Diabetic conditions affecting the legs and feet
The feet and legs are common sites for complications in people with diabetes mellitus and for this reason good foot care is very important. An injury to the foot or leg can be painful, but in people suffering from diabetic neuropathy (nerve damage) the sensations are dulled and minor injuries often go undetected and untreated, potentially leading to more serious damage.
Loss of temperature sensation is also a significant risk factor for injury in people with diabetes. This can result in a person being unaware that the bath water they are stepping into is scalding them. They may also be at risk of developing severe burns after sitting too close to a heater.
Special attention is needed to prevent circulatory disorders and infections that commonly occur in the lower extremities of people with diabetes. Areas with poor circulation heal badly and, if left unattended, such injuries may develop into ulcers or even become gangrenous.
Do not ignore pain in the feet or legs as this may indicate a problem. Corn plasters should not be used as they may cause foot ulcers.
Good foot care
Good foot care is vitally important for people with diabetes. Every day, wash your feet in warm (not hot) water. If you notice a callus forming, you can try to gently remove it (for example, with a pumice stone). However, once formed, calluses should only be treated by professionals. After washing, apply a moisturiser to your feet, but avoid moisturising between your toes. When you cut your toenails, cut straight across and file down any sharp edges.
Always wear shoes and socks, and choose your shoes carefully. Shoes should be large enough to be comfortable, but not large enough to be slipping off. They should have resilient (but not soft) insoles, and be smooth on the inside, with no rough areas.
Check your feet each night, looking for:
dry, scaly, red, itching or cracked skin;
areas where something has been rubbing on your feet;
cuts or abrasions;
corns or calluses;
thickened or discoloured nails;
blueness or any swelling; and
any red, hot or swollen areas.
If your vision is poor, get someone to check for you.
Any breaks in the skin need to be treated straight away, so see your doctor or podiatrist. Also, try to work out what might have caused the problem so that you can prevent it happening again. If one of your feet is hot and swollen, check it again the next day — see your doctor if it remains hot and swollen.
Your feet should also be examined regularly by a doctor, diabetes specialist or podiatrist. Your doctor or podiatrist can advise you on foot care and also on the selection of appropriate footwear.