(BlackDoctor.org) — Diabetes is a disease of the human endocrine system that affects an individual’s ability to produce sufficient insulin, a hormone that is essential to maintaining normal levels of blood glucose (sugar). Diabetes can negatively impact the vascular system, skin, kidneys, eyes and nervous system, and constant vigilance is needed to keep the disease and its potential complications under control.
When one has diabetes, blood sugar often comes to mind as the most important health concern for any person living with this common chronic disease. While maintaining well-controlled blood sugar is indeed paramount for any diabetic, there are also other health maintenance issues that demand daily attention, and proper foot care is one such crucial area for any diabetic.
The impact of diabetes is felt on many organs and tissues in the human body, and due to the fact that diabetes affects both nerve tissue and the circulatory system, the feet are a part of the body that is particularly vulnerable.
Circulation
Diabetes often leads to the development of peripheral vascular disease, wherein a narrowing of the blood vessels causes decreased circulation to the legs and feet. Poor circulation to these areas causes a lack of oxygen and nutrients being delivered to tissues in the extremities. Thus, injuries are slow to heal, skin becomes dry, and swelling and cracking of the skin may result. Slowly healing injuries can quickly turn into deep ulcers under these conditions, and dangerous infections are common, some of which can be life-threatening. Aside from avoidable death, amputation of an extremity is a very real consequence of circulatory issues from diabetes, thus attention is needed to avoid such complications.
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Neuropathy
Diabetic Neuropathy is a condition wherein nerve damage to the feet and lower legs causes a loss of sensation. This inability to feel pain, heat or cold can lead to unnoticed injuries that result in ulcers and infection. Neuropathy can also lead to conditions such as Hammer Toes and bunions, complications that can lead to problems with balance, chronic pain and difficulty walking.
Prevention
Preventing the development of diabetic ulcers, peripheral neuropathy and other foot-related complications is important for every diabetic. There are a number of things that the diabetic can do on a daily basis to care for their feet, and these can easily become habitual with time and dedication.
1) Footwear: Being fitted for proper footwear is essential for every person living with diabetes. While simply trying on a pair of shoes and seeing if they’re comfortable seems easy enough, a diabetic should be fitted for shoes by a trained professional.
Most insurance companies will pay for one pair of diabetic shoes every one or two years, and it is encouraged that diabetic individuals with insurance pursue this benefit aggressively. Special orthotic inserts can be fitted for most any shoe if diabetic shoes are too expensive or unavailable, and diabetic shoes themselves generally come complete with specialized insoles that protect the feet from shock, trauma, and the development of “hot spots” that may lead to ulcers and infection. Diabetics should never go barefoot or wear open-toed shoes, and it is advisable to always wear socks for protection and the absorption of moisture.
2) Daily foot checks: Every diabetic should inspect their own feet daily for cuts, bruises, sores, ulcers and other changes. Use a mirror or ask a family member or friend to check your feet if you cannot do so yourself, and it is recommended that the toenails of diabetics only be trimmed by a podiatrist, doctor, or specially trained nurse.
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3) Maintain well-controlled blood sugar: Normal blood sugar levels are essential to good circulation and the prevention of diabetic complications. Work with your doctor or nurse on developing a plan to keep blood sugars under tight control.
4) Monitor your circulation: Tight shoes and socks can constrict blood flow and lead to loss of sensation and other complications. Exercise daily, move your feet and ankles daily in order to pump the blood through your lower legs and feet, and watch for changes in color or sensation that may signal a circulatory problem. Also, do not cross your legs frequently, and remember that smoking can significantly decrease your vascular health.
5) Wash your feet daily: Feet that are regularly washed with warm water and soap and thoroughly dried are less prone to fungus, infection and skin breakdown. Dry carefully between the toes, and use a high-quality lotion on your feet after every washing.
6) Keep your feet protected from extreme temperatures: Heat and cold can damage the feet, and those with peripheral vascular disease may not be able to feel the sensations of heat and cold well enough to know when damage is being done.
7) Wear shoes and socks at all times: Protecting your feet from unnecessary injury is essential, and if you have had any loss of sensation, going barefoot or in open-toed shoes or sandals could lead to an injury that you may not detect until it’s too late. Also, do not wear tight footwear or socks that constrict your circulation.
8) Common sense: Diabetics should keep their weight down, refrain from alcohol and cigarettes, exercise moderately, and see their doctor and podiatrist regularly.
Conclusion
Diabetes is an increasingly common problem in the United States, along with obesity, high cholesterol and hypertension. Circulatory and nervous system damage to the feet and extremities are preventable with focused attention and good self care, and many diabetics live decades without a single complication.
Taking care of diabetic feet is essential for overall health. Following simple common sense, basic foot care recommendations, and maintaining tight blood sugar control are key ways to prevent unnecessary problems that can wreak havoc with quality of life and longevity. Diabetics should pay close attention to the health of their feet, and that attention will go a long way towards living a long, healthy and active life.
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