Diabetics' feet require special care

Summer is a time for sun and fun, beaches and bare feet, but it also poses a serious danger for those with diabetes. So much so, that the California Podiatric Medical Association urges diabetic patients to be aware that prolonged hot and humid weather can lead to a number of foot woes, including third-degree burns if they are not diligent in protecting their feet.

Neuropathy, nerve damage resulting in diminished sensations to the feet, is a common complication of diabetes. Such things as sunburn, hot sand and hot pavement, which would cause most people to react with pain, might not be noticed by someone with diabetes. The same with a too-hot hot tub, irritations from sandals or tight shoes, glass on the beach, rocks and sharp shells in the surf and chemical injury from over-the-counter corn removers.

“Each year nearly 55,000 people with diabetes have amputations. Most of these begin as minor injuries that were left untreated and allowed to develop into ulcers. What’s so tragic is that the vast majority of these amputations could have been prevented with basic foot care,” said diabetic wound care specialist Noah Blumofe, DPM, a podiatrist from Santa Monica.

Sandals also pose a problem for the diabetic according to Blumofe. “Any type of skin break on a diabetic foot has the potential of getting infected and ulcerate if not noticed and treated immediately. Therefore, wearing sandals all the time in the summer poses problems if you have diabetes. Feet constantly exposed in strap sandals and flip-flops lose moisture causing dry, rough skin prone to cracking. So, I advise patients who like to wear sandals a lot to inspect their feet very carefully each and every day and to alternate with regular shoes several days a week to limit exposure.”

Here are the Top 10 Tips for diabetic summer foot care from the CPMA:

• Wash your feet every day. Wash them gently but really wash them with soap and a washcloth. The water that runs off your body while you are standing in the shower doesn’t count. Do not put lotion between your toes and discuss foot powders with your doctor before using them.

• Check your feet every day. Check the top, bottom, sides and between the toes of each foot. If you have trouble seeing the bottoms of your feet, use a mirror. If you notice any red spots, wounds, bruises, rashes or injuries, call your doctor right away. Trim your toenails straight across and file the edges with an emery board or nail file. Do not try to remove corns or calluses yourself.

• Get regular foot exams. See your podiatrist as least once a year for a through foot exam to identify any conditions that could cause a foot ulcer, more frequently if you have bunions or hammertoes or diabetes related nerve damage.

• Control your blood sugars. High blood glucose can cause foot neuropathy. Good blood sugar control can reduce the risk and progression of diabetic neuropathy by 40 to 60 percent.

• Shoe shop with care. Your shoes should be comfortable the moment you put them on and not require any “breaking in.” Buy shoes at the end of the day when your feet are slightly swollen and wear the socks that you plan to use with them. Bulky socks require bigger shoes. Buy two pairs of shoes and alternate them, allowing each pair to dry naturally for a day before you wear them again.

• Consider prescription footwear. If you have foot deformities, a history of foot ulcers, nerve damage with calluses or a lack of sensation in your feet, your podiatrist can prescribe custom footwear. Medicare and many insurance carriers may cover much of the cost.

• Check inside your shoes before wearing them. Make sure the lining is smooth and there are no objects inside. Something my have fallen or crawled into them and if you have neuropathy you may not feel it. Make sure there are no loose pieces of fabric or leather inside the shoe that could rub against your foot. Discard shoes when they show signs of wear.

• Wear proper socks. Change your socks every day. Make sure they are smooth and they don’t wrinkle when you put them on. Some people with diabetes prefer seamless socks, but socks with flat, unobtrusive and soft seams are fine as well. Avoid socks with big seams.

• Keep the blood flowing into your feet. Put your feet up when sitting. Wiggle your toes and move your ankles up and down for five minutes, two or three times a day. Don’t cross your legs for long periods of time. Don’t smoke.

• Never walk barefoot, not even at the beach or pool, not even in the water. Wear sandals at the beach and swimming shoes in the water.

To learn more about foot health or to find a CPMA member visit http://www.podiatrists.org.