Want to keep your feet in dancing shape long into the future? You can, but it takes know-how and vigilance. For those who fail to protect their feet, the price is severe: Each year about 54,000 people with diabetes have amputations. However, most of those amputations are the result of minor injuries that were left untreated and allowed to develop into ulcers. That means that most of those amputations could have been prevented.
Here are some tips for protecting your feet.
1. Wash your feet every day. Wash them gently, but really wash them, with soap and a washcloth. The water that runs off your body while you are standing in the shower doesn’t count as washing. Then gently pat them dry with a clean, soft, absorbent towel. Do not put lotion between your toes. Discuss foot powders, or anything else you are considering using on your feet, with your doctor or podiatrist (foot doctor) before using them.
2. Check your feet every day. Check the top, bottom, sides, and between the toes of each foot. If you have trouble seeing the bottoms of your feet, or difficulty reaching over to inspect them, use a mirror. If you notice any red spots, wounds, bruises, rashes, or injuries, call your podiatrist or doctor right away, even if the injuries seem small. Do not try to remove corns or calluses yourself.
3. Get regular foot exams from your doctor or podiatrist. The American Diabetes Association recommends that everyone with diabetes have at least one thorough foot exam each year to identify any foot conditions that could pose a risk of developing foot ulcers. The examination should include a monofilament test to assess protective sensation and the presence of nerve damage; an analysis of foot structure, mechanics, and circulation; and an assessment of skin health and integrity.
If you have one or more deformities (bunions or hammertoes), or your doctor has told you that you have diabetes-related neuropathy (nerve damage), you should have foot exams more frequently. To help remind your doctor to check your feet, take off your shoes and socks when you have a physical.
4. Control your blood sugars. High blood sugars can cause neuropathy in your feet. This nerve damage can make it hard for you to feel discomfort or pain when your feet are injured. If you have an injury and don’t know it, it can become infected, grow into an ulcer, and lead to amputation. Several studies, including the Diabetes Control and Complications Trial, indicate that good blood sugar control can reduce the risk and progression of diabetic neuropathy by 40 to 60 percent.
5. Shoe-shop with care. Your shoes should be long enough, wide enough, and deep enough to cover your feet without rubbing or constricting any part of them. They should be comfortable the moment you put them on and not require any “breaking in.” Buy shoes at the end of the day, when your feet are slightly swollen, and wear the socks that you plan to use with them. Bulky socks require bigger shoes. Buy two pairs of shoes, and alternate them, allowing each pair to dry naturally for a day before you wear them again.
6. Check out prescription footwear. Several conditions warrant a prescription for custom footwear from your doctor or podiatrist: foot deformities, a history of foot ulcers, prior amputation, severe vascular disease in your feet, nerve damage with calluses, and insensate feet. Medicare and many insurance carriers will help pay for custom footwear.
7. Check inside your shoes before you put them on. Something may have fallen (or crawled!) into them when you weren’t looking. Feel inside each shoe to make sure nothing is inside, and make sure there are no loose pieces of fabric or leather inside the shoe that could rub against your foot. Discard shoes when they show signs of wear and tear.
8. Wear clean socks. Change your socks every day. Make sure they are smooth and they don’t wrinkle when you put them on. Some people with diabetes prefer seamless socks, but socks with flat, unobtrusive, and soft seams are fine as well. Avoid socks with big seams.
9. Watch out for the elements. If you engage in sports in extreme temperatures, talk to your doctor or podiatrist about ways of keeping your feet warm in the winter and cool and dry in the summer. Talk to your doctor before using toe warmers for outdoor winter sports. Although you certainly don’t want to risk frostbite, toe warmers can cause bums if used improperly, and if you can’t feel the injury, the damage can be severe. Do not use electric blankets or heating or cooling gels on your feet without talking to your doctor or podiatrist first.
8. Never walk barefoot. Not even at the beach or pool. Not even in the water. Wear sandals at the beach, and swimming shoes in the water.