Every morning for years, John would walk to the beach near his house, take off his shoes and walk on the sand as the sun rose. He enjoyed his morning walks tremendously. He loved the feel of the sand sifting through his toes. It gave him such a feeling of connection with nature. So, he was gravely disappointed when his doctor diagnosed him with diabetes and advised him to stop walking barefoot at the beach to avoid injuries that he might miss, resulting in serious complications.
John is not alone. According to the American Diabetes Association, 25.8 million people in the United States (8.3% of the population) are affected by diabetes. Like John, they are told to never walk barefoot on any surface due to their increased vulnerability to foot injury. Why is that?
How does diabetes make feet more vulnerable to injury?
Over time, diabetes can lead to poor circulation and nerve damage to the feet and hands, which results in decreased sensation and a dulled perception to pain and temperature. That can result in a person continuing with an activity even though it is injuring them. So, in John’s case if he were to walk barefoot at the beach and accidentally step on a rusty nail he might not even feel it. This could result in the injury being untreated, which could lead to infection with gangrene and ultimately an amputation of the affected limb or, if left untreated long enough, it could be life threatening.
Plus, the healing process for wounds for individuals with diabetes is quite impaired. Once you get a foot wound, the healing time is prolonged due to multiple factors. Chief among those is the lack of key chemicals and immune cells that are important for effective wound healing. Further complicating the healing process, impaired sensation at the peripheral nerves lends itself to aggravating the injury, slowing healing and sometimes even worsening the injury.
So how can I protect my feet?
There are many things you can do to ensure that you keep your feet protected and healthy.
- Inspect daily: Check your feet for a change in color, blisters, sores, cuts and calluses. Especially, after wearing shoes for a stretch of time. Pay close attention to the area between your toes and to your soles. Your toes should be free of debris between them. And if you are unable to see your foot, use a mirror or ask a friend or family member to help.
- Wash daily: Wash your feet throughly to ensure that they are completely clean. Make sure to dry gently afterward, especially between your toes.
- Apply lotion: After bathing, apply lotion to your dry feet. But do not apply lotion between your toes. That can lead to attracting debris to that area.
- Always wear socks with your shoes: Wear socks that are made from cotton or blends that are non-irritating, absorbent and can breathe. Never wear dirty socks with holes or darns.
- Wear comfort fitting shoes: Buy shoes that fit your feet, and are made from materials that mold to the shape of your foot (soft leather or athletic style shoes are good choices). Sandals and open toed shoes are poor choices. You may need to go to a professional to ensure proper fit. When shoe shopping, go later in the day when feet tend to be more swollen, so that you don’t buy shoes that end up being too tight. Prior to wearing your shoes, make sure to inspect the inside of your shoes to make sure that the lining is smooth and there are no objects in them. New shoes should only be worn for a maximum of 2 hours in one stretch and your feet should be inspected after each wear.
- See your physician regularly: Your physician will do a complete foot exam at least annually, but more if you have a history of foot problems. And they may refer you to a podiatrist, if necessary.
- Never go barefoot: Avoid going barefoot on any surface, which means both indoor and outdoor surfaces. At least wear slippers when at home.
- Trim nails carefully: When you trim your nails trim it straight across and, if you are unable, speak with your physician.
- Protect your feet from extreme temperatures: Check bath water with your elbow or forearm before bathing. And never use hot water bottles and heating pads.
- Don’t cut your own corn or callous: Your physician or podiatrist will do that for you. So, don’t try using corn and callous removers.
The bottom line:
When you have diabetes, you are more vulnerable to foot issues. However, if you dedicate some time each day to properly care for your feet, you can prevent many serious foot issues, by following the simple steps I mentioned above. And if you do get a foot injury, seek professional care right away. You only have two feet, so take good care of them if you want them to continue to carry you throughout the rest of your life.
Sources: Mayo Clinic and Northwest Hospital