Description: Diabetes is a disease that affects every part of the body, even when the diabetes is under control. Diabetics, because of the nature of their disease, have fewer defences against everyday wear and tear, especially where the feet are concerned.

People with diabetes often have trouble with their feet. Part of the problem is that the loss of feeling in your feet makes it hard for you to tell if you have a blister or sore. If little sores aren’t taken care of, they can get worse and turn into ulcers (serious, deep sores).

Sugar affects the nerves of the feet, causing peripheral neuropathy. Peripheral neuropathy is a disease, which can produce anything from strange feelings in the feet (burning, tingling, numbness, etc.), to a complete loss of feeling in the feet. The lack of proper feeling makes a diabetic person more likely to injure their feet without knowing it. This makes a diabetic more susceptible to infections; fractures which are not felt, and do not heal properly; and severe bone and joint disease which changes the contour of the foot.

Nerve damage can cause you to lose feeling in your feet. You may not feel a pebble inside your sock that is causing a sore. You may not feel a blister caused by poorly fitting shoes.

Examine your feet daily including the tops, bottoms, and between your toes. Look for inflamed areas, cuts, peeling and breaks in the skin, rashes, and swelling. Press on your toe nails to see if they are painful or ingrown. Touch your feet and make sure the temperature is the same in both, and that they are not cooler then the rest of your body. Test to see that you have good feeling in the bottom of both feet, by gently moving your finger from heel to toes.

Effective treatment involves educating patients on foot care, ensuring the patient is wearing breathable, protective, seam-free footwear that is not rubbing anywhere on the foot and custom foot orthotics. It is imperative that a patient affected by diabetes makes daily foot checks a routine.

Footwear: Wear properly fitted shoes, with uppers made of soft materials. The toe box (the area where the toes lie in the shoe) should be deep and wide to reduce pressure on the toes, and the heels should be no higher than 3/4 inch. Seamless socks and shoes cause less problems then those with seams. Always wear shoes and socks; they protect the feet from injury. Do not walk barefoot!

How can orthotics help? Orthotics act as a replacement for the thinning fat pad on the bottom of the feet, thus protecting the skin from excessive bone pressure. Orthotics will also gently support the arch and all the bones and joints of the feet. Orthotics are made of durable, comfortable, space-age materials. They are lightweight, and will fit in all flat shoes. Custom-made orthotics are the diabetic’s “ounce of prevention” that may eliminate a “pound of cure” later on.