DIABETES FEET & SKIN PROBLEMS

 Basic information

description

Infections of the skin, often of the feet, are more common in people with diabetes than in nondiabetics. The skin and feet of a diabetic person are more prone to injury. Diabetes also impairs the healing process.

FREQUENT SIGNS & SYMPTOMS

• Often there is no pain associated with infection or injury to the foot or skin.
• New foot sores or ulcers that take a long time to heal.
• Numbness, burning, or tingling sensations in the feet.
• Blood or pus stains on shoes or socks.

causes

• High blood sugar from diabetes causes damage to nerves in the legs and feet. With damaged nerves, a person may not feel pain, heat, or cold in the legs and feet. This lack of feeling is called peripheral neuropathy. Nerve damage can lead to a sore or an infection that can become severe before being noticed.
• The second problem happens when not enough blood flows to legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral vascular disease (PVD). Smoking when you have diabetes makes blood flow problems much worse.
• If blood sugar is high, the body loses fluid. With less fluid in the body, the skin becomes dry. Dry skin can be itchy, causing scratching and soreness. Dry skin can crack and allow germs to enter and cause infection. Dry skin can occur on legs, feet, elbows, and other places.

risk increases with

• Peripheral neuropathy.
• History of foot problems or foot deformity.
• Peripheral vascular disease.
• Poor glucose control.
• Having complications of diabetes (e.g., heart disease).
• Smoking.

PREVENTIVE MEASURES

• Wash your feet in warm water every day. Make sure the water is not too hot. Do not soak your feet. Dry your feet well, especially between your toes.
• Look at your feet every day to check for cuts, sores, blisters, redness, calluses, or other problems. Checking every day is even more important if you have nerve damage or poor blood flow. If you cannot bend over or pull your feet up to check them, use a mirror. If you cannot see well, ask someone else to check your feet.
• Rub lotion on your feet after you wash and dry them. Do not put lotion between your toes.
• File corns and calluses gently with an emery board or pumice stone. Do this after your bath or shower.
• Cut your toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board.
• Always wear slippers or shoes to protect feet from injuries. Always wear socks or stockings to avoid blisters. Do not wear socks or knee-high stockings that are too tight below your knee.
• Wear shoes that fit well. Shop for shoes at the end of the day when feet are bigger. Break in shoes slowly.
• Have a complete foot exam every year.
• For skin care, wash with a mild soap, make sure to rinse and dry completely. Check your skin after you shower or bathe. Make sure there are no dry, red, or sore spots that can lead to an infection. Use a lotion or cream after you wash. Wear all-cotton underwear. Cotton allows air to move around your body better.

expected outcomes

Using preventive measures and seeking early treatment of infections should help to avoid serious problems

possible complications

Serious foot infections, gangrene, and amputation.

 diagnosis & treatment

general measures

• See your health care provider if new skin problems occur and don't go away on their own in a day or two.
• To learn more: Contact the local or national office of the American Diabetes Association, Attention: National Call Center, 1701 North Beauregard St., Alexandria, VA 22311; (800) 342-2383; website: www.diabetes.org.

medications

Specific drugs for infections may be prescribed.

activity

Be as active as possible. Your health care provider can help plan an exercise program.

diet

Follow any prescribed diabetic diet.

 notify our office if

You or a family member has foot sores that are not healing properly or skin is extremely dry and itchy.

Special Notes: