Diabetes Complications | Diabetes Healthy Solutions

6 Tips for Diabetes Foot Care

What is proper foot care for diabetics?

People with diabetes are more likely to suffer from neuropathy and other foot problems as a result of nerve damage and reduced blood flow to the feet. Small sores and cuts may also take longer to heal. The biggest risk is infection when germs get into cracks or cuts.

Poor foot care with diabetes can lead to foot or leg amputation. Therefore, if you have an infection, it is essential to seek medical attention right away to keep it from spreading and causing other complications.

According to the ADA (American Diabetes Association), 1 in 5 diabetes patients seek medical care due to foot problems. Fortunately, you can avoid foot problems by keeping your blood glucose levels within the recommended range.

Here are some preventive measures diabetes patients can take to keep their feet healthy:

1. Wash your feet daily and keep them dry

Make it a daily ritual to wash your feet in warm water using mild soap to ensure that areas that are prone to infection remain clean and free of debris and dirt. Avoid using hot water and soaking your feet for too long as this could easily damage your skin. Use a sponge or soft cloth to wash your feet and dry them thoroughly after your foot bath.

Remember not to leave any moisture between the toes as this could break down the skin or cause fungus to grow leading to infection. Apply moisture to any cracked areas and away from your toes to avoid infection. Apply non-medicated powder before wearing socks and shoes to keep your feet dry.

In winter, central heating can help keep your feet dry and warm. Be sure to wear socks in cold weather or whenever your feet get cold.

2. Check your feet regularly

Doctors recommend checking the bottoms and tops of your feet daily. You can request someone else to do it or use a mirror if you can’t see them. Look carefully in good light so you can see problems such as cracked skin on the heels, toes, and feet.

Check your heels, feet and toes for cuts, blisters, scrapes, bruises, scratches, and other sores. Look between the toes for fungus and cuts that may cause infections or athlete’s foot.

Check for tenderness, redness, increased warmth, corns, calluses, and ingrown toe nails. Avoid “popping” blisters caused by your shoes. Put bandages over them and wear comfortable shoes.

3. Diabetic toenails – take care of your toes

Trim your toenails after washing your feet, when they have been softened by water. Avoid cutting deep into the corners of your toes and use a nail file to smooth them. Check for any corners growing into the skin as this could potentially lead to ingrown toenails.

You may want a foot doctor (podiatrist) or nail technician to trim your toenails for you. If you visit a nail salon for pedicures, bring your own tools. Avoid cutting cuticles and don’t use sharp tools to remove calluses or to clean under the toenails. This will help you prevent accidental cuts that could lead to infection. A pumice stone is great for smoothing the heels after washing your feet or taking a bath or shower. Be sure to rub gently to prevent injuries.

4. Be careful when working out

It is essential to work out regularly to maintain healthy blood flow. Workout for at least 30 minutes daily and be sure to do it in fitting, comfortable shoes.

Ask your physician what type of physical activities you should engage in if you have open injuries on your feet.

5. Avoid going barefoot

Don’t go only in socks or barefoot to avoid stepping on tacks, rocks, and other objects that could injure your feet. Protect your feet with hard-soled slippers, shoes, or similar footwear. Always protect your feet from moisture and cold. You can wear flip-flops at home.

Avoid wearing shoes with pointed toes and high heels or shoes that leave your heels or toes exposed, like slippers, open-toed shoes, and sandals. Wearing such footwear outdoors leaves your feet exposed to injury which could lead to infections.

Wear neutral materials such as wool, cotton, or cotton-wool blends. Don’t wear tight socks or socks with materials or rough areas that rub against the skin. Avoid tight-fitting shoes and look inside your footwear before wearing them to make sure there are no rough areas or irritating objects in them. Replace shoes that are showing signs of wear, and wear the type of shoes recommended by your doctor.

6. Wear fitting, comfortable shoes

Is your shoe too narrow? Are your feet crammed into your shoes? If you have nerve damage (neuropathy) it could be hard for you to notice that your footwear is too tight.

