Problems with our feet are more likely when we are living with diabetes. This is because diabetes can damage our nerves and decrease the blood flow to our extremities. When our nerves are damaged, they can no longer send signals to other parts of the body. Nerve damage can range from a sensation of mild numbness to pain that will make normal daily activities that much harder. As many as 50% of those living with diabetes will develop a form of diabetic neuropathy.
Diabetic Peripheral Neuropathy is only one type of nerve damage that can affect those with diabetes and is also the most common type. This is directly related to high blood sugar levels and will usually affect the feet and legs first, followed by the hands and arms. There are symptoms that you can watch out for:
· Tingling in feet or the sensation of “pins and needles”
· The feeling that you’re wearing socks when you aren’t
· Pain or cramps in your feet.
· An increase in sensitivity, especially during the night… sometimes even the weight of a bedsheet can become painful.
· Numbness and/or weakness in muscles
· Ulcers, infections, bone, or joint pain
· Small cuts or sores on your feet that seem to take longer to heal
So, why does all this happen to some people living with diabetes? Of course, it’s not just one cause, there are numerous factors that come into play:
· Increased (unmanaged or poorly managed) blood sugar levels for an extended amount of time. This will cause damage to the blood vessels that carry nutrients and oxygen to the nerves. This lack of nutrients and oxygen causes damage to the nerves which leads to them having either a dull reaction or no reaction to stimuli.
· Exposure to prolonged smoking and alcohol abuse. Both of these habits affect the circulatory and nervous systems.
· Being overweight
· Being 40 years old or older
· Having high blood pressure and high cholesterol
There can be complications that arise if those living with diabetes are not putting preventative measures in place: infections from small cuts on the feet can snowball pretty quickly if we aren’t checking our feet out daily. 70% of non-traumatic lower limb amputations in Canada are due to diabetes complications. 85% of these amputations started off with a foot ulcer that wouldn’t heal.
So, what are these preventative measures? It’s pretty simple but needs to be consistent.
· Check those feet daily for cuts, redness, swelling, blisters, corns, calluses, or any other changes to the feet. If you can’t see the bottoms yourself, get a mirror or a family member to help you out.
· Wash feet daily with warm water (don’t make it too hot – damaged nerves won’t be able to tell if it’s burning you!) Once washed, dry them completely and put lotion on them (just not between the toes as the moisture could lead to infection)
· Keep the footwear on (even when inside) to avoid injuries. Check shoes before putting them on each time…check for pebbles or other small objects and to see if the lining is smooth. If there is nerve damage, you may not be able to feel these things with your feet.
· Wear proper footwear, and always wear socks with the shoes.
· Trim toenails straight across and smooth out those sharp edges with a nail file. Can’t reach your feet? See a foot care specialist (like a podiatrist or foot care nurse) to trim those nails for you.
· Keep the corn and callus removal/reduction for the professionals. Over the counter products to remove them can be quite harsh and can burn the skin.
· Get your feet checked every time you see your family Dr. If you have a foot specialist, make sure you have a full foot assessment each year with them which includes checking for nerve damage and blood flow to the feet.
· Keep your blood flowing. Putting feet up while sitting, wiggling toes for a few minutes’ multiple times a day…this all helps with blood flow
· Feet-friendly activities. It’s important for those living with diabetes to adopt a healthy lifestyle. Walking (with the right footwear), riding a bike and swimming are all low impact activities that will not strain the feet but also keep that blood pumping.
· Manage those blood sugar levels and keep them in your target range (this is such an important part – not just for the feet, for the whole body!)
Nursing foot care is a way to help those living with diabetes keep foot complications at bay. The initial treatment will include a full nursing assessment. During each treatment, the feet are thoroughly examined and treated. Treatments may include:
· Nail trimming and filing
· Thick nail reduction
· Callous and corn reduction
· Massage and moisturize
· Health teachings and referrals when necessary
To stay consistent with your footcare, it’s suggested that you see a footcare specialist to do this type of treatment every 4 to 8 weeks for maintenance.
Much love, Natalie