Diabetes Awareness Month

November is Diabetes Awareness Month. Diabetes is the inability to make or properly use insulin. This impairs the body's ability to convert and use sugars, starches and other foods into energy. The result is an increase in blood sugar levels. Long-term elevation of blood sugar can lead to damage to the eyes, kidneys, nerves, blood vessels and feet.


Because diabetes affects many parts of the body, successful management requires a team approach. Regular visits with your podiatrist are important to help prevent and treat lower limb complications that may arise as a result of your diabetes. The American Podiatric Medical Association recommends diabetics see their podiatrist for a foot exam every 6 months.


Diabetes can lead to dry, flaking and cracked skin. This puts you at risk of developing an ulcer. You should apply lotion to your feet every day. Do not apply the lotion between your toes because this has been shown to increase the risk of developing a fungal infection. Diabetes also reduces the blood flow in your feet, making it harder for you to heal from an injury or ulcer. Nicotine is a vasoconstrictor so using tobacco products reduces the blood flow in your feet. The combination of tobacco use and diabetes can lead to serious vascular issues. Tobacco use slows wound healing and increases the risk of surgical complications.


Diabetic foot ulcers occur in approxately 15% of diabetic patients. Of those, 6% will be hospitalized with an infection related to the ulcer. Of those patients with a diabetic foot ulcer, 14-24% will require an amputation. After an amputation, the chance of another amputation is as high as 50% within three to five years. According to the American Podiatric Medical Association, including a podiatrist in your diabetes management can reduce the risk of a lower limb amputation up to 85% and lowers the risk of hospitalization by 24%. Early recognition and treatment of complications is key to helping prevent amputations.


You should check your feet daily for cuts, blisters, redness, swelling or nail problems. If you can't see the bottoms of your feet, put a mirror on the floor, or ask a friend or partner to help you. If you notice any issues, call your podiatrist right away. Even if you think the issue is small, it is important to have it looked at so it can be treated properly to reduce the risk of it developing into something serious.


Diabetes warning signs to watch for in the feet and ankles:

skin color changes



pain in the legs

open sores or cracks in the skin

ingrown nails

bleeding or any discharge from calluses or corns


You should never walk barefoot. This includes in your home. Wear slippers or shoes inside. You may not feel pain or discomfort if you step on something because elevated blood sugar can lead to nerve damange in your feet. Most of the items I remove from patient's feet were stepped on in their homes. Make sure the shoes and slippers you wear fit properly – not too big and not too small. Improperly fitting shoes can rub and cause blisters and ulcers. Check your shoes before you put them on to make sure there are no stones or other objects inside. If you weld, you should remove the insoles and check them before putting your shoes on. Metal filings can drop into your shoes from your pants when you take your shoes off. Diabetic shoes come in wide widths and extra depth to prevent rubbing. They also have special insoles that can be customized to your foot to reduce pressure points that can develop into sores. These are often covered by your insurance company. A foot exam must be done to see if you qualify for diabetic shoes through your insurance company.

Dr Katie Evans Dr Katie Evans writes a monthly column in the Hometown Focus. The articles cover a variety of issues concerning the foot and ankle. If you have any recommendations for future articles, email them to rangefootandankle@gmail.com.

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