Your shoes should be as wide as your feet and about ½ inch longer than the longest toe. Shows that are too loose or too tight may cause injuries, such as blisters.

If you have diabetes, shop for shoes that have:

Outer soles made of stiff materials
Closed heels and toes
Leather upper without suede, canvas, or seams inside. Choose shoes with cushioned soles to absorb pressure. It is also essential to note that shoes with laces provide better support compared to loafers.
Soft insides without any rough areas

Avoid wearing new shoes for extended durations. Break in them slowly by wearing them for 1 or 2 hours a day.

Although well-fitting shoes are extremely important, you may also want to consider wearing diabetic socks to keep your feet injury-free and healthy. Diabetic socks can help keep your feet warm and dry, improve blood flow, provide cushion, and prevent fungal infections.

When you buy through links on our website, we may earn a small commission at no cost to you. Thanks for your support 🙂

The best diabetic socks have features such as:

Stretchy cuffs to promote blood flow
No seams and rough materials to prevent rubbing

Moisture-wicking materials that help keep your feet dry
Soft and thick at the ball and heel of your foot
Comfortable fit with no bunches or wrinkles

The bottom-line

If you have any injuries on your feet, be sure to seek medical attention and follow your doctor’s recommendations and guidelines. Don’t self-treat foot problems such as calluses, scratches, blisters, cuts, scrapes or corns.

Check water temperature using a thermometer or your elbow, not your feet. Seek medical attention if you notice foot problems such as cracking between toes (athlete’s foot), ingrown toenails, increasing pain or numbness, signs of infection (redness, drainage, or swelling), bunions, blackening of the skin, hammertoes (bent middle joints), and nails that seem changed in shape, striped, yellow, or thicker.

Read more about what causes diabetic foot swelling HERE!

What Causes a Diabetic Foot Sore?

Causes, Risk Factors, Prevention, and Treatment of Diabetic Foot Sores

Persistently high blood sugar levels can cause nerve damage commonly known as diabetic neuropathy. Although diabetic neuropathy can develop in any part of the body, it mostly occurs in the feet and legs. The condition typically causes loss of feeling in the feet and as a result it becomes difficult to notice a cut, sore, or blister. For instance, you might not notice pebbles in your socks that are cutting your feet. A wound that goes unnoticed and hence untreated can easily become infected.

Diabetes might also affect the flow of blood to the feet and legs. As a result, diabetes patients are more likely to develop PAD 9peripheral artery disease), a condition that narrows or blocks arteries. Poor circulation (reduced blood flow) can make it hard for diabetic foot sores or infections to heal.

Diabetic foot sores and infections are common complications of poorly managed or unmanaged diabetes. Diabetes is managed through various methods including insulin treatment, exercise, and diet.

Foot sores as a result of the breakdown of tissue expose the delicate tissues underneath. Areas that are most commonly affected include the balls of your feet and your big toes, and they can damage your feet to the bones.

Diabetic foot sores can affect anyone but they can be easily prevented through good foot care. Treatment varies depending on the cause of the diabetic foot sores. Therefore, it is essential to discuss any foot concerns with your healthcare provider to ensure the problem is addressed, as infected sores can even result in serious complications including amputation if left untreated.

What are the causes of diabetic foot sores?

The most common causes of foot sores in diabetes patients include:

Nerve damage
Hyperglycemia (high blood sugar)
Poor circulation
Wounded or irritated feet

Poor circulation is one of the most common vascular diseases in which blood does not flow to the feet effectively. You should keep in mind that poor circulation makes it more difficult for foot sores, ulcers, and wounds to heal.

High blood sugar levels can also hamper the healing process of infected foot ulcers. Therefore, proper blood glucose management is extremely critical. People with ailments such as type 2 diabetes usually have a hard time fighting off infections including infections from foot sores.

Nerve damage is one of the long-term effects that can lead to loss of feeling in the feet. Moreover, damaged nerves tend to feel painful and tingly. Nerve damage also reduces sensitivity to pain and can easily cause painless wounds that cause foot sores.

Foot sores are usually identified by fluid drainage from affected areas and sometimes noticeable lumps that are not always painful.

