Proactive care of diabetes-related feet problems

Stubbing your toe, stepping on a sharp object, or getting a blister from tight shoes, are all common occurrences that you probably give little thought to. But if you suffer from diabetes, these small annoyances can lead to big feet problems if you don’t take proactive care of these minor wounds or injuries.

Podiatry Association of South Africa Diabetes Foot Health

If you are diabetic, you should always seek proper treatment no matter how small or superficial the wound may seem to be. Early and effective treatment can help you avoid feet problems and complications caused by infection and can speed up the healing process too.

Why diabetic wounds can cause problems:

  • Nerve damage (neuropathy). Diabetic neuropathy can sometimes mean that you don’t feel the pain of a cut or blister until it has grown worse or become infected.
  • Weakened immune system. When the body’s natural defences are down, even a minor wound may become infected.
  • Narrow arteries. Diabetics are prone to clogged arteries, which makes it harder for blood to get to a wound to heal it. As a result, this increases the likelihood of severe wounds, infections and slow healing.

How to treat a diabetic wound

Even a minor wound can become infected if bacteria are allowed to build up after injury. Take the following steps to avoid infection and promote healing:

  • Clean the wound. Remove any dirt by rinsing the wound under running water. Do not use soap, hydrogen peroxide or iodine, as these can irritate the injury. Apply antibiotic ointment to prevent infection and cover the wound with a sterile bandage. Change the bandage daily and use soap to clean the skin around the wound. Inspect your wound daily for any signs of infection.
  • Consult your doctor. Don’t take any chances! Have your doctor check even minor skin problems or areas of redness before they turn into larger problems.
  • Keep pressure off the wound. Often diabetic people will develop wounds on the bottom of their feet due to calluses and blisters. In this case, it is important to keep pressure off the wound as much as possible to allow it a chance to heal.

The dangers of foot wounds:

Feet and ankles are particularly vulnerable to diabetic wound problems. This is because these lower limb areas are prone to swelling, which can hinder the healing process. People with diabetes are also more likely to have calluses, dry skin and nerve damage. This makes it difficult to avoid foot wounds, increasing the risk of ulcers and infection.

Early detection of wounds can be a challenge for diabetics, as many lose feeling in their feet. Vision impairment is also a common symptom, making it difficult to see small wounds before they’ve already developed into a bigger issue. This is hugely problematic as when a wound becomes infected it can be far more serious than simply causing pain and inconvenience. For diabetics, complications can cause so much tissue and bone damage that amputation is sometimes the only option.

Research shows that ulcers precede most lower limb amputations in people with diabetes. This is why it is vital to take proactive care of minor feet problems before they’re able to develop into something more serious, or if possible, avoid wounds altogether.

How to prevent wounds

The best way to avoid problems is to prevent them:

  • Check your feet for problems daily. Look for blisters, calluses, chafing, and redness. This is the single most important thing you can do to avoid diabetic foot problems. If you have trouble seeing, ask someone else to check your feet every day.
  • Pay attention to your skin. Check for small, seemingly minor skin problems like infected hair follicles or inflamed areas around the fingernails. If you notice a problem, speak with your podiatrist.
  • Moisturise your feet. Avoid dry and cracked feet by using a moisturiser but avoid using lotion between your toes as this can lead to a fungal infection. If treating athlete’s foot, use a prescription cream antifungal product that doesn’t leave a moisture residue between the toes.
  • Invest in quality footwear. Protect your feet by always wearing closed shoes to avoid the risk of foot injury. Choose well-fitting shoes to help avoid blisters or speak to your podiatrist about custom-made shoes if you’re struggling to find a good fit for your feet.
  • Inspect your shoes daily. People with diabetic neuropathy may walk around with a stone or object in their shoe without knowing it is there. Make sure you also check for any tears or rough areas on the inside of the shoe that may lead to feet problems, injury or discomfort.
  • Choose the right socks. Avoid socks with seams and choose a material that wicks moisture away from the skin. Ask your podiatrist for socks that are made specifically for people with diabetes as these are beneficial and widely available.
  • Wash your feet daily. After washing, dry your feet carefully, including between your toes.
  • Smooth away calluses. After your bath or shower, use an emery board or pumice stone to gradually and carefully remove calluses. Never cut calluses with scissors or nail clippers.
  • Keep toenails clipped and even. Ingrown toenails can lead to foot problems so make sure your podiatrist or doctor checks your feet regularly for any potential issues.
  • Manage your diabetes. To prevent serious foot issues, you need to keep your diabetes under control. In addition, it is recommended to go for regular medical check-ups, take the medications your doctor prescribes, monitor blood sugar, blood pressure, and cholesterol levels. Finally, diabetics should try to lead a healthy and active lifestyle by eating healthy foods, exercising regularly, and avoiding alcohol and cigarettes.