Maintaining Healthy Feet
By Kathryn Marchi

Until eight years ago, a podiatrist wasn’t on my doctor list. A very painful ingrown toenail prompted me to visit a local podiatrist, surgery was performed and that was that.

However, after my husband was diagnosed with Type 2 Diabetes, he was sent to a podiatrist by our primary care physician. When he came home with specially designed shoes and socks and all sorts of dire warnings about foot care, I really began to pay attention. Periodic foot exams with the podiatrist became the norm, along with a toenail trim.

So, why all of the fuss about diabetic foot care? Here is an explanation along with a few sensible, proactive measures for keeping your feet healthy.

Diabetes is a disease that occurs when the pancreas does not produce insulin in the body or the insulin that is produced is inadequate to carry out necessary daily functions including processing the food we eat and turning it into energy. Out of the 25 million Americans with diabetes, an estimated one-fourth of them will develop foot problems related to the disease. These problems are brought about because diabetes can limit or restrict blood flow. This then causes peripheral vascular disease and changes nerve sensations to the extremities, causing neuropathy, which results in numbness and loss of sensation. Often with this condition pain cannot be sensed, so any wounds or damage to the foot are not readily noticed.

According to the American College of Foot and Ankle Surgeons (, diabetes is the leading cause of amputation of the lower limbs not caused by a traumatic injury. Because of this possibility, if you have been diagnosed with diabetes, you should examine your feet for numbness, redness, swelling or wounds that do not heal. If not treated, these wounds can become ulcers that are very difficult to heal. Even before the diagnosis of diabetes, your feet can present the same symptoms and indicate a more serious problem.

Here are some guidelines to help prevent complications of diabetes in your feet:
(American Podiatric Medical Association

• Inspect your feet daily. Look for cuts, blisters, redness or nail problems. Be sure to check the bottoms of your feet. Even corns, calluses, bunions, cracked skin and hammertoes can be a result of poor circulation brought about by diabetes.
• Wash your feet daily in lukewarm water. Use a soft cloth, rinse well and dry carefully between the toes.
• Moisturize feet after washing to prevent cracks and dry skin. Do not moisturize between toes.
• Look for changes in circulation: are your toes red, pink or purple when hanging down? That could be a sign of poor circulation.
• When trimming nails, carefully cut straight across and file the edges. Better still, if you suffer any numbness, it’s best to have a podiatrist do it for you. The same advice applies to calluses or corns. Wear clean, dry socks and change them daily. There are special diabetic socks that are not so tight and less likely to reduce circulation.
• Do not walk barefoot, inside or out. Any sharp objects can scratch or cut your feet and cause infection.
• Get foot exams twice annually by a foot surgeon.
• Stay healthy by not smoking and checking sugar levels regularly to keep them within normal ranges.

Diabetics aren’t the only ones who should be concerned with foot care. Folks with any type of vascular problems in the legs should take serious note and follow the same regimen. Worrisome conditions include neuropathy or stenosis.

Kathryn ([email protected]) interviewed Dr. Mark Goldberg DPM for this article. To reach Dr. Goldberg, call 410.778.1801.

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