Diabetes and Your Feet: What You Don’t Know Will Hurt You

There is no doubt that diabetes is a global epidemic of epic proportions–especially amongst people of color. Diabetes, or hyperglycemia, is high blood glucose.

According to the Center for Disease Control, 13.2% and 12.2% of women and men respectively African-Americans worldwide with having the second highest incidence of diabetes. American-Indians lead amongst all racial groups with 15.3% of American Indian women being diagnosed with type 2 diabetes. Also by 2050, 1 in 3 people will have type 2 if the current trends continue. 1

“Type 2 diabetes is the most common form of diabetes and is triggered by a combination of unchangeable factors, such as family history and race, and controllable factors, such as obesity and inactivity, according to the Mayo Clinic. It’s also the seventh leading cause of death in the United States, according to 2007 data, and is the leading cause of leg and foot amputations, kidney failure and new cases of blindness in adults under age 75, according to the CDC.” 2

People are living longer and an aging population and the growth of minority populations are expected to add to the disease’s prevalence. Because of that most Unfortunately African-Americans, Latinos, Native Americans and Asians and Pacific Islanders are also at high risk of developing diabetes.

“Advances in medicine, which may help people with the disease live longer, and better detection of diabetes are other reasons why its prevalence could dramatically increase by 2050, she said. Right now, 24 million Americans have Type 2 diabetes, but a quarter of them don’t know it, according to the CDC.” 2

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Diabetes when uncontrolled can be problematic. If blood sugar levels are not normalized in a diabetic, the body may have trouble fending off infections due to decreased functioning of the

immune system. This can affect the feet in particular due to peripheral artery disease (lack of circulation) and peripheral neuropathy (loss of feeling).

As a result of diabetes, the feet may become susceptible to a slew of problems, such as ulcers and wounds that do not heal properly, fungal infections, ingrown or brittle toenails, corns, calluses, hammertoes, athlete’s foot, and cracked or dry skin. Gangrene, or dead tissue, can develop, causing bacterial infections that may result in amputation of the affected areas. Even everyday activities such as walking can cause issues in the feet of a diabetic, as the bones, joints, and skin are affected by the condition.

For the diabetic, proper and thorough foot care is imperative. Diabetics should check their feet daily for early detection of foot problems or injuries.

Here are proper foot care suggestions for diabetics to follow:

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• Keep feet clean, warm, and dry (thoroughly dry between toes)
• Wear comfortable shoes and do not wear the same pair every day (look for roomy toe boxes, leather uppers, and shoes that do not pinch, rub, or cause pressure; avoid stiff shoes and gradually break-in new footwear)
• Always wear clean, dry socks without tears or irritating seams (thin cotton is absorbent and helps keep feet dry)
• Do not leave feet exposed or unprotected (sleep in loose socks; do not wear flip flops or sandals; do not go barefoot)
• Never expose feet to heat or high water temperatures (burns can occur due to loss of feeling)
• Maintain better foot circulation (do not smoke; avoid stockings or socks with tight elastic bands; do not cross feet or legs when sitting)
• Treat the feet gently (pat dry; avoid cutting or tearing the skin)
• Carefully shape toenails straight across with an emery board (avoid ingrown toenails) if you have feeling in your feet
• Do not use over-the-counter foot products such as antiseptic solutions, plasters, tapes, or anything sticky (they can damage the skin and lead to wounds)
• Use moisturizer to keep skin supple (do not leave excess moisturizer between toes)
• Do not treat corns or calluses at home by self-removal with sharp instruments or perform “bathroom surgery”; see a doctor for care

It is important that diabetics seek podiatric care on a regular basis to prevent foot problems that can easily get out of control. A podiatrist will ensure proper foot care, from maintenance to the treatment of any developing problems. Any foot problem should be immediately addressed in a diabetic to avoid serious complications.

Citations:
1. https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html
2. https://www.livescience.com/10195-1-3-americans-diabetes-2050-cdc.html

Dr. Monique Renee Rolle, DPM, MEd, AACFAS is an Associate of the American College of Foot and Ankle Surgeons, member of the American Diabetes Association, Virginia Podiatric Medical Association, American Podiatric Medical Association, & Owner/Podiatrist of Lansdowne Podiatry with locations in Leesburg, VA and on Capitol Hill. She is also an entrepreneur with her own foot product line, Dr. Mo’s Products. You can follow her on social media @drmrolle, @doctormosproducts, www.facebook.com/LansdownePodiatry.