CLINICAL DIABETES
VOL. 18 NO. 3 Summer 2000

PATIENT INFORMATION

How To Avoid Foot Problems If You Have Neuropathy

Ingrid Kruse, DPM

Inspect Your Feet Daily.
Look at your feet every day. Check for blisters, cuts, scratches, or cracks in the skin (commonly in the heel). Remember to check between your toes. A mirror can help you see the bottom of your feet, or you can ask a family member or friend to help you.

If you experience flu-like symptoms or increased blood glucose levels, be sure to check your feet. They may provide the only warning signals you will receive when a foot infection is present.

Make the daily foot inspection a regular part of your morning or evening routine, just like brushing your teeth. This simple task has kept many people with diabetes from losing their feet by helping them identify problems early on.

Wear Proper Shoes and Socks
All shoes should be comfortable at the time of purchase. Choose a shoe with a soft leather upper, or try athletic shoes for everyday wear. Do not try to "break in" uncomfortable shoes. Buy your shoes at the end of the day when your feet tend to be more swollen than in the morning.

The first time you wear your shoes, wear them only for 1 hour and only around the house. Take them off and inspect your feet for blisters or red areas. Slowly increase the wearing time, giving yourself about a week before you wear a new pair all day.

Do not wear sandals with thongs between the toes because they can rub deep gashes.

Never wear shoes without socks. Socks should be changed daily. Avoid wearing socks with holes or those that have been mended. In sporting good stores, you can find socks that have extra padding under the heel and ball of the foot for better shock-absorption.

Do not forget to check your shoes before you put them on by sliding your hand into them. Feel for nail-points and foreign objects such as keys, small toys, bird seed, or pebbles.

Practice Proper Foot Hygiene.
Wash your feet daily with mild soap, and dry them carefully, especially between the toes. Apply a moisturizing cream everywhere except between the toes. Too much moisture between toes will encourage the growth of microorganisms that can cause infection.

Trim your nails straight across with a slightly rounded edge. If you have trouble seeing, have neuropathy, or have difficulty trimming your nails yourself (because of thick fungus on your nails, for example), see a podiatrist. Avoid all types of "bathroom surgery," such as trying to fix an ingrown nail yourself or trimming your own corns and calluses. The results can be disastrous.

Do not walk barefoot—even in the house—because of danger from stepping on pins, needles, tacks, glass, or other items on the floor.

Be Mindful of Other Dangers to Your Feet.
Neuropathy can affect the set of nerves that detect heat. When these nerves are damaged, you cannot always tell when something is too hot, making burn injuries more likely. Always check bath water with your hands, or use a thermometer if you also have neuropathy in your hands.

Other heat-related problems that could cause serious burns include walking on hot pavement in the summer, using heating pads or hot water bottles to warm your feet, or putting your feet too close to radiators or space heaters in the winter.

If your feet feel cold at night, wear a pair of socks to bed. This is most likely due to neuropathy and not to poor circulation. Neuropathy can cause hot or cold sensations in your feet.

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Copyright © 2000American Diabetes Association
Updated 7/00
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