Footcare for diabetes

Taking good care of your feet is important for all of us, but for people with diabetes, they require special attention. Health reporter Catherine Milford explains.

It’s easy for us to take our feet for granted. As they’re hidden from view for most of the time, we tend to pay them little mind until something happens to them. For people with diabetes though, protecting and caring for your feet is vital.

Foot problems are a common complication in people with types 1 and 2 diabetes, and it’s not unusual for problems to go unnoticed until they have become quite serious. Blood vessels and nerves can be damaged as a result of long-term high blood-sugar levels, meaning pain and soreness may go unnoticed. As a result, approximately 5 per cent of people with diabetes will eventually require the amputation of a toe or foot.

“Foot issues affect those with both diabetes types, as problems happen in response to blood sugar levels,” explains podiatrist Lauren Earl. “If your blood sugar levels are elevated, or if you’ve had the disease for more than 15 years, you’re more likely to develop foot complications.”

Foot trouble can range from fungal infections, calluses, bunions, pressure spots and ulcers, through to serious issues such as infection, poor circulation and gangrene, which can result in amputation. In most cases however, problems can be prevented simply by managing bloodsugar levels and ensuring your feet are cared for.

“Foot care is important for both type 1 and 2 diabetes, but there are some good general health guidelines to help you manage it,” according to dietitian Brad Brosnan. “Type 1 diabetes isn’t preventable, but it can be managed with medication, healthy food choices and regular exercise.

“In type 2 diabetes, either the body doesn’t produce enough insulin or the body’s cells don’t recognise the insulin it does have. The end result is the same as with type 1, high levels of glucose in the blood.”

FOODS TO EAT FOR YOUR FEET

Put simply, mindful nutrition can mean better-managed blood-sugar levels. If your diet is healthy and diabetes-friendly, you’re less likely to develop complications. “If you’ve been diagnosed with type 1 or type 2 diabetes, the first step is to get a clinical assessment of your nutrition intake and lifestyle habits,” Mr Brosnan advises. But that doesn’t mean cutting out entire food groups or making one or two changes.” Both diabetes types should look at their overall diet and managing daily blood sugars within their personal target range.”

Colourful veggies

Veggies will ideally take up half your plate at meal times.

Whole grains

Swap refined foods for whole grains, such as brown rice or grainy bread, while watching portion sizes – no more than a quarter of the plate.

Protein

Aim to fill quarter of the plate with protein such as legumes, fish, seafood, eggs, poultry or red meat (fat removed). Enjoy some low-fat dairy products.

What to watch

Limit sugary, high-carb and ultra-processed foods such as lollies, biscuits, potato chips, white bread and chocolate.

For good hydration, plain water is always the best option

Step it up with the right footwear

To give your feet the best chance, make sure you wear the correct footwear. Shoes should fit well and feel snug but not tight. Choose cotton socks that fit loosely and change them daily. “It’s important to have a supportive shoe that has structure to it,” Ms Earl explains. “This means a shoe with a firm heel counter [the little cup at the back of the shoe that holds your heel in place], a stiff shank [the supportive structure under the arch of the foot that runs between the insole and outsole] and a flexible forefoot. It’s a good idea to get your footwear fitted by a specialist store that will match your foot type with the shoe you need.”

8 top tips for foot health

1 Wash feet daily in lukewarm water using mild soap. Dry feet thoroughly, and take care to dry between the toes.

2 Moisturise your feet well after washing.

3 Don’t smoke. Smoking worsens heart and vascular problems and can reduce circulation to the feet.

4 Eat a healthy diet and exercise regularly to help maintain a healthy weight. This is important for people with both types 1 and 2 diabetes, however, it’s especially important for people with type 2 diabetes, who may also have high blood pressure and a poor lipid (blood fat) profile.

5 Check your feet daily. Look for skin breaks, blisters, swelling or redness, including between and underneath toes, where any damage may be hidden.

6 People who have had type 1 diabetes for at least five years are advised to have an annual diabetic foot check-up. People with type 2 diabetes need annual checks by a doctor, podiatrist or diabetes nurse. Seek professional advice immediately if you see any irregular changes to your feet.

7 Have toenails cut every six to eight weeks by a podiatrist or professional.

8 Ensure any corns or calluses are checked by a podiatrist.

Tread carefully

Foot issues to watch for:

✽ Dry patches or patches of thickened skin on your feet

✽ Changes in toenails, including fungal infections

✽ Any cuts and sores that take a particularly long time to heal

✽ Any numbness or tingling sensations in your feet.