Are you at risk of developing diabetic foot sores?

All diabetes patients are at risk of developing diabetic foot sores, which may have several causes. Factors that increase the risk of foot sores include:

Poor quality or poorly fitted shoes
Poor hygiene (Feet should be washed regularly and dried well)
Untrimmed or poorly trimmed toenails
Eye disease (typically from diabetes)
Kidney disease
Alcohol consumption
Heart disease
Tobacco use (can inhibit circulation)
Obesity

Diabetic foot sores are also more common in older people especially men.

Signs of diabetic neuropathy

Symptoms of diabetic neuropathy include:

Pain
Darkening of the affected area and the surrounding skin
Tingling
Loss of hair in the area
Diminished sensitivity to cold or hot
Numbness

If diabetic neuropathy causes diabetic foot sores, some of the symptoms you should watch out for include:

Changes to the toenails or skin, including sores, cuts, blisters or calluses
Pain
Discharge of pus or fluid
Swelling
Redness
Foul smell
Skin discoloration

Treatment for diabetic foot sores

Doctors may recommend off-loading (staying off your feet) which helps prevent pain from foot sores and has been proven to be helpful for all forms of foot sores caused by diabetes. Remember, pressure from activities such as walking can expand foot sores and make infections worse. You may also be prescribed certain items to reduce pain and protect your feet:

Foot braces
Shoe inserts (to prevent calluses and corns)
Compression wraps
Casts
Shoes designed for diabetes patients

Preventive measures

Infection of diabetic foot sores can be prevented with:

Disinfecting the area surrounding the sore
Footbaths
Frequent dressing changes to keep the sores dry
Dressings to prevent bacteria growth
Enzyme treatments

It is essential for people with diabetes to take proper care of their feet and keep their blood sugar levels within the recommended ranges to prevent diabetic foot sores and more serious complications such as hospitalization or amputation (to prevent the infection from spreading).

Diabetic Foot Ulcer Treatment

What is a Diabetic Foot Ulcer?

A foot ulcer forms when skin tissue anywhere on the foot or toes breaks down exposing inner layers. It can involve the entire thickness of your skin, including deep structures such as tendons or bones. On the other hand, it can be redness or a shallow sore that involves only the skin surface.

People with poor circulation and diabetes patients in particular, are at a higher risk of developing foot ulcers. In people with diabetes, foot ulcers can be difficult largely because even small foot ulcers can easily become infected, especially if it is not treated properly.

Sometimes you may not know you have foot ulcers until you notice wetness or drainage on some parts of your socks. Drainage can be red, brown, or yellow and it may also contain blood or pus.

If a foot ulcer becomes infected and if not treated promptly, it can gradually develop into:

A pocket of pus (an abscess)
Cellulitis (a spreading infection of underlying fat as well as the skin)
Osteomyelitis (a bone infection)
Gangrene (an area of dead body tissue as a result of poor blood flow)

In uncontrolled or poorly controlled diabetes severe foot infections may eventually require some part of the lower leg, foot or toe to be amputated usually start as a foot ulcer.

Factors that Increase the Risk of Diabetic Foot Ulcers

Poor blood flow
Numbness and nerve damage in the feet
Uncontrolled blood sugar levels
Corns or calluses on your toes or feet
Foot deformities such as hammertoe or bunion
Poor vision that causes you to trip on objects in your way
Alcohol use or cigarette smoking
Being overweight

Is coconut oil good for Diabetic feet?

Diabetic Foot Ulcer Treatment Options

Antibiotic cream for foot ulcers

Your diabetic healthcare provider may suggest applying antibiotic cream to help prevent infection and relieve the sore. Thereafter, it’s important to cover the area to avoid infection or further damage.

Wound dressing of foot ulcers

A bandage or other types of dressing will be put on the ulcer and your doctor will give you instructions in the changing routine. The dressing may contain medication to help the ulcer heal faster and prevent growth of unhealthy tissue. If the sore is already infected, your doctor will give you antibiotics to fight the infection.

