About Diabetkc Site. If Bone fractures and prevention are a Diabetic neuropathy foot care Clinic patient, neugopathy could include protected health information. Diabetic neuropathy foot care a small injury can lead to a serious infection. Skip to main content. Managing diabetes is important since high blood glucose blood sugar levels make it hard to fight infection. Loss of hair on your toes, feet, and lower legs.

Diabetic neuropathy foot care -

They might cut, burn, or scrape their feet without noticing. Diabetics also report issues with poor blood flow in these areas, leading to slow healing, ulcers, infections, and even amputation. However, many diabetics experience nerve pain in their feet — even if they can feel nothing else.

The first step to managing your condition is to keep your blood sugar balanced. This can prevent the neuropathy from worsening. Over-the-counter pain relievers can treat nerve pain, though your doctor may prescribe something else if the pain is persistent or severe.

Some lotions and prescription medications are also used to treat nerve pain in those suffering from diabetic neuropathy.

The most important part of managing neuropathy is to take quality care of your feet. You can do this by:. You should have a podiatrist on call for wounds and basic foot care. They can help you manage cuts, ulcers, and other issues with your feet before they worsen. Signs of poor circulation — A weak pulse, cold feet, thin or blue skin, and lack of hair in the area suggest that your feet are not getting enough blood flow.

There are several things you can do to reduce your chances of developing foot problems. In addition to managing your blood sugar, practicing good foot care habits and checking your feet daily are important for preventing complications. Avoid activities that can injure the feet — Certain activities increase the risk of foot injury or burns and are not recommended.

These include walking barefoot since you could step on something without realizing it , using a heating pad or hot water bottle on your feet, and stepping into a hot bath before testing the temperature.

Use care when trimming the nails — Trim your toenails straight across, and avoid cutting them down the sides or too short figure 1.

You can use a nail file to remove any sharp edges to prevent the toenail from digging into your skin. Never cut your cuticles or allow anyone else eg, a manicurist to do so.

See a foot care provider such as a podiatrist if you need treatment of an ingrown toenail or callus. Wash and check your feet daily — Use lukewarm water and mild soap to clean your feet.

Thoroughly dry your feet, paying special attention to the spaces between the toes, by gently patting them with a clean, absorbent towel. Apply a moisturizing cream or lotion.

Check the entire surface of both feet for skin breaks, blisters, swelling, or redness, including between and underneath the toes where damage may not be easily visible.

Do not pop blisters or otherwise break the skin on your feet. Let your health care provider know right away if you notice any changes or problems.

See 'Self-exams' above. Choose socks and shoes carefully — Wear cotton socks that fit well, and be sure to change your socks every day. Select shoes that are snug but not tight, with a wide toe box figure 2 , and break new shoes in gradually to prevent any blisters.

It may be helpful to rotate several different pairs of comfortable, well-fitting shoes to avoid consistent pressure on one part of your foot. If you have foot deformities or ulcers, ask your foot care provider about customized shoes; this can reduce your chances of developing foot ulcers in the future.

Shoe inserts may also help cushion your step and decrease pressure on the soles of your feet. Be sure to get regular foot exams — Checking for foot-related complications should be a routine part of most medical visits; however, this is sometimes overlooked.

Don't hesitate to ask your provider for a foot check at least once a year, or more frequently if you have risk factors or notice any changes. See 'Clinical exams' above and 'Risk factors' above. Quit smoking — Smoking can worsen heart and circulation problems and reduce circulation to the feet.

If you smoke, quitting is one of the most important things you can do to improve your health and reduce your risk of complications. While this can be difficult, your health care provider can help you and provide other resources for support.

See "Patient education: Quitting smoking Beyond the Basics ". Importance of blood sugar management — In general, you can reduce your risk of all diabetes-related complications, including foot problems, by keeping your blood sugar levels as close to your target as possible.

Careful management of blood sugar levels can reduce the risk of circulation problems and nerve damage that often lead to foot complications. Managing your blood sugar requires seeing your doctor regularly, making healthy diet and lifestyle changes, and taking your medications as directed.

