If you have diabetes, here’s a way to keep standing on your own two feet: check them every day—even if they feel fine—and see your doctor if you have a cut or blister that won’t heal.

There’s a lot to manage if you have diabetes: checking your blood sugar, making healthy food, finding time to be active, taking medicines, going to doctor’s appointments. With all that, your feet might be the last thing on your mind. But daily care is one of the best ways to prevent foot complications.

Between 60% and 70% of people with diabetes have diabetic neuropathy (nerve damage). You can have nerve damage in any part of your body, but nerves in your feet and legs are most often affected. Nerve damage can cause you to lose feeling in your feet.

Feeling No Pain

Some people with nerve damage have numbness, tingling, or pain, but others have no symptoms. Nerve damage can also lower your ability to feel pain, heat, or cold.

Living without pain sounds pretty good, but it comes at a high cost. Pain is the body’s way of telling you something’s wrong so you can take care of yourself. If you don’t feel pain in your feet, you may not notice a cut, blister, sore, or other problem. Small problems can become serious if they aren’t treated early.

Risk Factors

Anyone with diabetes can develop nerve damage, but these factors increase your risk:

• Blood sugar levels that are hard to control.
• Having diabetes for a long time, especially if your blood sugar is often higher than your target levels.
• Being overweight.
• Being older than 40 years.
• Having high blood pressure.
• Having high cholesterol.

Nerve damage, along with poor circulation—another diabetes complication—puts you at risk for developing a foot ulcer (a sore or wound) that could get infected and not heal well. If an infection doesn’t get better with treatment, your toe, foot, or part of your leg may need to be amputated (removed by surgery) to prevent the infection from spreading and to save your life.

When you check your feet every day, you can catch problems early and get them treated right away. Early treatment greatly reduces your risk of amputation.

Start Off on the Right Foot

What’s the most important thing you can do to prevent nerve damage or stop it from getting worse? Keep your blood sugar in your target range as much as possible. Other good diabetes management habits can help, too:

• Don’t smoke. Smoking reduces blood flow to the feet.
• Follow a healthy eating plan, including eating more fruits and vegetables and less sugar and salt.
• Get physically active —10 to 20 minutes a day is better than an hour once a week.
• Take medicines as prescribed by your doctor.

Tips for Healthy Feet

Check your feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or any other change to the skin or nails. Use a mirror if you can’t see the bottom of your feet, or ask a family member to help.

Wash your feet every day in warm (not hot) water. Don’t soak your feet. Dry your feet completely and apply lotion to the top and bottom—but not between your toes, which could lead to infection.

Never go barefoot. Always wear shoes and socks or slippers, even inside, to avoid injury. Check that there aren’t any pebbles or other objects inside your shoes and that the lining is smooth.

Wear shoes that fit well. For the best fit, try on new shoes at the end of the day when your feet tend to be largest. Break in your new shoes slowly—wear them for an hour or two a day at first until they’re completely comfortable. Always wear socks with your shoes.

Trim your toenails straight across and gently smooth any sharp edges with an emery board. Have your foot doctor (podiatrist) trim your toenails if you can’t see or reach your feet.

Don’t remove corns or calluses yourself, and especially don’t use over-the-counter products to remove them—they could burn your skin.

Get your feet checked at every health care visit. Also, visit your foot doctor every year (more often if you have nerve damage) for a thorough exam, which will include checking for feeling and blood flow in your feet.

Keep the blood flowing. Put your feet up when you’re sitting, and wiggle your toes for a few minutes several times throughout the day.

Choose feet-friendly activities like walking, riding a bike, or swimming. Be sure to check with your doctor about which activities are best for you and any you should avoid.

Be sure to ask your doctor what else you can do to keep your feet healthy.

When To See Your Doctor

If you experience any of these symptoms, don’t wait for your next appointment. See your regular doctor or foot doctor right away:

• Pain in your legs or cramping in your buttocks, thighs, or calves during physical activity.
• Tingling, burning, or pain in your feet.
• Loss of sense of touch or ability to feel heat or cold very well.
• A change in the shape of your feet over time.
• Loss of hair on your toes, feet, and lower legs.
• Dry, cracked skin on your feet.
• A change in the color and temperature of your feet.
• Thickened, yellow toenails.
• Fungus infections such as athlete’s foot between your toes.
• A blister, sore, ulcer, infected corn, or ingrown toenail.

Most people with diabetes can prevent serious foot complications. Regular care at home and going to all doctor’s appointments are your best bet for preventing foot problems (and stopping small problems from becoming serious ones)

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