Have dead tissue removed (debrided)

Removal of any dead tissue and skin around foot ulcers can help with healing and prevent infection.

Manage your blood glucose levels and any other health problems

Health issues such as blood sugar levels, cholesterol and blood pressure need to be managed to help foot ulcers heal. Your doctor will help you create a plan to manage any health issues you may have.

Take the pressure off your foot ulcer

In some cases, you may need special support shoes with braces, cushions, or insoles to offload the pressure off your foot ulcer. You may also be advised to use crutches or a wheelchair until your foot ulcers heal. These items help keep irritation and pressure off the area of the foot ulcer. Foot ulcers heal faster without irritation and pressure.

Read more about Diabetic foot sores HERE!

Increase blood flow to your feet

Your doctor may recommend negative pressure wound therapy or hyperbaric oxygen therapy to increase blood flow to the lower extremities. You can consult your healthcare provider for more information about these treatment techniques.

Visit a specialist as directed

Your doctor may advise you to see a vascular surgeon, an orthopedic, or a podiatrist. These professionals can help you manage your specific condition and treatment regimen.

Negative pressure wound therapy

This diabetic foot ulcer treatment option involves the use of a vacuum to remove extracellular waste and fluid from the wound. The administration of negative pressure wound therapy requires specialized skills for positive outcomes in treating wounds and ulcers.

Extracellular matrix replacement therapy

A diabetic foot ulcer is primarily a complication of Type 2 Diabetes that needs timely intervention to avoid more serious outcomes such as amputation. Research shows that diabetic foot ulcers are responsible for about 84 percent of all lower leg amputations. Diabetic foot ulcers are considered to be a result of micro and macrovascular complications.

Slow healing or failure of sores and wounds to heal as a result of chronic diabetes can be treated with extracellular matrix replacement therapy. Diabetes foot ulcer treatment largely rests on techniques such as negative pressure wound therapy, skin substitute, and advanced moist wound therapy.

When it comes to treatment for foot ulcers, you should keep in mind that different treatment options and therapies have different benefits and side effects as well. Moreover, diabetic foot ulcer treatment can vary depending on the causes. Therefore, it’s important to discuss different options with your healthcare provider to determine the most suited therapy or treatment option.

Read more on Diabetes Foot Swelling Here!

Can Low Level Laser Irradiation Help Diabetes?

LLLT (low level laser therapy) has been suggested for the treatment of a wide range of chronic pain disorders. Low level laser irradiation has been advocated for relief of many symptoms of inflammation, pain and is used in nerve regeneration and wound healing.

Type 2 diabetes is one of the most disabling and progressive diseases. The prevalence of both type 1 and type 2 diabetes worldwide is about 371 million people.

People living with diabetes mellitus may experience insensitivity or numbness to temperature changes and pain, cramps or sharp pains, a tingling, pricking or burning sensation, loss of coordination and balance, and extreme sensitivity to touch.

What is Diabetic Foot Syndrome?

The most complex diabetes-associated complication, is diabetic foot syndrome a condition which is mainly characterized by long-lasting or non-healing chronic skin ulcers in people living with diabetes.

Diabetic foot syndrome is the most prevalent cause of limb amputation in diabetic patients. This has a significant impact on diabetic patients’ quality of life and the national health system.

Diabetic foot ulcers are categorized according to severity as:

Severe (accompanied by metabolic perturbations or systemic signs),
Moderate (more extensive or deeper skin ulcers) or
Mild (superficial or limited in depth and size).

Conventional treatment methods of diabetic ulcers include various kinds of wound cleaning skin grafting debridement, vasodilators, pain management, antibiotics, and even the use of fly maggots. However, even in multidisciplinary therapeutic treatment methods for diabetic foot syndrome, treatment results are usually unsatisfactory and treatment is often difficult.

Is Low Level Laser Therapy Effective in Alleviating the Symptoms of Diabetic foot Syndrome?

Since diabetic ulcers are often impossible or very difficult to treat using available conventional treatment methods, researchers are relentlessly looking for alternative treatment methods.

