only an hour or two at a time.
There are open-toed sandals designed especially for diabetics, such Ambulator Conform Sandals. These sandals accommodate bunions, hammer toes, claw toes, and mallet toes, problems that are not unusual in diabetics’ feet. It's OK to buy cheap diabetic shoes as long as they have inserts to minimize skin damage in daily use.
Every time you see your primary health care provider, make sure he or she examines your feet. Do not hesitate to call if a sore on your feet is not healing well.
Try not to sit with your legs crossed. Crossing legs reduces blood flow to the feet.
Examine your shoes regularly to make sure they have not picked up any stones, tacks, nails, or street debris.
If your feet get cold at night, wear socks, but do not use heating pads, because diabetic neuropathy make prevent your feeling burns.
It’s OK to remove dead skin, but do not remove calluses covering a wound. Don't pick at dry skin and calluses. They are there for a reason.
And do what you can to control your neuropathy. One of the things about neuropathy that the experts don't tell us is that loss of sensation in the feet can result in "stepping wrong," losing balance, or tearing tendons in the knees to maintain balance. Surprisingly, taking care of your feet can save your knees and lower back. That's what the books don't tell diabetics.
Photo Credit: By Milorad Dimic MD, Niš, Serbia (Own work) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons.