Having diabetes ups the ante for staying healthy.

For example, consider a pebble that’s worked its way inside your shoe. For most people, this is a minor irritant easily resolved with a good shake.

If you have diabetes, you could lose your foot.

That little pebble increases your risk for developing a diabetic ulcer, an open sore that can lead to amputation. According to the Centers for Disease Control and Prevention, 68,000 lower limb amputations related to diabetes occur every year. Most of these amputations are preceded by a foot ulcer.

The best way to prevent something like this from happening to you is to give as much attention to your feet each day as you do to maintaining a normal blood sugar level.

Diabetic Foot Ulcers

Nerve damage – diabetic neuropathy – is a common complication of diabetes. It can cause pain and tingling or (as often happens in the lower limbs) loss of feeling. So when someone with diabetes gets a pebble in their shoe, they might not know it’s there. When a blister forms from the pebble rubbing against their foot, they don’t feel that either and don’t take protective measures like applying a bandage or changing their gait. Dr. Joseph LeMaster at the University of Missouri–Columbia School of Medicine says this makes the blister more likely to become infected and turn into an ulcer.

“That ulceration can go right down to the bone and become an avenue for infection into the whole foot,” said LeMaster. “That’s what leads to amputations.”

Treatment Complications

Peripheral arterial disease (narrowing of the arteries), another common complication of diabetes, makes diabetic ulcers difficult to treat. Peripheral arterial disease reduces blood circulation. Skin that isn’t well-supplied with blood doesn’t heal well. It’s also more fragile and more easily damaged. This is why a minor injury like a blister, bruise or scratch can easily progress to something more serious.

Take Care of Your Feet

Having your feet examined at least once a year by your health care professional, along with good foot care at home, can reduce your risk for diabetic ulcers. This includes:

• Checking your feet daily. Let your health care provider know right away if you see anything new such as a cut or redness.
• Washing them well. Soap feet with warm water and fully dry them, including between the toes. Use lotion or cream to keep skin from drying or cracking, which can cause sores.
• Trimming your toenails. Ask a podiatrist if he should cut your toenails to prevent injury. Never go to a salon.
• Never going barefoot or wearing flip-flops even if you are at the beach.

It’s also important that you wear the right shoes. The National Diabetes Education Program advises:

• Never wear vinyl or plastic shoes. They do not stretch or “breathe.”
• Make sure your shoes have enough room for your toes. Do not wear shoes with pointed toes or high heels.
• Buy shoes at the end of the day when your feet are their largest.
• Consider prescription footwear. Medicare Part B covers custom-made shoes and inserts for people with diabetes. Other health insurance policies may also cover this footwear. Check to see what your policy provides.
• It’s also important that your socks fit. Socks that are too large, too small or wrinkled can cause blisters.

Diabetes affects more than 34 million people in the United States and Canada of which 15 percent will develop a foot ulcer. Examine your feet at the same time of day that you brush your teeth to reduce your likelihood for being among that 15 percent. Living with diabetes is a challenge, but with care, you can minimize its complications.

The LHSFNA has developed a number of materials to help you manage and reduce your risk for diabetes. These include the Laborers’ Health & Wellness: Diabetes brochure and Health Alert and the Nutrition & Fitness for Laborers and Build a Better Body pamphlets. Click here to order.

[Janet Lubman Rathner]