How Do I Do A Diabetic Self Foot Exam?

As a diabetic, there are so many things to remember in terms of your health – balancing a healthy lifestyle including diet, exercise, taking blood sugars, and keeping appointments with your primary care physician and dietician and endocrinologist.  Your primary care physician in addition to all other aspects of health may have also advised that at least once a year, you should see an eye doctor to have your eyes checked, and to see a podiatrist to have your feet checked.  When you come to our office, our doctors will perform a thorough exam including radiographs (X-rays) if there are any concerns or bony abnormalities.  Our doctors will also perform a thorough lower extremity physical exam, including checking for palpable pulses (yes, you can feel your pulse in your wrist, but also on the top of your feet and your ankles!) and testing for reflexes, vibratory sensation, and sharp dull sensation.  But examining your feet should not just be a once-in-a-while occurrence, in fact if you are diabetic, I recommend that you perform a diabetic self-foot exam at least 2-3 times a week. Follow my easy steps, and this will become as routine as brushing your teeth! I recommend the following steps.

Check Between Your Toes

What are you looking for between your toes?  You want to take note of any cracks or break in skin, any areas of redness, or any areas of skin buildup.  These may be signs of the start of an athlete’s foot, or fungus between the toes.  These are important to note, and important to bring these to the attention of your doctor.

Look For Any Cracks In Your Skin And Heels – Use A Mirror If You Need To!

Any cracks in your skin can cause bacteria to enter, and may cause a skin infection.  If there are cracks in your skin, visit our office and we can recommend urea cream to help moisturize the skin and prevent cracks.  If the cracks are getting worse even with the urea cream, then you should make an appointment with one of the doctors to make sure it is not already infected, or there is not another concurrent fungal infection.  It’s better to get it checked out sooner than later! I recommend my patients take a compact mirror and place it on the floor, then hover your foot over the mirror.  This will help in identifying any cracks on the bottom of your foot or to see any areas that are difficult so see. Or better yet, recruit a family member or caregiver to help examine your feet.  Sometimes two sets of eyes are better than one!

Look For Any Areas of Redness Or Irritation On Your Lumps And Bumps

No one’s feet are perfect – there will always be lumps and bumps caused by bony abnormalities.  These lumps and bumps can range from hammer toes to bunions, and any of these lumps can cause irritation on the skin when it rubs up against your shoe.  If you do identify an area of irritation, make sure there is no break in the skin.  If there is any break in the skin, then you do need to be seen by your podiatrist to make sure this does not develop into a sore, and to make sure it is not infected.

 

Examine Your Toenails – Make Sure They Are Cut Straight Across

Your toenails, in theory, should be cut straight across, and should not be incurvated at the ends and digging into your skin.  Sometimes, ingrown nails can be hereditary, bur often times they are caused by tight shoes, tight socks, or cutting the nails improperly/digging them out.  If you find that your toenails are incurvated and digging into your skin, this needs attention.  If they keep growing this way, then it may cause an infected ingrown nail.  You will start to feel discomfort or pain, see some drainage or puss, and see some swelling.  If this happens, be sure to call our office and let us know what is going on, as this may be a sign of an infection or a pending infection.

Take A Look At Your Shoes

We recommend a shoe with a wide toe box. Pointy shoes may be fashionable, but not the best for your feet!  Also, you may qualify for diabetic shoes and inserts per Medicare or your insurance guidelines.  This benefit was introduced because something as simple as the proper shoe gear and inserts can prevent areas of irritation in your feet, and thus, prevent a break in skin that can lead to an infection, or even more seriously, lead to an amputation.  The shoes should have a solid sole that is not slippery, and not so flexible that there is no support.  Be sure to be sized for your shoes as well.  You may swear up and down that you have always been a size 9 for the past few years, but as time passes, your foot shape, arch height, and structure changes.  Your ligaments stretch, and this may give the appearance that your foot has “grown” when in fact the bone size has stayed the same, it is simply the soft tissue that may have expanded, and now you are no longer a size 9 but maybe a size 9 ½ or a 10!  

Take A Look At Your Socks

Some patients have been advised to only wear white cotton socks.  Well, as you know, cotton is nice and soft but not always the best for absorbing moisture! In fact if your feet sweat a lot, the with cotton socks, this tends to keep the moisture against your skin.  Think of it like wearing a wet T-shirt – the moisture just sticks around! Instead, choose a material for you socks with a combination of cotton and another material that wicks moisture away from the skin.  A cotton blend, if you will.  This way, if your feet sweat a lot in the summer or even if they sweat in the winter wearing heavy boots, the moisture does not stick around, and instead evaporates.  If moisture stays against your skin too long, this is again an environment for fungus and warts (considered a virus) to thrive. In order to decrease the chance of bacteria or fungus infesting your shoes, our office carries an antifungal spray that will get rid of bacteria or fungus in the shoe, and help with odors as well. 

Make An Appointment With Your Podiatrist

Most importantly, if you are diabetic and have any questions about your foot care, make an appointment with your podiatrist.  She will perform a thorough exam, make suggestions in your treatment plan, and even provide a prescription and guidance to get to you to a certified pedorthist in the area to obtain diabetic shoes and inserts.  At the very minimum, perform this daily self-foot exam.  You will be glad you did!

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