The prevalence of diabetes is growing day by day. In the last few years, awareness of diabetes has tremendously increased. A majority of people are being screened for diabetes and treated for it. Even among diabetic patients, awareness about the course of the disease, its management, and its complications is increasing. Nerve damage and poor circulation are the two major complications of diabetes that lead to foot problems in diabetic people.

What Are the Risk Factors for Having Nerve Damage With Diabetes?

The following are the risk factors:

Blood sugar levels that are difficult to be kept within the range.
Being diabetic for a long time particularly if the levels of blood sugar are above the normal values.
Those who are above 40 years of age.
Being overweight.
Having high cholesterol and high blood pressure.

Nerve damage accompanied by poor blood flow can increase the chance of developing a foot ulcer. A foot ulcer could get infected and not heal properly. If an infection is irresponsive to treatment, the toe, foot, or a part of the leg may need to be removed by surgery (amputation). This is done to prevent the infection from spreading to other parts of the body.

What Are the Signs and Symptoms of Foot Problems in Diabetes?

The signs and symptoms are as follows:

Loss of sensation to touch, heat, or cold.
Burning, tingling, or painful sensation in the feet.
Alteration in the color and shape of the feet.
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The toenails can thicken and turn yellow.
Loss of hair on the toes, feet, and lower legs.
The appearance of blisters, sores, ulcers, red spots, infected corns, or ingrown toenails.

How Should a Diabetic Person Take Care of Their Foot Daily?

The following methods should be followed by a diabetic person daily:

Feet Inspection: The feet and the toes must be examined daily. The top, sides, soles, heels, and the area between the toes should be carefully observed for any changes. If one cannot examine their feet, they can take help from someone or use a mirror. If any bruises, cuts, blisters, redness, or sores are discovered, one must seek medical help right away.
Washing the Feet: The feet should be washed daily using warm water and mild soap and not with hot water and harsh soaps as these can harm the skin. One can use their fingers or elbows to check the water temperature if they are unable to sense it using their feet.
Dry the Feet: The feet, especially the area between the toes should be dried using a neat towel. The feet should be kept dry since infections are prone to manifest in moist areas.
Use of Moisturizer: Moisturizer, lotion, or oil can be used if the skin and feet are dry. The lotion should not be used between the toes.

What Are the Tips for a Healthy Foot?

The following are a few general tips to keep the feet healthy:

Antiseptic solutions should not be used on the feet without a doctor’s recommendation since they could burn the skin.
One should not walk barefoot. Since a diabetic person cannot feel any pain at times, walking barefoot in the house could lead to injuries or sores that can become infected.
A heating pad, electric blanket, or hot water bottle should not be used on the feet.
One must keep their feet protected from heat or cold.
It is not advisable to sit with legs crossed or stand in one posture for a long time.
Each foot should be observed and felt for the presence of any swelling. Swelling in one foot and not in the other can indicate ‘Charcot foot’. It can occur in individuals with nerve damage and can damage the bones and joints.
One must not try to remove warts, calluses, corns, warts, or other foot lesions by themselves. Similarly, razor blades, corn plasters, chemical wart removers, callus, or liquid corn removers must not be used without a physician's approval.

What Are the Toenail Care Tips for Diabetic Patients?

Visual difficulty, circulatory changes, or nerve damage could make the toenail care routine difficult for diabetic patients. Trimming the toenails safely is important to avoid developing a foot sore or an ulcer. A proper toenail care routine for diabetic patients includes:

The toenails can be trimmed when the feet are wet after washing as this would soften the toenails.
One should be cautious so as not to cut the toenails too short.
The corners of the toenails should not be cut, instead, an emery board should be used to smoothen the edges.
The toenails should be cut straight rather than in a curved manner to avoid ingrown toenails.
The toenails can be trimmed by a healthcare professional or a podiatrist (an expert in treating the feet and related ailments) if one cannot view their toenails properly or if the toenails are thick and yellow.

What Are the Footwear Precautions for Diabetic Patients?

Nerve damage or neuropathy can affect the sensitivity in the feet which might make the cuts or bumps go unnoticed. This can be overcome by wearing shoes. The following are a few footwear precautions that diabetic individuals can follow:

Tight shoes should not be preferred with the hope that they would stretch with use. One must choose well-fitting and comfortable shoes with plenty of space in the toe region.
Shoes made of canvas, leather, or suede should be preferred, and those made of not breathable materials like plastic should not be preferred.
The inside of the shoes must be examined regularly for any tears or bumps that could exert pressure or cause any irritation.
Very high heels, flip-flops, pointed-toe, open-toe, and thong sandals need to be avoided.
If one suffers from nerve damage, the feet should be given a break or must be changed after five hours to shift the pressure points on various areas of the feet.
Shoes that can be adjusted with buckles, Velcro, or laces should be preferred.
Socks offer a soft, extra layer of protection between the foot and the shoe.
One can wear socks to sleep if the feet feel cold.
One must wear clean, dry socks, or a pantyhose that is non-binding. Any socks or garments with seams that are too tight or cause additional pressure points should be avoided.
One should consult a physician if problems in the feet recur frequently.

What Are the Major Locations on the Bottom of the Feet That Need to Be Examined by a Diabetic Person?

The major locations on the bottom of the feet are as follows:

The tip of the big toe.
The base of the middle toes.
The base of the little toes.
The heel.
Across the ball of the foot.
The outside edge of the foot.

What Are Good Diabetes Management Habits?

The following are a few good diabetes management habits:

One must refrain from smoking as it can deteriorate the blood flow to the feet.
A healthy diet must be followed. This includes a diet with plenty of vegetables and fruits but with less salt and sugar.
It is important to exercise regularly for at least 10 to 20 minutes a day.
The medications prescribed by the physician should be taken regularly.
Regular check up with a podiatrist (foot doctor) especially if one has nerve damage.

Conclusion:

Foot problems are usually ignored by diabetic people. A few people with nerve damage experience tingling, numbness, or pain while others do not have any symptoms. Nerve damage has an impact on the sensation of pain, heat, or cold. Experiencing no pain can sound good but a pain sensation is an indication that something is not right in the body. Without any feeling of pain, a cut, sore, blister, or other issues can go unnoticed. It is important to curb the foot problems in diabetes in the early stages else, it would lead to serious complications like amputation (surgical removal of a limb).