A person with diabetes often has peripheral vascular disease, or decreased circulation to the legs and feet. Any damage to the feet may heal slowly because of the poor circulation.
The person may also have diabetic neuropathy, in which nerve damage from diabetes causes decreased sensation in the legs and feet. The person can develop an open area from pressure or from a cut, and not even feel the sore. Untreated, the damaged area can develop a diabetic foot ulcer.
The following factors increase a person’s chance of developing a foot ulcer:
- diabetic neuropathy, with damage to the nerves supplying the feet
- peripheral vascular disease, with decreased blood flow to the feet
- a history of 10 years or more of diabetes
- male gender
- blood sugar levels that are not under control
- diabetic retinopathy, or damage to the retina of the eye caused by diabetes
- cardiovascular problems caused by diabetes
- kidney problems caused by diabetes, including chronic renal failure
- a history of skin ulcers or amputation of a limb
- conditions caused by increased pressure on the feet, such as corns and calluses
- foot bones that are deformed or have limited movement, such as bunions
- thick toenails.
Guidelines for preventing foot ulcers from diabetes
- Inspect the feet daily for blisters, cuts, scratches, scalings, discolorations, and unusual swelling of the feet or toes.
- Pay particular attention to the area between the toes. If vision is poor or if reaching the feet is difficult, a member of the family should assist.
- Clean and soak both feet in luke warm water for 15 minutes before trimming toenails. Trim toenails so they are even with the end of the toe, and file sharp edges smooth. Corners should never be cut or dug out. See a Podiatrist if the nails grow into the flesh or if they are difficult to cut. Never cut your own nails if you have neuropathy.
- Wash feet daily with warm water and mild soap. Dry feet completely, especially between the toes.
- Gently massage a bland lubricating cream into the feet after drying them, especially around the toenails and heels. Do not put creams or ointments between the toes.
- Wear clean cotton or wool socks to bed if feet are cold. Hot water bottles or heating pads should not be used.
- Change socks and stockings daily.
- Avoid walking barefoot or wearing open-toed or open-heeled shoes.
- Break new shoes in gradually, by wearing them for a short time each day. Check inside shoes daily for foreign objects, nail points, and torn linings. If the linings are torn or crumpled, the shoe should be discarded.
- Corns or calluses should be treated by a professional. Never cut them with a razor blade or use chemicals to remove them.
- Be sure to get your feet checked by a podiatrist on a routine basis. A few minutes in the doctors office can save your limb or your life.