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Kristen Nichols HeitmanKristen Nichols Heitman, MPH, is an epidemiologist in the Rickettsial Zoonoses Branch in the Division of Vector-Borne Diseases in the National Center for Emerging Zoonotic and Infectious Diseases at the Centers for Disease Control and Prevention (CDC). She received a Master of Public Health (MPH) with a concentration in epidemiology from Georgia State University.

Managing your diabetes is important for many reasons, but did you know diabetes can affect your feet? Over time, high blood sugar levels can cause neuropathy (nerve damage) and circulation problems, which can cause you to lose feeling in your feet. Neuropathy occurs in about 70 percent of people with diabetes. Left unnoticed or untreated, sores, ingrown toenails and other problems can lead to infection. Poor circulation caused by diabetes makes healing an infection difficult. The American Diabetes Association estimates that foot problems are the reason why one in five people with diabetes who seek hospital care do so. Infections that do not heal can cause skin and tissue to die and turn black, known as gangrene. Treatment can involve surgery to amputate a toe, foot or part of a leg.

This is why foot care is very important for people with diabetes, and even more important if you exhibit these five signs and symptoms of foot problems:

  1. Burning, tingling, pain or numbness in your feet
  2. Changes in the shape or color of your feet or toes
  3. Loss of hair on the toes, feet or lower legs
  4. Thickening or yellowing of the toenails
  5. Sores, cuts or ulcers on your feet that do not heal

Managing your diabetes and maintaining a healthy lifestyle can help keep your feet healthy. To reduce your chances of experiencing serious foot problems, follow these tips:

Monitor and manage your blood sugar. Work with your healthcare provider to keep your blood glucose in your target range.

Attend regular medical exams that include foot checks at every visit.

Maintain a healthy lifestyle with physical exercise and a healthy diet. Walking is a great exercise because it doesn’t put too much pressure on your feet.
Follow healthy foot care daily habits:

  • Inspect your feet, including the tops, sides, soles, heels, and the area between your toes. To help view the bottoms of your feet, use a mirror. Contact your healthcare provider if you discover any sores, redness, cuts, blisters, or bruises.
  • Wash your feet daily in warm water with mild soap. Hot water and strong soaps can damage your skin.
  • Dry your feet well — don’t forget to dry between your toes. Infections are more likely to develop in moist areas.
  • Moisturize dry skin on your feet, but do not use lotion between your toes.
Perform routine toenail care.

  • Trim toenails after washing feet.
  • Make sure to cut straight across the nail and use an emery board to smooth sharp edges.
  • If you can’t see well, or if your nails are thick or yellowed, have your toenails trimmed by a foot doctor or other healthcare provider.
Wear socks and comfortable, well-fitting shoes at all times to protect your feet from cuts or bumps. Never walk barefoot in- or outdoors. Make sure to change your socks daily.
Keep the blood flowing to your feet. Elevate your feet when sitting. Don’t cross your legs or stand in one position for long periods of time. Wiggle your toes and move your ankles up and down for five minutes, two or three times per day.
Don’t smoke!
As part of your regular exams, your healthcare provider should examine your feet at every visit and do a thorough foot exam once a year. If you have a history of foot problems, you should be checked more often. Ask your healthcare provider for more information on foot care. Report any corns, calluses, sores, cuts, bruises, infections or foot pain. Diabetes-related foot problems can worsen very quickly and are difficult to treat, so it’s important to seek prompt medical attention.

The conclusions, findings, and opinions expressed by the author do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.

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