What is Diabetes?
Diabetes is a chronic, often debilitating disease in which the body either cannot produce insulin or cannot properly use the insulin that it produces.
Insulin is a hormone that regulates sugar in the bloodstream. Diabetes leads to high blood sugar levels, which can damage various systems in the body including the organs, blood vessels and nerves. The body needs insulin to properly break down sugar to use as an energy source.
How does diabetes effect your feet and lower limbs?
Diabetes can cause nerve damage and blood flow problems in the feet and lower limbs. As a result, people with diabetes are at a higher risk for developing complications from minor injuries such as blisters or cuts. Nerve damage reduces sensations in the feet, making it difficult to feel when an injury has occurred. Poor blood flow makes it difficult for the body to heal from small cuts or wounds.
These impairments in combination can cause a small injury to become a much larger problem.
What are the Symptoms of Diabetes?
Over time, people with diabetes may experience various changes or symptoms in their feet:
- Numbness, tingling or unusual sensations
- Heavy, spongy feeling in the feet
- Dry, peeling, or cracking skin
- Development of calluses, corns, or other skin issues
- Change in shape, flexibility, or movement
- Delays in healing, including chronic foot wounds
- History of gestational diabetes
- Family history of diabetes
- High blood pressure
- High cholesterol
- History of high or inconsistent blood glucose levels
What can you do to manage symptoms of Diabetes in your feet?
- Check your footwear regularly. Wear shoes that fit well and support your foot. Shoes should be supportive, low-heeled, and wide enough to accommodate your foot. Shoes should not rub or pinch in any area and, ideally, should be lined with a soft, seamless interior. Shoes that are either worn out or do not fit properly often contribute to foot complications.
- Protect your feet, both inside and outside the home. Wear a hard-soled slipper or sandal inside to protect against injury. Always wear socks for added protection.
- Inspect your feet and toes daily. Look for any changes to the skin: redness, blisters, cracks, dry patches, etc. Check toenails for sharp edges, cracks or other changes.
- Maintain a healthy lifestyle. Healthy eating, blood glucose management, and weight control are essential to successful diabetes management. Consult your family doctor, dietician, or diabetes care team for more information.
What are my options for treatment? Who can help?
There are a wide variety of resources and treatment options for people living with diabetes. Diabetes may be medically managed by your family physician, nurse practitioner, or diabetologist. Many communities have diabetes care teams that incorporate dieticians, nurses, kinesiologists, physical therapists, and other healthcare providers to provide a variety of treatments and management strategies, including exercise prescription, physical therapy, diet plans, and lifestyle modifications.
Foot care for people with diabetes starts with prevention. Your pedorthist can help you reduce your risk for diabetes-related foot complications with footwear advice, modifications to your footwear, custom orthotics or off-the-shelf foot orthoses, stretching and range of motion exercises, and most importantly, annual foot exams.
Custom Orthotics for Diabetes
Custom orthotics are manufactured specifically for you, using a 3D cast of your foot. Your Pedorthist will design your orthotics with materials and additions specific to your needs and will be able to adjust the support for both your needs and your comfort at any time. Your Pedorthist will also consider your activity level, occupation, footwear, and other factors when designing your orthotics.
A custom orthotic is another tool that is useful for people with diabetes. Unlike orthotics for other conditions, where correction or control may be required, orthotics for diabetes require redistribution of pressure along the soles of the feet to reduce areas of high pressure, friction, or shear. Soft, accommodative, full-length orthotics are the most effective at preventing foot injury in people with diabetes.
Prevention/Prehabilitation of Diabetic Symptoms
- Wear well-fitting shoes
- See a professional for corn and callous treatment
- Wear shoes (outside) or slippers (inside)
- Wear socks (regular or special diabetic socks), or use an extra blanket if your feet are cold.
- Exercise regularly to maintain circulation
- Maintain a healthy diet and lifestyle
- See a professional for the right off-loading insole for you
- Shoes that are too tight, worn out or otherwise ill-fitting.
- Using over-the-counter treatments for callouses, corns, or warts.
- Going barefoot (even indoors!).
- Using heating pads or hot water bottles on your feet.
- Sitting with your legs or ankles crossed for long periods of time.
- Smoking—cigarettes can impair circulation.
- Wearing OTS insoles.
Staying active with Diabetes
Everyone can benefit from regular physical activity. The Canadian Diabetes Association recommends 150 minutes of aerobic exercise per week for people living with diabetes. That amounts to 30 minutes, five times per week. Aerobic exercise is any continuous exercise that increases heart and breathing rates. Examples include walking, bicycling, and jogging. Getting your recommended physical activity can be as simple as a 30-minute walk with the dog after dinner each weeknight!
Regular physical activity helps your body manage blood glucose levels by using the glucose as fuel for your activity. Physical activity also helps to maintain circulation and cardiovascular fitness.
Using appropriate footwear is extremely important when engaging in any physical activity. Talk to your pedorthist about which shoes are right for you and your chosen activity.
Always consult your family doctor or primary healthcare provider before starting or making changes to your physical activity levels.