From the NIH, every 20 seconds someone loses a limb to diabetes in the U.S. 85% of leg or foot amputations that are done, begin with an ulcer. Unfortunately, diabetic foot ulcers more often than not come back in 40-65% of patients. A diabetic foot ulcer is a major cause of a lower quality of life, disability, and even death. To read more from the NIH on diabetic foot disease, click the following link here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919962/
One of my goals as a doctor is to prevent as many diabetic foot ulcers as I can. So today, this blog post is dedicated to things you can do, to prevent your risk of developing a diabetic foot ulcer.
1. Control your blood sugar
This is probably the best way to keep from developing a diabetic foot ulcer in the first place. If you are already diabetic, tight blood sugar control is key for lowering your risk of a diabetic foot ulcer. The longer that your blood sugar is higher, the more damage that does to your legs and feet, and the more likely that a foot ulcer will happen down the road. Work with your primary care doctor, or endocrinologist to bring your AIC down to a healthy range.
Also, a nutritionist, one that is focused on diabetes education, and nutrition for diabetes is paramount for good blood sugar control. A nutritionist has the specialized training to work with you and educate you on how to construct your meals, which foods to focus on in your diet, and which to avoid in order to keep your blood sugar in a healthy range over time.
Daily blood sugar checks are also critical for diabetics to remain healthy, but also key for diabetic foot ulcer prevention as well. If your blood sugar is too high, and you don't know that it is, this overtime can increase your risk of developing a diabetic foot ulcer due to all of the ways that diabetes attacks your legs and feet by damaging your arteries, nerves, causing changes to the shape of your feet and toes. To learn more about the foot problems seen in diabetic feet, click the link here for another one of my blog posts on this topic: https://www.directpodiatryaz.com/post/most-common-diabetic-feet-issues
2. Check your feet daily
Another key tip for preventing diabetic foot ulcers is checking your feet daily. Look at your feet at least once a day. If your eyesight isn't the best, ask a family member to check your feet daily. If you ever notice any changes to your feet including blisters, redness, calluses, cuts, sores, or anything at all, call your foot doctor at once. They will fit you in, examine your feet, and treat any breaks in the skin before they become a bigger issue.
Diabetes does cause neuropathy or nerve damage in the feet, which can make it harder, if not impossible for diabetics to feel their feet if anything is injured. This is why it is so important that you or someone you trust, lay eyes on your feet every day.
If you live alone and aren't flexible enough to reach your feet to inspect them, a retractable mirror is cheap, and can easily help you see the bottom of your feet.
To view this and more products that are key to keeping diabetic feet healthy, click the following link for bone of my blog posts on what should be in your diabetic foot care kit: https://www.directpodiatryaz.com/post/6-products-for-diabetic-foot-care-kit
3. Never walk barefoot, inside or outside
This tip is also crucial for diabetic foot ulcer prevention. Never walk barefoot. Anytime the skin is broken or cut, this is a door for bacteria to enter your body. Diabetes, unfortunately, does lower your immunity and makes it much harder to fight infection, as well as heal any kind of wound. This is why if you have diabetes, a house shoe, or slipper at least should be on your feet at all times. This will protect your skin from any possible injury, and therefore from any ulcer forming. This also will protect your skin from ground that is too hot or too cold, and prevent things like 2nd to 3rd degree burns on your feet from hot pavement, sand, or frostbite from ice-cold ground. All of these, personally Ive seen unfortunately lead to a foot amputation in someone with diabetes
For diabetics with neuropathy, this is extra important because if you can't feel your feet, you won't know if they are injured. If you can't tell that something is wrong with your feet, then care is given to that area, and infection has a chance to set in.
At the bottom of my blog post for items to include in your diabetic foot care kit, I do include some options for house shoes or slippers that are great for diabetic feet. Click this link to view my post here: https://www.directpodiatryaz.com/post/6-products-for-diabetic-foot-care-kit
4. Do not trim nails or calluses by yourself, or allow anywho is not a foot doctor, or healthcare professional to trim them
Some of the most heartbreaking amputations I've done have been due to an accidental nick or cut done by the patient themselves, or at a nail salon when trying to trim nails. Diabetes lowers the circulation to your feet and toes, so any accidental nick can turn into a foot ulcer quickly.
To read more in-depth on why diabetics should not cut their own toenails click, the following link for another of my blog posts here: https://www.directpodiatryaz.com/post/why-can-t-a-diabetic-cut-their-toenails
And to read more on why diabetics should not get pedicures from nail salons, click here: https://www.directpodiatryaz.com/post/can-diabetics-get-pedicures
5. See a foot doctor regularly
Foot doctors of podiatrists have specialized training to treat, manage, and prevent all of the complications possible with the diabetic foot. If you are diabetic, you should have a podiatrist as a part of your healthcare team, and be seeing them on a regular basis. A foot doctor can address any changes to your feet at your regular appointment before the changes turn into a diabetic foot ulcer.
6. Address any other health problems you have
Diseases like kidney disease, hypertension, atherosclerosis, and more do increase the burden on your body, increase chronic inflammation, and therefore also do increase your risk of developing a diabetic foot ulcer.
7. Wear shoes that fit properly
Shoes that are too tight, or too loose can lead to blisters or calluses, and for someone with diabetes can turn into a foot ulcer quickly. If you haven't been fitted for shoes in the last several years, it's a good idea to get fitted. Your shoe size can change throughout your life for many reasons.
8. Don't smoke
Smoking, like diabetes, damages the blood vessels responsible for bringing blood to your feet. The combination of diabetes and smoking together can be a recipe for disaster when it comes to possible diabetic foot ulcers and increased risk of amputation.
The reasons why someone would develop a diabetic foot ulcer are many and complex. But as Benjamin Franklin said, "Prevention is worth an ounce of cure". These are my tips for preventing a diabetic foot ulcer.