Each winter in the US, approximately 15-20% of people with diabetes end up in the hospital because of a foot ulcer or infection. In some cases, these foot problems lead to amputation. That’s why I tell all of my diabetic patients at Westchester Health that foot care is always very important but during the winter, it is even more crucial to keep your feet healthy. Winter moisture, cold and dryness can easily cause numbness and decreased circulation, increasing the risk of a diabetic foot problem.
7 important steps to take to keep diabetic feet healthy
To keep your feet healthy through the winter and avoid problems, I offer the following essential tips:
1) Inspect your feet every day
If you have diabetes, you need to have a daily protocol for foot inspection and stick to it. Look carefully at all the pressure areas of your feet and between your toes. Inspect for any breaks in the skin, discharge, changes in color, changes in odor and/or painful corns or calluses. Let your doctor know about any changes you find. Also, inspect your socks for any stains and your shoes for any stones or rough edges. If you have trouble seeing your feet closely, ask a friend, family member or medically-trained person to help with your diabetic foot care.
2) Choose the right footwear
Winter cold and dampness combined with decreased circulation in your feet can increase your risk for a diabetic foot ulcer. To avoid this, make sure your winter shoes and boot provide warmth, protection from snow and ice, and proper padding. Also make sure they are roomy enough not to constrict blood flow to your feet. Avoid synthetic shoe or boot materials that lock in moisture (your feet need to breathe, even in the cold), and choose the right socks. I recommend wool socks which provide cushioning protection and warmth. You might also consider wearing polypropylene stockings under your socks to wick away moisture.
3) Keep your feet dry
Sloshing through wet snow or icy puddles can lead to dangerously damp feet for a diabetic person. Moisture that collects for too long between your socks and feet, and between your toes, allows potentially problematic bacteria to grow. When your feet get wet from winter weather, you need to dry them carefully and completely, including between your toes. Inspect your feet for areas that are pale in color, which could mean they haven’t been thoroughly dried and still contain too much moisture. Also, it’s vital to change out of wet socks as soon as possible.
4) Moisturizing your feet is essential
Diabetic nerve damage and poor circulation can cause decreased function of the moisturizing glands of your feet. Dry winter heat (from a fire, electric space heater or a car heater blowing on your feet), can make dryness worse and lead to skin breakdown. Be on the lookout for red, shiny areas when you perform your daily foot inspection. Ask your doctor or podiatrist to recommend a good moisturizer for diabetic foot care. Use this moisturizer after bathing your feet every day but avoid leaving too much between your toes.
5) Trim your toenails
Untrimmed or infected toenails are a frequent cause of infections and ulcers and can potentially lead to amputation. Ask your doctor or podiatrist how to trim your toenails correctly or make an appointment to have him/her trim them. If you’re trimming them yourself, soak your feet first to soften the nails, then cut them straight across. Nails that are thick, crumbly or discolored may need professional care and should not be ignored.
6) Never burn your feet
Nerve damage in your feet caused by diabetes can make keeping them warm in winter dangerous because you may not feel when they are getting dangerously hot. Be very careful when using electric blankets, hot soaks, heating pads or warming your feet on a radiator—you could seriously burn your feet and not know it. Always check the water temperature with your hands or a bath thermometer before putting your feet in. A second or third degree burn can cause a major foot problem. If this happens, contact your doctor immediately.
7) Control your blood sugar
Keeping your diabetes under control is one of the most important aspects of diabetic foot care. Because your feet absorb much of the weight and daily wear and tear of your body, they are one of the first places insufficient diabetes control will show up. Work with your doctor for successful ways to control your blood sugar. Also, monitor your diet, maintain your weight (maybe lose weight), exercise regularly and avoid smoking. This way, during the winter and all through the year, your feet—and you—will be healthier.
If you have a foot problem of any kind, come in and see me
If you have diabetes and are concerned about the condition of your feet, ankles and toes, have pain in your feet or heels, or are experiencing any other problems with your feet, please call (914) 232-1919 to make an appointment to come see me at one of my Westchester Health offices. I’ll examine your heels, ankles and feet, evaluate your condition, and together with you, determine the best course of treatment for your specific condition. Whenever, wherever you need us, we’re here for you.