We walk on our feet every day, yet rarely give them the attention they deserve unless there is a problem. As we get older, it becomes more difficult to wash our feet, especially between the toes. Toenail care can also be challenging if nails become thick or toes crowd each other.
People with diabetes can be especially prone to problems with their feet due to neuropathy. Neuropathy can also be caused by other conditions, such as vitamin deficiencies (B12, folate), alcoholism, autoimmune diseases like lupus and rheumatoid arthritis, and by some medications.
Diabetic peripheral neuropathy (damage to the nerves in the feet and hands) is caused by persistently high blood sugar levels. Sensations that can occur in feet and hands with neuropathy include numbness, tingling, pins and needles, prickling, burning, cold, pinching, buzzing, sharp or deep stabs.
There are treatments that can lessen the painful symptoms of neuropathy, however, there is no cure. Loss of balance is common with neuropathy as one loses the ability to feel their feet firmly in their shoes and on the floor.
Neuropathy can also create a dulling of sensations that would otherwise alert you to damage. Individuals may stub their toe or walk with a small pebble in their shoe and not be aware of it until an open sore occurs.
Neuropathy can also lead to toe deformities. Muscles of the feet and toes can atrophy, or become small and weak. This motor neuropathy can cause clawing of the toes and may contribute to hammertoe formation. Shoes that are too small or rub over toes can cause calluses, corns, or abrasions.
Diabetes can also damage the blood vessels to the legs and feet. This decreased circulation along with neuropathy can lead to excessive dry skin that can itch or even crack, allowing microbes to enter and cause infection.
Tight blood sugar control can prevent or delay the onset of neuropathy and peripheral vascular disease, as well as other complications associated with diabetes.
Check your feet
It is important to inspect feet daily. Look for areas of redness or irritation on the tops, bottoms, and between toes. If irritation is noted, try to determine the cause. Do the shoes fit appropriately? Was there a wrinkle or seam in the sock? Were you walking barefoot? Do not wear shoes that are causing problems.
Ensure shoes fit properly. Shoes should not rub on the toes, the widest part of the foot, or the heel. Shop for shoes with a high toe box that are wide enough to accommodate the ball of the foot. The sole of the shoe should be firm enough to provide support. People with toe deformities may benefit from small silicone pads or toe sleeves, which can reduce pressure to sensitive areas.
Wash feet with gentle soap and water, and dry thoroughly. Apply a cream or lotion to feet and legs daily, avoiding products with heavy fragrance that may contain alcohol, which can dry out the skin.
Toenails should be trimmed straight across, leaving a small amount of white nail border. File corners if needed to avoid sharp edges that can rub or cut into surrounding toes.
People who have diabetes or other conditions associated with peripheral vascular disease or neuropathy may benefit from professional care for their corns, calluses, and thick nails by a podiatrist, nurse specializing in nail care, or other healthcare provider.
Report pain in your feet, excessively dry skin, irritation, open areas, and other concerns with your healthcare provider.
Routine inspection and good skin care will help keep your feet in good condition for years to come.