Summer Foot Care for Happy Diabetic Feet

By GabbyPA Latest Reply 2012-01-21 04:07:57 -0600
Started 2011-05-25 11:31:38 -0500

by Roberta Kleinman, RN, M.Ed., CDE

Summer is finally here and nothing beats wiggling your toes in the sand or the surf after a long freezing winter. The problem is, if you have diabetes, the risk of kicking off your shoes is not worth it.

According to The California Podiatrist Medical association nearly 55,000 Americans with diabetes suffer from a lower limb amputation each year. Many of them could be prevented. They usually begin as a minor problem that left untreated can develop into serious foot ulcers or eventual gangrene. Nerve damage or neuropathy along with poor circulation can lead to this scenario.

Sunburn on the feet, second or third degree burns on the soles of the feet due to hot sand or hot pavement, glass or broken shells in the sand, insect bites, hot tubs, corn or callus over the counter remedies causing chemical injury, abrasions from rough areas like pool bottoms or anti-slip surfaces can all be detrimental to people with diabetes. Hot summer temperatures cause our feet to swell especially at the end of the day if we have been standing for long periods of time.

Sandals or flip-flops are poor choices for summer foot wear. These open shoes allow you to lose moisture setting you up for rough and dry skin. This causes an increased risk of skin cracking and exposure to bacteria or fungus.

Athlete’s foot is the same fungus as nail fungus-thickened yellow nails, and people with diabetes are very prone to both of these conditions especially in summer heat.

How to protect your feet-do not forget the basics
1. Wash daily with warm water and mild soap. Put lotion all over the foot except between toes. Lotion between toes increases fungus.

2. Check feet daily-look for blisters-do not pop them, they protect the injured area. Look for changes in foot temperature or hot spots. Look for bruises ,rashes, bleeding ,white or red spots, blue toes which could mean a blood clot, ingrown toe nails .If you see drainage-check for an odor which could indicate an infection. Use a magnifying or hand held mirror to examine feet closely. Look at changes in freckles or moles. Trim nails straight across and use an emery board to smooth out the nail. Use a wet pumice stone in the shower to lessen rough spots, corns or callus.

3. Schedule a foot exam with a podiatrist. Take your shoes off at your physician appointment every time.

4. Control your blood sugars and get your A1C between 6.5-7.0%. Do not allow postprandial readings to go above 180mg/dl.

5. Buy shoes at the end of the day. Have your feet measured each time. You can change your shoe size 4-5 times over a life time due to weight gain or loss, pregnancy or decreased circulation. Buy breathable shoes like leather not plastic. Change off shoes to allow them to dry out when feet perspire. You are entitled to a pair of shoes and three inserts by Medicare Part B. Check with your physician.

6. Change socks daily. Try to remove wrinkles. Make sure the ankle band is not tight. Look for socks with few seams. Look for a blend which will help wick perspiration away.

7. Encourage blood flow-do not smoke. Try exercising daily. Elevate feet for 15 minutes at the end of the day. Wiggle toes and do ankle rolls. Try not to cross legs except at ankle area.

Summer is a wonderful time to enjoy the outdoors, just try it with shoes on!

15 replies

JSJB 2012-01-21 04:07:57 -0600 Report

Thank you for the great article. Never thought of getting too much sun on my feet. My feet were really rough so I started to use Lotramin on the bottoms of my feet which helped a little. I deffinetly will try Flexitol. I don't mind wearing shoes but how about sneakers???? Never did like sandles or flip flops.

maria.inspireme 2011-05-28 06:39:20 -0500 Report

I absolutely hate waering shoes. Everyone gets on me about it too, but no matter the shoe, it doesn't feel good. I'm usually in sandals, even in the rain. I too have grown up barefoot and prefer feeling the earth, despite knowing the risks. My heals are cracked and I have ingrown toe nails. I just can't get it in my head to have better foot care. It's like, with shoes on, I can't stretch my feet, move my toes. Any advice please?

GabbyPA 2011-05-28 09:17:13 -0500 Report

Your cracked feet often come from being barefoot. It is a-kin to athletes foot and needs to be treated. I found once I stopped wearing sandals everywhere including in the rain, my feet did much better. The dirt, sweat and other fungal cruds love to live in the moist soles of our feet and then they make it crazy.

I used to have cracked heels, and now they are beautiful. But if I stop taking care and protecting my feet it will come back. It is a huge process of lotions, soaking, and care for about a month to get the cracks healed up, but once you have it healed, maintaining it is easier. Here is what I use:
But the cracks can lead to infections, so you really want to get that under control.

