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People with diabetes have a number of potentially serious health problems that can be cause by the condition, including eye, heart, and kidney disease. One of the most common is diabetes-related foot problems.
High glucose levels from diabetes can result in poor circulation to your lower legs and feet. Often, this causes nerve damage, called neuropathy, which can lead to a lack of sensation in your feet, foot ulcers, and in severe cases, results in amputation. Fortunately, with conscientious treatment of diabetes and good foot care, many of these problems can be avoided or at least treated.
Diabetic Neuropathy
When you have neuropathy in your feet, it’s very difficult to feel pain, cold, or heat. Because you have this loss of feeling, you may not feel a foot injury. For example, if you develop a blister, you may not know it. Often, you won't notice a foot injury until the skin breaks down and becomes infected.
Changes in Your Skin and Feet
The skin on your feet can change with diabetes.
- Your skin can become very dry, peel, or crack. This is because the nerves that normally control moisture to your feet no longer work.
- Calluses—These happen more often and build up faster for diabetics.
- Foot ulcers or sores that won’t heal—Ulcers usually occur on the ball of your foot and can be the result of poorly fitted shoes.
- Poor circulation—This makes it harder for your feet to heal and fight infection.
- Your feet and or toes may change shape.
Be Careful with Temperature Changes
Because diabetic neuropathy results in loss of feeling, you must be careful with heat. If your feet are cold and you want to warm them up, remember that you will not be able to tell what temperature is too hot.
The Importance of Good Food Care
There are many things you can do to prevent further problems with your feet. Most of them involve good foot care. But start by taking care of your diabetes overall. If you keep your glucose level under control, you are less likely to have foot problems.
The following are good foot care tips:
- Check your feet every day for cuts, red spots, sores, or infected toenails.
- Wash your feet every day in warm, NOT hot water. Dry your feet well, especially between the toes.
- Put on a thin coat of lotion or petroleum jelly on the tops and bottoms of your feet. Do not put the lotion between your toes because it can cause an infection.
- Treat corns and calluses gently. Check with your doctor or podiatrist about how to care for them.
- Trim your toenails weekly, or have a foot doctor do it if you can’t see well or reach your feet.
- Wear shoes and socks at all times. Never go barefoot because you could step on something and hurt your feet.
- Always wear shoes at the beach or on hot pavement to protect them from heat. Wear socks at night if your feet get cold. Check your feet often in cold weather in case of frostbite.
- Always check the insides of your shoes to make sure there are no stones or other objects in them.
- Wear shoes that fit well.
- Put your feet up when sitting. Wiggle your toes for 5 minutes, two or three times a day.
- Do not cross your legs for long periods of time.
It’s important to tell your doctor or health care provider if you are having any foot problems. You should have him check your feet each time you have an appointment.
Medicare Coverage for Foot Exams
It’s important for diabetics to have special diabetic foot exams. Medicare Part B will pay for two foot exams per year. You must follow these guidelines:
- You have diabetes-related nerve damage (neuropathy).
- The exams must be done by a Medicare-approved podiatrist or other foot specialist.
- You pay 20% of the Medicare-approved amount for the doctor’s visit.
- Your Part B deductible applies.
NOTE: This service is covered under Part B of Original Medicare. If you have a Medicare Advantage Plan, the services should also be covered, but check with your specific plan.
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