As I mentioned in my last blog (Living with diabetes – selecting shoes), purchasing properly fitted, supportive shoes is very important but you need to do even more if you want to avoid painful foot wounds that can lead to serious complications.
Check your shoes daily to see if any small stones or foreign objects are caught inside. Also carefully examine the top, heel and toe of your shoes to make sure they haven’t broken down or worn. Damage to the shoe (as shown in the image to the left) changes the fit which can cause a bad sore to develop even after just one day of wear. One patient of mine was wearing good diabetic shoes but her shoes were loose at the heel so they moved up and down creating a sore. The patient thought it was just a small sore and didn’t treat it. However it became infected and eventually she had to have her leg amputated.
Also make sure you wear seamless, moisture-wicking socks and change them daily. Sock seams can put pressure on your foot so if you have reduced sensation in your feet they are best avoided. Moisture wicking socks will keep your feet dry and further reduce risks of sores as they won’t “pill” and rub.
Cut your toenails square, leaving a bit of nail over the toe as shown in this image. This will help prevent ingrown toenails which can lead to infection. As people living with diabetes have a decreased ability to fight infections, preventing infection is easier than curing it.
If a sore develops – it doesn’t matter how small – stop wearing the shoe that caused the wound and treat it immediately with antibiotic or silver nitrate cream. Keep pressure off the wound until it heals. If the wound is on the bottom of your foot, a Canadian Certified Pedorthist can create a device to re-distribute the pressure on your foot that will allow the wound to heal. Be patient – it can take up to five years for a sore to heal on some feet due to poor circulation.
Most importantly, keep your sugar under control by staying active, eating well and taking your medications. Better sugar control decreases the rate of side effects like peripheral neuropathy, loss of sensation which in turn will reduce the likelihood of foot injuries and complications. If you are living with diabetes you have to take extra care of your feet but if you are vigilant, follow my tips and work closely with your Canadian Certified Pedorthist your diabetes shouldn’t slow you down.
By Jim Pattison, C. Ped (C), Prince Albert, SK