I also tend to have ingrown toenails. YUCK. I have had two removed and now I am starting on a third one. =0( But at least the doc and I are keeping an eye on it and trying to see if we can help it heal on it's own. If not, he will remove the entire side so it won't grow back. It is a HUGE relief to have them removed, and much healthier for your feet in the long run. So it sounds like a visit to a podiatrist is in order for you.

melissa5786 2011-05-27 08:47:47 -0500 Report

I check my feet every night before I go to bed. Besides dryness, which I am slowly remedying, I have no problems. I used to go barefoot everywhere. Outside to check the mail, around the house. At work. Now, I don't. I wear flip flops and sandals in the summer months and I feel that as long as I check my feet on a daily basis and I see no signs of harm, I'll be fine.

I've never gone barefoot on the beach. Even before I was diabetic. So, that won't change. The minute I see a change you bet I'll be lacing up my sneakers all year round.

GabbyPA 2011-05-27 08:27:56 -0500 Report

Sadly, I have put my feet in shoes. I used to be the barefoot queen. I went everywhere barefoot. Even as a kid with tar bubble streets and gravel. I was barefoot. On my honeymoon, in the cold of early spring I took of my shoes to run my bare feet in the rye grass. But my feet became so sensitive to anything that now they are only comfortable in shoes. It kills me, but it is best for me.

I love sandals and don't even own a pair now. I also found that sandals are prone to giving us athletes foot that leads to cracking feet, that leads to trouble. I have some dresses that require a "pretty" sandal, so I may get one that I wear on special occasions only. Like Keddiekilowatt, I work in the garden a lot and with outside animals, so boots are my best friends then. Nothing worse than dropping a post hole digger or rake on your toes.

Gimpalong 2011-05-27 14:30:23 -0500 Report

Hi Gabby, I used to be the barefoot queen around our neighborhood. I hate shoes, but alas I wear them anyway. LOL I wear leather shoes to help keep my feet from sweating, but I wear an ole pair of houseshoes that are as close to barefoot as I can get when I'm in the house. I also wear diabetic socks that I get at WalMart, which has helped to cut down on swelling in my ankles and feet. I do check my feet daily.

Keddiekilowatt 2011-05-26 21:55:01 -0500 Report

In the spring thru fall I prefer to wear the old fashion canvas tennis shoes. They allow air circulation around the feet and protection from foreign objects. I raise chickens and they have been known to peck my feet, so I always wear shoes. Open toe shoes like sandals I sometimes wear, but for occasions like a dinner out. Never around the chickens or anything I would do on the farm. I might go bare foot on a beach I am familiar with, but that would also depend on how hot the sand is. Even before I became diabetic I knew better than walk on hot sand or cement surface like a sidewalk. However after saying this, I check my feet nightly even though I still have feeling in my feet. If my feet is cracking due to dry skin or has a cut or blister I wash and treat them with a triple antibiotic suave until it is healed. I use lotion often, because I do have a dry skin problem.

Graylin Bee
Graylin Bee 2011-05-25 16:47:08 -0500 Report

Good advice to follow with no exceptions. I hsve seen the results of not doing some of the things reccommended for safety and foot health.
I have had problems with socks becoming too tight as the day progressed the other year. Due to my venous stassis, before it was diagnosed, I had edema in my legs. The socks would get tight and compress the nerves causing pain.
My husband has always had problems with ingrown toenails. His incomplete spinal cord injury caused his left leg and foot to be partaily paralysed. The first time his toenail caused a problem after it happend he did not catch the ingrown until his foot had swollen and became infected. He had relied on the tingle of pain to remind him to take care of his toenails. Now he makes sure and checks daily.
For the first 4 months after being diagnosed with Diabetes I was very creful to always were shoes indoors. After several weeks of watching all my barefooted relatives at Mom's (aka The Cake Lady) on Tuesday night, mine joined the party. One evening s sister cut her foot on something hidden in the carpet. Now I am back to shoes at all times in all places, except in be and the shower.

granniesophie 2011-05-25 14:11:53 -0500 Report

OK, so I live in Phoenix, where it gets to be 115 freaking degrees in July and August and I wear sandals from May to October, just like everyone else who lives here. I do not wear shoes and socks except in the "winter" months because it is too darn hot and my feet immediately sweat.
This being said, I also never go barefoot, even at home. I have an unhousebroken dog, and she leaves surprises everywhere, and that is not the most fun you can have!
You also don't go barefoot outside, since the concrete is hot enough to fry an egg, and your feet, as well!
Everyone puts sunblock everywhere, you don't have to be diabetic to do that, just a human being.
So, this article, while extremely useful, is, like Diabetes itself, not one size fits all. I would just like to say, how about we just use some common sense and do what works for us where we live, and also follow what our doctor's tell us do to, as well.

realsis77 2011-05-25 13:06:22 -0500 Report

I accidently sunburned my feet this year and they got blisters from the sun! So it is so important to remember our feet! Now my feet are burned and hurt!

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