More information about managing your diabetes is available separately. See "Patient education: Type 1 diabetes: Insulin treatment Beyond the Basics " and "Patient education: Type 2 diabetes: Treatment Beyond the Basics " and "Patient education: Glucose monitoring in diabetes Beyond the Basics " and "Patient education: Preventing complications from diabetes Beyond the Basics ".

TREATMENT OF FOOT ULCERS. Superficial ulcers — Superficial ulcers involve only the top layers of skin picture 1. Treatment usually includes cleaning the ulcer and removing dead skin and tissue by a health care provider; this is called "debridement. After debridement, the area will be covered with a dressing to keep it clean and moist.

If the foot is infected, you will get antibiotics. You should clean the ulcer and apply a clean dressing twice daily or as instructed by your foot care provider; you may need to have someone help you with this. Keep weight off the affected foot as much as possible and elevate it when you are sitting or lying down.

Depending on the location of the ulcer, you might also get a cast or other device to take pressure off the area when you walk. Your health care provider should check your ulcer at least once per week to make sure that it is healing properly.

More extensive ulcers — Ulcers that extend into the deeper layers of the foot, involving muscle and bone picture 4 , usually require treatment in the hospital. Laboratory tests and X-rays may be done, and intravenous IV antibiotics are often given.

In addition to debridement to remove dead skin and tissue, surgery may be necessary to remove infected bone. You may also get something called "negative pressure wound therapy"; this involves covering the ulcer with a bandage and using a special vacuum device to help increase blood flow and speed healing.

If part of the toes or foot become severely damaged, causing areas of dead tissue gangrene , partial or complete amputation may be required. Amputation is reserved for wounds that do not heal despite aggressive treatment, or times when health is threatened by the gangrene.

Untreated gangrene can be life threatening. Some people with severe foot ulcers and peripheral vascular disease poor circulation may require a procedure to restore blood flow to the foot.

See "Patient education: Peripheral artery disease and claudication Beyond the Basics ". While foot problems in diabetes are common and can be serious, keep in mind that there are things you can do to help prevent them.

Quitting smoking, if you smoke, is one of the most important things you can do for your overall health and to prevent foot problems. In addition, while daily self-care can be challenging, managing your diabetes from day to day, including foot care, is the best way to reduce your risk of developing complications.

See 'Preventing foot problems in diabetes' above. Your health care provider is the best source of information for questions and concerns related to your medical problem. This article will be updated as needed on our website www.

Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition. These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: Type 2 diabetes The Basics Patient education: Nerve damage caused by diabetes The Basics Patient education: The ABCs of diabetes The Basics Patient education: Gangrene The Basics Patient education: Diabetes and infections The Basics.

Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient education: Type 1 diabetes: Overview Beyond the Basics Patient education: Exercise and medical care for people with type 2 diabetes Beyond the Basics Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Hypoglycemia low blood glucose in people with diabetes Beyond the Basics Patient education: Preventing complications from diabetes Beyond the Basics Patient education: Diabetic neuropathy Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics Patient education: Quitting smoking Beyond the Basics Patient education: Peripheral artery disease and claudication Beyond the Basics.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings.

These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based. Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.

Screening for diabetic polyneuropathy Evaluation of the diabetic foot Management of diabetic foot ulcers. Why UpToDate?

Product Editorial Subscription Options Subscribe Sign in. Learn how UpToDate can help you. Select the option that best describes you. View Topic. Font Size Small Normal Large. Patient education: Foot care for people with diabetes Beyond the Basics. Formulary drug information for this topic.

No drug references linked in this topic. Find in topic Formulary Print Share. Author: Deborah J Wexler, MD, MSc Section Editor: David M Nathan, MD Deputy Editor: Katya Rubinow, MD Contributor Disclosures.

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Poor circulation neuropaghy flow can make your foot less able to fight infection and to heal. Diabetes causes blood vessels of the foot and leg to narrow and harden. You can control some of the things that cause poor blood flow. Don't smoke; smoking makes arteries harden faster.

