Over a long period of time, high blood glucose levels can cause damage to different areas of your body and this includes your feet and legs.
High blood glucose levels can cause damage to the nerve systems in your body, which stops important messages from getting to and from your brain.
The nerves in your body that are most likely to be affected are the longest ones – those that have to reach all the way to your feet and legs. Damage to your nerves is the thing most likely to affect your feet if you have diabetes. Nerve damage is also sometimes called neuropathy.
When it affects your feet it can lead to the following:
- Damage to sensory nerves
- Damage to motor nerves
- Damage to autonomic nerves.
Damage to sensory nerves, which means that you start to lose sensation in your feet and are less able to feel pain, temperatures, and vibrations
Damage to motor nerves, which can affect the muscles in your feet causing toe joints and bones to change shape
Damage to autonomic nerves, which can reduce the amount of sweat that your feet produce, which will make your skin very dry.
The other important reason why some people with diabetes develop foot problems is that high blood glucose levels can also damage your blood vessels.
This can affect the blood supply (circulation) to your feet and legs and may mean that less blood gets to your skin, muscles, and tissues.
Many people with diabetes believe that foot problems are caused by a poor blood supply, and therefore think that if their feet are warm and pink then they are healthy.
In fact, foot problems are often caused as a result of damage to the nerves that supply your feet and legs. Because nerve damage often shows itself gradually you may not know that you are at risk of foot problems.
So, even if your feet look healthy, it’s important to check them regularly and to make sure your nerves are tested at your annual diabetes review.
Because damage to the nerves and blood supply to your feet happens gradually, it’s important to know what to look for and how to spot the signs of any change.
By checking your feet regularly you can spot the signs of any damage early. This means that you can get help quickly and can prevent the damage from getting any worse. There are a number of different things for you to look out for. These are the main ones:
- Changes to nerves
- Changes to blood supply
- Tingling or pins and needles
- Cramp in your calves
- Shiny, smooth skin
- Losing hair on your feet and legs
- Sweating less
- Thickened toenails
- Feet may look red and feel hot to the touch
- Cold, pale feet
- Changes in the shape of your feet
- change in the colour of the skin on your feet.
As well as the symptoms, which you might spot yourself, your health professional will also be testing for changes to your feet. When you go to your annual diabetes review he or she will look for changes to your nerves and the blood supply as well as checking the shape and condition of your feet.
How do I look after my feet?
Try building foot care into your routine when you get up or before you go to bed. If you have a bath or shower every day then that’s an ideal time to add in your foot care. There are three steps to your routine:
3 STEPS 3 MINUTES CHECK
If any small wound has not started to heal more than two days after an injury then you should see your podiatrist, nurse or doctor straightaway. If you have damage to your nerves or the blood supply to your feet then you shouldn’t wait, but instead see your doctor as soon as you can, however small the injury may be.
Step 1: Check your feet
You’re looking for any changes from yesterday as well as the previous days and weeks. Check for:
- Any other change in the colour of your skin – for example, pale, bruised or purple skin
- Injuries like blisters or cuts
- Fluid coming from any wound
- Pain – especially if you usually have little or no feeling in your feet.
If you find it difficult to bend down or lift your feet up to check properly then use a mirror. Put it on the floor so you can see the soles of your feet. Or ask someone else to look for you – your partner or carer for example.
Small injuries like cuts and grazes can often be looked after by you at home. Clean the injury and put on some antiseptic cream and a dry, sterile dressing.
Check the injury regularly and if you see signs that it is infected (redness, swelling or fluid coming from the wound) see your GP straightaway. If you spot any other changes to your feet that last for more than two days, see your GP.
Step 2: Wash your feet with warm water and soap
Check the temperature of any water before you put your feet in it, to make sure it’s not too hot.
You can do this by dipping your elbow or hand in. Use a mild normal soap or cleanser to clean your feet. Don’t soak your feet, for example don’t spend too long soaking in the bath. Soaking makes your skin soggy, which means it can be easily damaged.
Dry your feet well, taking care to dry well between your toes. Drying your skin well will help prevent infections like athlete’s foot from starting. It’s also important to make sure your feet are properly dry after you have been swimming.
Step 3: Use a moisturiser
Ask your pharmacist for a moisturiser that you can use for dry skin. There are moisturising creams available just for the skin on your feet.
Use the moisturiser after you have dried your feet and rub it into the main parts of your foot, both underneath and on top, to keep the skin on your feet supple. Don’t use it between your toes as it will make your skin there moist, which could make an infection like athlete’s foot more likely. If you use talc, only use a small amount as it can become clogged up, which increases your chances of developing an infection.
That’s it. That’s your basic daily foot care routine.
Of course, as well as helping to prevent foot problems, this skincare routine will help you to keep your feet in top condition, with supple and healthy skin and feet that not only look good but feel great!
What other help can I get to look after my feet?
Everyone who has diabetes should have their feet checked regularly and at least at their annual review. A healthcare professional that has been specially trained to look after people with diabetes will do the check up with you. This could be your podiatrist*, nurse or doctor.
By always going to your appointments you will be able to find out about any problems early and can get advice on foot care, shoes and any problems you may be having.
Even if you think a problem may be small or not worth worrying about, always tell your health professional if you notice any changes to your feet.
If you need help in between your annual reviews, make an appointment with the person who usually looks after your diabetes care. He or she can help you to make an appointment with a podiatrist.
The Society of Chiropodists and Podiatrists