Check Your Feet Every Day.

• Check your feet for cuts, sores, red spots, swelling, and infected toenails. You may have foot problems, but feel no pain in your feet.
• Check your feet each evening when you take off your shoes.
• If you have trouble bending over to see your feet, use a mirror to help. You can also ask a family member or caregiver to help you.

Wash Your Feet Every Day

• Wash your feet in warm, not hot, water. Do not soak your feet because your skin will get dry.
• Before bathing or showering, test the water to make sure it is not too hot. You can use a thermometer (90° to 95° F is safe) or your elbow to test the water.
• Use talcum powder or cornstarch to keep the skin between your toes dry to prevent infection.

Keep The Skin Soft And Smooth

• Rub a thin coat of lotion, cream, or petroleum jelly on the tops and bottoms of your feet.
• Do not put lotion or cream between your toes because this might cause an infection.

Smooth Corns and Calluses Gently

• Thick patches of skin called corns or calluses can grow on the feet. If you have corns or calluses, check with your foot doctor about the best way to care for them.
• If your doctor tells you to, use a pumice stone to smooth corns and calluses after bathing or showering. A pumice stone is a type of rock used to smooth the skin. Rub gently, only in one direction, to avoid tearing the skin.
• Do not cut corns and calluses.
• Do not use razor blades, corn plasters, or liquid corn and callus removers - they can damage your skin and cause an infection.

If You Can See, Reach, and Feel Your Feet, Trim Your Toenails Regularly

• Trim your toenails with nail clippers after you wash and dry your feet.
• Trim your toenails straight across and smooth the corners with an emery board or nail file. This prevents the nails from growing into the skin. Do not cut into the corners of the toenail.
• Have a foot doctor trim your toenails if:
  • (i) you cannot see or feel your feet
  • (ii) you cannot reach your feet
  • (iii) your toenails are thick or yellowed
  • (iv) your nails curve and grow into the skin

Wear Shoes and Socks at All Times

• Wear shoes and socks at all times. Do not walk barefoot when indoors or outside. It is easy to step on something and hurt your feet. You may not feel any pain and not know that you hurt yourself.
• Make sure you wear socks, stockings, or nylons with your shoes to keep from getting blisters and sores.
• Choose clean, lightly padded socks that fit well. Socks that have no seams are best.
• Check inside your shoes before you put them on. Make sure the lining is smooth and that there are no objects in your shoes.
• Wear shoes that fit well and protect your feet.

Neuropathy Test

Diabetic nerve disease (neuropathy) is the damage caused to the nerves of the body due to high blood sugar levels from diabetes. Those who have long term, uncontrolled high sugar levels are at high risk of developing weak nerves in all the vital organs of the body (Autonomic Neuropathy) like brain, heart, stomach, bladder, intestines, lungs etc. When the extremities, especially the leg and foot nerves are affected, it is called Peripheral Neuropathy.Almost half of long term diabetic patients with uncontrolled blood sugar levels have been seen to develop peripheral neuropathy.

Risk Factors & Causes

• Long term diabetes;
• Uncontrolled blood sugar levels

Symptoms

• Loss of sensation in toes, feet, arms and legs; you may not feel the pain if you have a small blister or cut and may find it difficult to distinguish between hot and cold temperatures;
• Deep pain in feet and legs;

• Tingling and burning sensation in arms and legs
• Sluggish digestion causing diarrhoea, constipation and bladder problems
• Sexual problems – difficulty in achieving and sustaining erection long enough to complete the sexual act (erectile dysfunction) in men; vaginal dryness and inability to achieve orgasm in women
• Changes in skin colour
• Fast heart rate
• Sudden drop in blood pressure when you stand up after sitting or lying down
• Dizziness and nausea.

Recommended Tests

• Diabetic Peripheral Neuropathy: Filament test and Biothesiometry to detect nerve damage in early stages
• Autonomic Neuropathy: Cardiac Autonomic Nerve testing and evaluation of gastroparesis (“sluggish intestines”) for evaluation of internal nerves.

Complications

• Frequent bladder and kidney infections
• Foot complications: If a small cut or bruise or blister goes unnoticed, it may not heal due to high sugar levels and the surrounding area may take on a bluish hue due to lack of blood supply and oxygen leading to gangrene, or even amputation.

Treatment and Prevention

• Strict control of blood sugar levels with medications, lifestyle modifications and moderate diet combined with adequate exercise.
• Examine feet and nails daily: keep them clean and also visit a podiatrist.
• Medications to improve nerve strength.
• Medicines to treat erectile problems.
• Wear proper footwear and keep feet protected in order to prevent even minor injury.