Low level laser irradiation, also known as soft laser is a treatment method that supplies bio-stimulative light energy to cells.

The laser energy is absorbed in order to stimulate atoms and molecules of cells without causing any significant changes in tissue temperature. LLLT (Low Level laser Therapy) is a pain-free, non-invasive treatment method with minimal side effects. There’s no single explanation of how laser therapy functions in the treatment of diabetic foot syndrome. However, there are several studies trying to examine various effects of low level laser therapy on tissue repair mechanisms.

Animal and cell studies conducted In vitro suggest that laser irradiation promote wound healing mainly as a result of improvement of various factors that play essential roles in tissue repair mechanisms. Moreover, histological and biometrical analysis show faster lesion contraction indicating reformed connective tissue and quicker re-epithelization with collagen fibers that are more organized in irradiated wounds.

Low level laser irradiation promotes proliferation of myofibroblasts and reduces inflammation in experimental cutaneous wounds. Growth of fibroblasts and an increase in cell division play a critical role especially in wound healing.

Researchers have tested different wavelengths of LILI (Low Intensity Laser Irradiation) on cellular proliferation, viability, and migration in both unwounded human skin and diabetic wounded fibroblast cells. Cells that were irradiated at 632,8 nm showed a significantly higher degree of ATP luminescence as well as migration and haptotaxis as compared to cells that were irradiated at 830 nm.

The results of this study show that diabetic wounded cells benefit more particularly in wound healing in the low level irradiation (visible range) than in the higher range (infrared). However, near infrared laser therapy might be beneficial for deep ulcers because it has a deeper penetration capacity compared to visible red light.

Both blue light laser (470 nm) and red light laser (630 nm) help improve perfusion by stimulating the release of nitric oxide, elevated keratin-10 mRNA level, and enhanced epithelialization. Blue light laser also facilitates the recovery of mitochondria that is inhibited by NO gas hence improving wound healing through the NO pathway. This also activates growth factors and increase keratin expression which induces endothelial cell migration.

The anti-inflammatory effects of low level laser irradiation can be explained by the inhibition of interleukin, cytokine, and prostaglandine in animal and cell models. Moreover, experiments with a low level laser (415nm) show an antibacterial effect on E.coli and S.aureus by induction of ROS.

Low level laser irradiation can also increase the blood flow velocity and diameter of the peripheral arterioles hence enhancing microcirculation. According to studies, LLLT showed positive results as a treatment method for diabetic foot ulcers.

Conclusion

Since most conventional therapies for treating diabetic foot syndrome are variable in their ability to offer complete healing, there’s need to develop alternative treatments that can accelerate or improve the healing process. Available studies show that LLLT is effective for most diabetes patients, easy to learn and cost effective. The studies give encouraging results and warrant further investigations in order to understand the exact mechanisms of low level laser irradiation effects particularly on diabetic ulcers.

Check out our article on the best lotions for circulation in diabetic feet!

Everything You Should Know About Coronavirus and Diabetes

Coronavirus and Diabetes: What are the Risks.

The global coronavirus pandemic is looming larger, with news of additional infections and deaths, potential economic fallout and travel advisories. The media has been reporting that people with diabetes and other “underlying conditions” face higher risk of serious complications from coronavirus, the virus associated with COVID-19.

But, why are people with diabetes considered particularly high risk? And how should they manage diabetes during the COVID-19 pandemic?

What is Covid-19 (Coronavirus)?

According to the World Health Organization (WHO) and the Center for Disease Control and Prevention, SARS-CoV-2 is a virus that is common in animal species, and it rarely infects and spreads among humans. However, coronavirus first began infecting and spreading among humans in Wuhan, China in December 2019. From there, the disease has spread all over the globe.

The virus spreads through human to human contact and respiratory droplets (from sneezing and coughing). Therefore, everyone should be cautious. Coronavirus has an incubation period of 2 to 14 days. This means infected people can spread COVID-19 for days or even weeks before developing symptoms. The CDC reports that it might take up to a year to get a vaccine for the virus.

What are the COVID-19 Symptoms?

