Podiatrists play a key role in the early detection and treatment of foot problems in people with diabetes. Neuropathy (nerve damage), arthropathy (joint damage), vasculopathy (blood vessel damage), and other complications can be avoided or delayed with annual comprehensive foot exams and treatment if needed.
A podiatrist is an important part of any diabetes health care team. At The Walking Clinic, our team of podiatrists are specifically trained in diabetes foot care and can assess nerve damage, identify specific foot health risks and help come up with a treatment and prevention plan.
Generally speaking, a diabetic patient that has good ciruculation and no neurologic deficit (numbness/burning/tingling) can be seen on an annual basis. However, if one is at higher risk with poor circulation and/or numbness in the feet, then exams/treatments should be done every 2-3 months.
While examining the feet of a diabetic, always be mindful to check for wounds or foot ulcers, which are common in diabetics. A trained podiatrist can not only trim the toenails professionally but will be diligent in spotting any other foot-related problems.
Avoid soaking your feet, as this can lead to dry skin. Dry your feet gently, especially between the toes. Moisturize your feet and ankles with lotion or petroleum jelly. Do not put oils or creams between your toes — the extra moisture can lead to infection.
Tingling, burning, or pain in your feet. Loss of sense of touch or ability to feel heat or cold very well. A change in the shape of your feet over time. Loss of hair on your toes, feet, and lower legs.
A diabetic foot ulcer typically appears as an open sore or wound on the bottom of the foot or the toes. The ulcer may be round or oval in shape and may be surrounded by red or discolored skin. The sore may be shallow or deep, and it may be painful to the touch.
Medicare will cover the treatment of corns, calluses, and toenails once every 61 days in persons having certain systemic conditions. Examples of such conditions include: Diabetes with peripheral arterial disease, peripheral arterial disease, peripheral neuropathy, and chronic phlebitis.
Wear socks or stockings with shoes. Wear socks without seams. Avoid tight-fitting socks and garters. Wear socks in bed if your feet are cold at night.
People with diabetes can easily get wounds on their feet. Improper cutting or care of toenails and feet is the leading cause that could lead to toe finger and foot amputation.
When you have diabetes, high glucose levels in the blood can damage nerves and blood vessels. Because the nerves and blood vessels supplying the feet are so long and delicate, the feet — and especially the toes — often get affected first.
Proper foot care requires that you keep your feet clean by washing them daily. Only use lukewarm water, like the temperature you'd use on a newborn baby. With hot water, you could burn the skin on your feet and not know it.
How does diabetes cause foot problems? Foot problems are common in people with diabetes. They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy, can cause numbness, tingling, pain, or a loss of feeling in your feet.
Podiatrists have the same rights to prescribing, administering, and dispensing medication that all licensed physicians do.
Management and Treatment
Care for diabetes-related foot pain may involve a doctor who specializes in the feet, called a podiatrist.
As you have a diabetic foot ulcer, you will need regular podiatry treatment. Your podiatrist will draw up a treatment plan for you. Prescription footwear and insoles can reduce the risk of ulcers but cannot remove the risk altogether.
Poor blood circulation often causes swollen feet and ankles when you have diabetes. Swelling in the feet and ankles is caused by excess fluid that builds up in the body tissue. The swelling is called edema, which is often caused by an underlying issue such as congestive heart failure, kidney disease, or diabetes.
Diabetes can cause changes in the skin of your foot. At times your foot may become very dry. The skin may peel and crack. This problem is caused by nerve damage that affects your body's ability to control the oil and moisture in your foot.
Exercise to benefit problem areas
If you are having circulation problems, choose exercises that focus on that part of the body. If circulation is poor in your feet, walking gets blood moving in your toes, feet, ankles and legs. If you can't get outside, target your lower body with squats, leg lifts and calf raises.
Diabetics often have reduced blood flow to their feet, which may cause thicker toenails or numbness.
Removing the toenail completely is not recommended for individuals who have diabetes, since the risk of complications due to poor wound healing and infection is high. I would highly recommend that you go to your doctor or a podiatrist to manage the trimming and, if necessary, the removal of the nail.
Taking excellent care of your feet is crucial. Diabetes Forecast says you can get a pedicure at a nail salon as long as you don't have an infection cut ulcer or neuropathy — but urges you to use caution and good judgment. The most important thing they advise is to make sure the salon you choose is extremely clean.
It can be an early sign of so-called "diabetic belly," a build-up of visceral fat in your abdomen which may be a symptom of type 2 diabetes and can increase your chances of developing other serious medical conditions.
Typically, epsom salt soaks are not recommended for people with diabetes. The primary reason is that such soaks can dry out the feet. When the skin is dry it is more vulnerable to cracking and chafing, which can lead to skin lesions and wounds, which if not properly attended to can lead to ulcerations.
When treating diabetic foot ulcers it is important to be aware of the natural history of the diabetic foot, which can be divided into five stages: stage 1, a normal foot; stage 2, a high risk foot; stage 3, an ulcerated foot; stage 4, an infected foot; and stage 5, a necrotic foot.