Whether you have type 1 or type 2 diabetes, good foot care is essential. Over time, diabetes can lead to complications in your feet due to decreased circulation and changes in blood vessels, which may lead to neuropathy, a loss of sensation in the feet.1 And if your feet are numb, you may not even notice a small wound. These sores can quickly become seriously infected before they're even discovered, which is why it's key to pay close attention to your feet.
Common Foot Problems
Poor circulation and nerve issues can cause a multitude of problems in the feet, ranging from skin issues to staph infection and ulcers.2
More mild foot conditions associated with diabetes include:
Calluses and corns
Brittle nails due to fungal infections
Hammertoes (bent toes)
Then there are other, more serious conditions that may occur:
Diabetic neuropathy, or nerve damage, arises when excess sugar due to poorly controlled diabetes contributes to blood vessel breakdown and inadequate nerve communication, affecting nerve transmission primarily to the extremities, such as the hands and feet. Neuropathy is to blame for tingling, numbness, and pain, and may also cause muscle weakness and wasting, and inability to feel hot/cold temperatures.3 The loss of feeling from neuropathy is responsible for the dangers of undiscovered minor foot injuries becoming major infections.
Having diabetes also puts you at risk for peripheral artery disease (PAD), which involves a hardening of the arteries outside of the brain and heart. This narrowing (occlusion) of the arteries makes it harder for blood to flow to the toes and fingers, and can affect oxygen delivery to the feet and hands. This decreased oxygen may lead to ulcer formation, open sores that are difficult to heal and may extend through the entire skin layer. Ulcers may form on the bottom of the foot or underneath the big toe, or on the sides of the feet due to shoe friction.4
The ulcers and open sores that can occur in feet as a result of diabetes can put you at risk for contracting MRSA or other infections.
People with diabetes are also at risk for contracting methicillin-resistant Staphylococcus aureus (MRSA), a type of staph infection that is resistant to multiple antibiotics. Anytime there is a break in the skin, germs may enter and cause an infection. Diabetes increases your chances of getting MRSA because sores and ulcers can occur without your knowledge.5 A MRSA infection can appear as a reddish rash, such as a small boil, and when open, can look like an abscess. There are two major categories of MRSA: nosocomial infection, meaning that it's an infection that is transmitted mostly in healthcare settings, or community-acquired MRSA. This strain of MRSA is transmitted by contact. It can live on surfaces and is also spread by skin-to-skin contact. It has become a major concern because the number of people contracting it has recently increased.6 There are a few antibiotics and topical antibiotic treatments that are successful in treating MRSA, but re-occurrence can still be a problem for many people.
With good hygiene practices and good foot care, you can reduce your risk for sores and infections, including MRSA. Keeping your blood sugar under control can also help by lowering your risk of all foot complications including sores, ulcers, and neuropathy.
Blood Sugar Management
To best manage your blood sugar, use a glucometer to test your blood sugar levels several times per day to help you establish a consistent picture of your fluctuations, and to inform your daily treatment decisions. Additionally, be sure to get regular checkups with your practitioners and get the hemoglobin A1c test, which will provide a picture of your average blood glucose control over three months. The A1c test should be performed two to four times per year.7
Good Hygiene Practices
To limit your exposure to infection and disease, follow these tips.8
Washing your hands frequently with soap and water or alcohol-based hand sanitizer.
Never share towels, razors, or other personal items.
Never share insulin pens or needles with another person.
If you use equipment that is regularly used by others, such as at the gym, on airplanes, or on the subway, make sure that the surfaces are wiped down to the best of your ability with an antibacterial wipe or spray before you use it, or use hand sanitizer after you're finished using the equipment.
Regular Foot Care
Being proactive about your foot care means you might be able to avoid a lot of the foot complications that sometimes come with diabetes down the line.9
Inspect your feet every day for sores and open areas.
Do not go barefoot. Keep your feet covered with dry, clean socks and well-fitting shoes.
Wear white socks, so you can visibly notice if there's any blood or pus forming.
Try compression socks that work to promote good circulation.
Get regular checkups at the podiatrist (a doctor who specializes in feet) and be sure to get any open sores quickly treated. Keep the sore covered with a clean, dry bandage.
Trim toenails carefully by clipping straight across the edge, then filing down sharp corners with an emery board.
Avoid pedicures at nail salons, as these could potentially open you up to the risk of infection.
It's important to change any habits that limit circulation and blood flow, such as smoking or a sedentary lifestyle.
What to Do If Foot Issues Arise
If you notice a new blister, sore, or another foot issue, your best course of action is to get it immediately treated by a professional. This could be a podiatrist or your general practitioner. Because circulation and nerves may be affected by diabetes, the healing process could take longer than normal, so be sure to monitor your feet daily to be sure the healing process is taking place.10 If things start to worsen, reach back out to your care provider immediately.