It’s that time of year again when we need to wrap up warm against the midwinter chill. But even though our long-suffering feet may be hiding away inside warm socks and winter boots, it shouldn’t be an excuse to neglect them. Our feet need extra special care, and diabetic foot care is especially important, as those of us with diabetes are particularly vulnerable to the cold weather.
One of the complications of diabetes is poor circulation, and this often leads to problems with the legs and feet. According to Diabetes UK’s campaign Putting Feet First, over 7,000 people with diabetes in England have leg, foot or toe amputations each year. There are, in fact, more than 100 diabetes-related amputations in the UK every week. People with diabetes are also 23 times more likely to have an amputation than the rest of the population.
Although these are fairly daunting statistics, the encouraging factor is that Diabetes UK says up to 80 per cent of amputations are preventable. This can be down to just getting into a routine of checking your feet each day.
Be Sensation Aware
The effects of high blood sugar in people with diabetes can cause nerve damage, resulting in a loss of sensory awareness, particularly in the feet. This means it is not always possible to feel pain if you are diabetic and injure your foot. If you do discover you have injured your foot, it may actually be some time since the injury occurred and be too late to prevent any infection and ulceration.
Margaret Stubbs, Clinical Advisor at Diabetes UK, says: “During the colder months it’s particularly important to be aware of any loss of sensation in your feet. Don’t go barefoot and avoid extremes of temperature if you think you have lost feeling in any part of your feet.”
Stubbs says it is important to particularly be careful when using equipment, such as electric blankets, hot water bottles, heat pads, or resting feet near or on radiators or electric fires.
“If your sensation is lowered you are more at risk of burns and blisters,” she says.
Also, check your shoes or boots for things like tiny pebbles or twigs, before putting them on. Stubbs says these can rub, which means if your sensation is damaged, blisters may go unnoticed. Also remember that if you are wearing thicker socks or tights, normal shoes may rub too.
Diabetes UK provides a straightforward system for patients to monitor foot sensitivity between their appointments. The system is called Touch the Toes Test. Don’t worry, it’s not a PT workout but just involves having your partner, or a family member, help you by lightly touching randomly chosen toes on both of your feet to check for reaction. The system can be downloaded from the Diabetes UK website via this link.
Wear the right shoes
Investing in the right footwear for your chosen exercise is not a luxury, it’s a total necessity. Stubbs says you should always wear well-fitted shoes that protect and support your feet.
“Ideally choose shoes that are broad fitting, have a deep rounded toe area, are flat or low-heeled and are fastened by a lace or buckle to keep your heel in the back of your shoe,” she says.
If you wear training or walking shoes, they should be made of natural or breathable fabric, which gives a firm but gentle support to the arch and ankle. They should also have a generous toe area and a Velcro or lace fastening that ensures your foot does not slide around inside the shoe.
Stay Active
Despite all these warnings, don’t let concerns about the risk of foot damage prevent you from keeping active. Exercise is one of the most powerful tools in fighting the symptoms of diabetes. The keyword when it comes to foot care is ‘vigilance’, and this is within your power to control, so with that in mind, go ahead and enjoy those winter walks.
Visit a podiatrist
Most importantly, don’t hesitate to visit your GP or, better still, your podiatrist, if any foot injury you incur, no matter how slight, does not show signs of healing after just one day. Remember, it may be too late to avoid infection if you leave it any longer than this.
Stubbs says: “If you notice any changes to your feet, you should make an appointment with your GP, podiatrist or nurse.”
Diabetic Foot Care Check list
Use the checklist below to help with your vital daily foot care.
- Check your feet each day for cuts or abrasions, corns, blisters, red patches and swellings. Also look for hard or cracked skin, sharp, snagged or ingrowing toenails and fungal infections.
- Wash feet in warm, not hot, water every day.
- Dry feet well. Be sure to dry between the toes. After drying, rub a thin coat of moisturising lotion over the tops and bottoms of feet, but not between toes to avoid any build up of moisture.
- Smooth corns and calluses gently with a pumice stone.
- Trim toenails straight across and smooth edges with an emery board.
- Wear comfortable, well-fitted shoes and never walk barefoot.
- Protect feet from extreme temperatures and wear socks at night if feet are cold.
- Help circulation by putting feet up when sitting, wiggling toes about and moving ankles up and down for five minutes several times a day.
- Don’t cross legs for long periods of time.
- Don’t smoke.
- Be more active.
Finally to read more about diabetics and the global situation, click on this link to our article:
The Missing Million Diabetic Epidemic
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