Also, follow your diabetes care team's advice for keeping your blood pressure and cholesterol under control. Diabetc your feet are carr, you may want to warm them. Keep aware that, unfortunately, if you have nerve damage, your feet may not be able feel heat properly and it is easy for you to burn them with hot water, hot water bottles, or heating pads.

The best way to warm cold feet is to wear warm socks. Some people feel pain in their calves when walking fast, up a hill, or on a hard surface. This condition is called intermittent claudication. Stopping to rest for a few moments should end the pain.

If you have these symptoms, you must stop smoking. Work with your diabetes care Dixbetic to get started on a walking program. Some people can also be helped with medication to improve circulation. Exercise is good for poor circulation. It stimulates nneuropathy flow in the legs and feet.

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Neglecting ulcers can result in infections, which in turn can lead to loss of a limb. What your doctor will do varies with your ulcer. Your doctor may need to take x-rays of your foot to make sure the bone is not infected.

The ulcer may also need to have any dead and infected tissue cleaned out. You may need to go into the hospital for this cleaning. Also, a culture of the wound may be used to find out what type of infection you have and which antibiotic will work best.

Keeping off your feet is very important. Walking on an ulcer can enlarge it and force the infection deeper into your foot.

Your doctor may put a special shoe, brace, or cast on your foot to protect it. If your ulcer is not healing and your circulation is poor, you may be referred to a vascular surgeon. Managing diabetes is important since high blood glucose blood sugar levels make it hard to fight infection.

After a foot ulcer heals, treat your foot carefully. Scar tissue from the wound will break down easily. You may need to wear special shoes after the ulcer is healed to protect this area and to prevent the ulcer from returning.

People with diabetes are far more neuopathy to have a foot or leg amputated than other people. The problem? Many people with diabetes have peripheral artery disease PADwhich reduces blood flow to the feet. Also, many people with diabetes Diabteic neuropathy, causing you to not feel your feet.

Together, these problems make it easy to get ulcers and infections that may lead to amputation. Most amputations are preventable by checking your feet daily, go to regular visits with your doctor, and wear proper footwear.

For these reasons, take good care of your feet and see your doctor right away if you see any signs of foot problems. Ask about prescription shoes that are covered by Medicare and other insurance. Always follow your doctor's advice when caring for ulcers or other foot problems.

One of the biggest threats to your feet is smoking. Smoking affects small blood vessels. It can cause decreased blood flow to Diabetix feet and make wounds heal slowly. A lot of people with diabetes who need amputations are smokers.

Call QUIT-NOW if you need help quitting. For more tools and resources visit our Amputation Prevention Fare page. Whether you are newly diagnosed or have lived with diabetes for years, taking good care of your feet is essential.

Learn best practices and top tips tailored to wherever cade are on cate diabetes journey. Breadcrumb Home About Diabetes Diabetes Complications Foot Complications.

Diabetes Complications. Learn about diabetes-related foot complications and how you can treat and prevent them. People with diabetes can develop many different foot problems.

Even ordinary problems can get worse and lead to serious complications. Take care of your feet. Let your doctor know if you find any of these. Wear moisture-wicking socks Before putting your shoes on, check for sharp objects i. The basics of foot complications.

Skin changes. Poor circulation. Foot ulcers. Start now. We're here to help. Read more. Some symptoms of type 2 are so carr they can go unnoticed. Learn more.

: Diabetic neuropathy foot care

Diabetes Foot Care Guidelines	Without enough insulin, glucose can't get into your cells as quickly as usual. The glucose builds up in your blood and causes high blood sugar levels. Foot problems are common in people with diabetes. They can happen over time when high blood sugar damages the nerves and blood vessels in the feet. The nerve damage, called diabetic neuropathy , can cause numbness, tingling, pain, or a loss of feeling in your feet. If you can't feel pain, you may not know when you have a cut, blister , or ulcer open sore on your foot. A wound like that could get infected. The infection may not heal well because the damaged blood vessels can cause poor blood flow in your feet. