The Diabetic Foot
Diabetes is a serious disease that can
develop from lack of insulin production in the body or due to the
inability of the body's insulin to perform its normal everyday functions.
Insulin is a substance produced by the pancreas gland that helps process
the food we eat and turn it into energy.
Diabetes affects approximately 16 million
Americans and is classified into 2 different types: Type 1 and Type 2.
Type 1 is usually associated with juvenile diabetes and is often linked to
heredity. Type 2, commonly referred to as adult onset diabetes, is
characterized by elevated blood sugars, often in people who are overweight
or have not attended to their diet properly.
Many complications can be associated with
diabetes. Diabetes disrupts the vascular system, affecting many areas of
the body such as the eyes, kidneys, legs, and feet. People with diabetes
should pay special attention to their feet.
Of the sixteen million Americans with
diabetes, 25% will develop foot problems related to the disease. Diabetic
foot conditions develop from a combination of causes including poor
circulation and neuropathy. Diabetic Neuropathy can cause insensitivity or
a loss of ability to feel pain, heat, and cold. Diabetics suffering from
neuropathy can develop minor cuts, scrapes, blisters, or pressure sores
that they may not be aware of due to the insensitivity. If these minor
injuries are left untreated, complications may result and lead to
ulceration and possibly even amputation. Neuropathy can also cause
deformities such as Bunions, Hammer Toes, and Charcot Feet.
It is very important for diabetics to take
the necessary precautions to prevent all foot related injuries. Due to the
consequences of neuropathy, daily observation of the feet is critical.
When a diabetic patient takes the necessary preventative footcare
measures, he or she reduces the risks of serious foot conditions.
Diabetes often leads to peripheral vascular
disease that inhibits a person’s blood circulation. With this condition,
there is a narrowing of the arteries that frequently leads to
significantly decreased circulation in the lower part of the legs and the
feet. Poor circulation contributes to diabetic foot problems by reducing
the amount of oxygen and nutrition supplied to the skin and other tissue,
causing injuries to heal poorly. Poor circulation can also lead to
swelling and dryness of the foot. Preventing foot complications is more
critical for the diabetic patient because poor circulation impairs the
healing process and can lead to ulcers, infection, and other serious foot
Treatment and Prevention
Footwear and orthotics play an important
role in diabetic footcare. Orthotics designed with Plastazote“ foam, the
#1 material for protecting the insensitive diabetic foot, are usually
recommended. Plastazote is a material designed to accommodate pressure
“hot spots” by conforming to heat and pressure. By customizing to the
foot, Plastazote provides the comfort and protection needed in diabetic
footcare. Footwear constructed with Plastazote is also recommended
frequently for the diabetic patient. Diabetic footwear should also provide
the following protective benefits:
- High, wide toe box (high and wide space
in the toe area)
- Removable insoles for fitting
flexibility and the option to insert orthotics if necessary.
- Rocker Soles designed to reduce pressure
in the areas of the foot most susceptible to pain, most notably the
- Firm Heel Counters for support and
If you are a diabetic, you should be
particularly alert to any problems you may be having with your feet. It is
very important for diabetics with neuropathy to take necessary precautions
to prevent injury and keep their feet healthy. If you have diabetes and
are experiencing a foot problem, immediately consult your foot doctor.
Footcare & Diabetes
Proper footcare is especially critical for
diabetics because they are prone to foot problems such as:
- Loss of feeling in their feet
- Changes in the shape of their feet
- Foot ulcers or sores that do not heal
Simple daily footcare can prevent serious
problems. According to the National Institute of Health, the following
simple everyday steps will help prevent serious complications from
- Take Care of Your
Make healthy lifestyle choices to keep your blood sugar close to normal.
Work with your health care team to create a diabetes plan that fits your
- Check Your Feet Every
You may have foot problems that you may not be aware of. Check your feet
for cuts, sores, red spots, swelling, or infected toenails. Checking
your feet should become part of your daily routine. If you have trouble
bending over to see your feet, use a plastic mirror to help. You can
also ask a family member to help you.
Important Reminder Be sure to call your doctor immediately if a cut,
sore, blister, or bruise on your foot does not heal after one day.
- Wash Your Feet Every
Wash your feet in warm, NOT HOT, water. Do not soak your feet because
your skin will get dry. Before bathing or showering, test the water to
make sure it is not too hot. You should use a thermometer or your elbow.
Dry your feet well. Be sure to dry between your toes. Use talcum powder
to keep the skin dry between the toes.
- Keep the Skin Soft
Rub a thin coat of skin lotion or cream on the tops and bottoms of the
feet. Do not put lotion between your toes, because this might cause
- Wear Shoes and Socks
At All Times
Wear shoes and socks at all times. Do not walk barefoot, not even
indoors. It is extremely easy to step on something and hurt your feet.
Always wear seamless socks, stockings, and nylons with your shoes to
help avoid the possibility of blisters and sores developing. Be sure to
choose seamless socks that are made of materials that wick moisture away
from your feet and absorb shock and shear. Socks made of these materials
help keep your feet dry. Always check the insides of your shoes before
putting them on. Make sure the lining is smooth and there are no foreign
objects in the shoe, such as pebbles. Wear shoes that fit well and
protect your feet.
- Protect Your Feet
From Hot and Cold
Always wear shoes at the beach or on hot pavement. Put sunscreen on the
tops of your feet for protection from the sun. Keep your feet away from
radiators or open fires. DO NOT use hot water bottle or heating pads on
your feet. If your feet are cold, wear seamless socks at night. Lined
boots are good to keep your feet warm in the winter. Choose socks
carefully. DO NOT wear socks with seams or bumpy areas. Choose padded
socks to protect your feet and make walking more comfortable. In cold
weather, check your feet often to keep your feet warm avoid frostbite.
- Keep the Blood
Flowing to Your Feet
Put your feet up when you are sitting. Wiggle your toes for 5 minutes, 2
or 3 times a day. Move your ankles up and down and in and out to improve
blood flow in your feet and legs.
- DO NOT cross your legs for long
periods of time.
- DO NOT wear tight socks, elastic, or
rubber bands, or garters around your legs.
- DO NOT wear restrictive footwear or
foot products. Foot products that can cut off circulation to the feet,
such as products with elastic, should not be worn by diabetics.
- DO NOT smoke. Smoking reduces blood
flow to your feet.
If you have high blood pressure or high cholesterol, work with your
health care team to lower it.
- Be More Active
Ask your doctor to plan an exercise program that is right for you.
Walking, dancing, swimming, and bicycling are good forms of exercise
that are easy on the feet. Avoid all activities that are hard on the
feet, such as running and jumping. Always include a short warm-up or
cool-down period. Wear protective walking or athletic shoes that fit
well and offer good support.
- Communicate With Your
Ask your doctor to check the sense of feeling and pulses in your feet at
least once a year. Ask your doctor to tell you immediately if you have
serious foot problems. Ask your doctor for proper footcare tips and for
the name of your local podiatrist.
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