According to the CDC, recorded cases of coronavirus have included mild to severe symptoms. About 2 to 14 days after getting infected, people may experience:

Dry cough
Shortness of breath
Fever

Emergency warning signs of corona virus include:

Difficulty breathing
Bluish face or lips
Pressure or persistent pain in the chest

Should People with Diabetes (PWDs) be Concerned?

As people with diabetes adjust their routines, it’s extremely important that they follow a few extra safety precautions and plan ahead. According to the American Diabetes Association online Coronavirus resource, people with diabetes are not more likely to get coronavirus than the general population. Instead, they face a greater risk of developing severe complications if they get infected with coronavirus.

For instance, data from COVID-19 cases in China show that diabetes patients have much higher rates of severe complications and fatalities than people without diabetes.

Those with more underlying health conditions, such as heart disease and diabetes, have a higher risk of experiencing severe health complications, the American Diabetes Association (ADA) says. Moreover, being ill makes it even more difficult for people with diabetes to monitor and manage their blood glucose levels.

However, people with diabetes should not panic or worry. Instead, they should take extra precautions, continue monitoring their glucose levels as prescribed by their physician, and practice the recommended hand washing and social distancing guidelines.

Your Risk of COVID-19 with Diabetes

People with diabetes face a higher risk of complication especially when it comes to viral infection like flu, and this is likely true with coronavirus, the ADA said in late February. The fact is that diabetes patients are at a higher risk when dealing with pneumonia, flu (influenza), and now coronavirus because when blood glucose level are elevated or fluctuating consistently, they have lower protection against disease (a lower immune response), so they risk developing complications quicker.

Even if their glucose levels are within the recommended range, there’s an underlying risk of aggravated illness. When you’re ill, fluctuating glucose levels cause symptoms to become much worse and extend recovery time. Although there’s no confirmed connection between deaths from coronavirus and diabetes, data from the JAMA (Journal of American Medical Association) reports shows that there is a higher case-fatality rate among high risk individual (people with underlying conditions):

Cardiovascular disease: 10.5%
Diabetes: 7.3%
Chronic respiratory disease: 6.3%
Hypertension: 6.0%
Cancer: 5.6%

Coronavirus Protection Guidelines for Everyone

The Center for Disease Control’s recommendations for protecting against coronavirus include:

Washing hands regularly with water and soap for at least 20 seconds
Social distancing (at least 6 feet)
Making sure you and your loved ones are up to date with the pneumonia and flu shot
Keeping your hands away from your face (particularly the nose, mouth and eyes which are potential entry points for germs).
Wearing face masks or cloth face coverings in areas where social distancing guidelines are difficult to maintain and areas of community-based transmission
Keep distance and avoid physical contact with people who are coughing, sneezing, or showing other signs of respiratory illness

These guidelines are important to slow the spread of coronavirus and help prevent asymptomatic people from spreading it to others. Authorities including the CDC are emphasizing that people who think they might be sick, self-quarantine.

What About People with Diabetes?

Most doctors who treat diabetes are emphasizing illness precautions and basic hygiene, as well as maintaining good glucose control. It’s also important for people with diabetes to stay hydrated because they are generally more prone to dehydration. Stock up on clean drinking water and liquids that can provide energy and electrolytes in an emergency situation.

If you get flu symptoms that progress to pneumonia, get treatment and support fast.

What should people with diabetes do to prepare for Coronavirus?

The Coronavirus pandemic reminds us how poorly we are prepared for emergency and disaster situations. People with diabetes are reliant on the uninterrupted manufacture of glucose monitoring supplies and life-sustaining insulin. Therefore, disaster and emergency planning is a vital component to survival. It is recommended that you have extra diabetes monitoring supplies, along with extra insulin, at least a month’s worth.

See information on Home Supply Delivery HERE!

You can consult your doctor about working through and around barriers of affordability and access to supplies. Thankfully, many pharma and medtech companies are tackling disease preparation and awareness as it relates to coronavirus – notably Roche, Medtronic, and J&J.

More information on the complications of diabetes HERE!