Diabetic Foot Care: Prevent Foot Problems in Diabetes

Managing type 2 diabetes is like juggling with several balls in the air. And every one of them is important!

It requires maintaining blood sugar levels within the normal range, adhering to medications prescribed, eating a healthy diet regularly, engaging in physical activity, making time to de-stress, keeping up with all doctor appointments, ensuring regular lab assessments while leading a healthy lifestyle with smoking cessation and reducing alcohol intake. Phew!

Why do healthcare professionals recommend this? Uncontrolled diabetes can lead to several problems starting with damage to the nerves and blood vessels, eventually causing damage to the body's various organs, such as the eye, the kidneys, and the heart.

While most patients are aware of the risks of diabetes-related complications, the most common complication of diabetes and the one that is most preventable, often goes unacknowledged. We are talking about the diabetic foot.

Let’s look at this complication of diabetes, understand what causes it, and what diabetic foot care involves.

Diabetic foot: bringing life to its knees

Did you know every 20 seconds, a foot is getting amputated because of diabetes? 

Diabetic foot is an expensive complication of diabetes that not only affects the quality of life of people with type 2 diabetes but also increases the future risk of diabetes-related complications and longevity.

It is also one of the major causes of repeated hospitalisations which can cause economic and psychological distress. Moreover, once diagnosed with diabetic foot, the prognosis is quite painful, not just for the person with diabetes but also for the caregivers and family.

Identifying diabetic feet early and ensuring timely treatment can prevent these serious risks.

Causes of diabetic foot

Persistently high blood sugar levels in diabetes can cause nerve damage and reduced blood flow -the two main culprits that cause diabetic foot.

Nerve damage is one of the earliest effects of diabetes. While some people with diabetes may have no symptoms of nerve damage, for others, it may cause a tingling sensation or excessive pain or feeling of being hot or cold, especially in your feet.

Some people may also feel a loss of sensation in their feet. When such symptoms are seen, it needs to be immediately brought to the attention of the consulting healthcare professional.

Nerve damage may cause the skin of the feet to get dry, causing a physical change in the foot's shape. This causes increased pressure in the areas of the feet that bear the body's weight. This includes the tip of the toes, the heel, and the area just below the back of the toes of the body, commonly called the ball of the foot. This leads to thickening these areas of the foot (callus formation).

The loss of sensation in the feet due to nerve damage can often make these wounds go unnoticed.

Continued pressure on these calluses may cause them to break and bruise, causing the formation of a wound or ulcer. Micro-organisms can easily access such a wound.

Diabetes is also known to increase the obstruction of blood flow in the body. The high blood sugar levels make the blood flow more sluggish, causing reduced blood flow.

As a result, important blood components that can fight infections cannot reach the affected foot in time and in the quantities required, leading to foot infections. Because of reduced oxygen supply to these parts due to reduced blood flow, that part of the foot gets further damaged, aggravating the situation further.

If not identified and treated on time, the infections can spread to:

• The bone causing infection of the bone
• The entire foot causing the need to amputate the affected leg to protect the life of the person in question or
• Other parts of the body causing sepsis, a medical emergency that can be detrimental to life

Risk factors for diabetic foot

Diabetic foot is more often seen in people with:

• Perpetually high blood sugar levels that are not controlled by any means
• Long duration of type 2 diabetes
• Age above 40 years
• Excess weight
• High blood pressure
• High cholesterol

Diabetic foot care tips

1. Maintain blood sugar levels within the normal range

• Keeping blood sugar levels under control is fundamental to maintaining healthy feet.
• This will require regular monitoring of blood sugar levels at home, adhering to medications prescribed, and following your healthcare team's diet and exercise recommendations.

2. Examine your feet every day

• Checking your feet daily can go a long way in preventing diabetic foot.
• One should start by checking for any loss of touch, sensations like tingling or burning in the feet, or the presence of a warm foot.
• One should also look for thickening of the skin, check for the presence of any wounds or cuts and inform the healthcare team immediately if any wounds seen are not healing. For examining the lower part of the foot, a mirror can be used, or the help of a podiatrist or nurse can be taken.

3. Ensure proper foot care

• Washing the feet daily with warm water and soap and patting them dry, especially between the toes, can help prevent diabetic feet.
• Washing with hot water should be avoided as it can damage the skin.
• Once dry, the foot needs to be kept moisturized with diabetes-friendly products by applying over and under the feet but not in between the toes, as it can lead to infections.

4. Engage in foot-friendly activities

• Keeping active with feet exercises like walking, swimming, and cycling can help improve blood flow and prevent diabetic foot.
• Keep regular follow-ups with your healthcare team
• Keeping up with follow-up appointments with the health care team and regular check-ups can help not only keep diabetes under control but also protect the feet.
• At these visits, it is important to ensure that one’s feet are checked for wounds, sensations, and blood flow.

5. Keep regular follow-ups with your healthcare team

• Keeping up with follow-up appointments with the health care team and regular check-ups can help not only keep diabetes under control but also protect the feet.
• At these visits, it is important to ensure that one’s feet are checked for wounds, sensations, and blood flow.

6. Use proper footwear

• Using the right footwear that is not too tight is important. Checking the footwear for smoothness to protect against bruises should be a norm before wearing them every time.
• Also, wearing socks with shoes can be helpful for comfort and protection. While wearing new shoes, it is important to slowly get accustomed to them by wearing them for gradually longer periods of time instead of starting out for a whole day.

7. Avoid walking without footwear

• Walking barefoot on the grass can be refreshing, but mind you, walking barefoot can increase the risk of getting cuts and wounds that can go unnoticed with loss of sensation in the feet.
• Even while walking at home, it is prudent to walk with comfortable footwear.

8.Trim your toenails regularly

Trimming and smoothening of the toenails are important to prevent accidental injuries.

9. Maintain a healthy lifestyle

Smoking cessation and reducing alcohol intake can help lead a healthier life and prevent the risk of diabetes-related complications.

Conclusion

Diabetic foot is the most preventable complication of diabetes. Maintaining blood sugar levels under control, leading a healthy lifestyle, ensuring daily foot care, doing regular check-ups, and following the healthcare team's advice can help protect your feet from the harmful effects of diabetes.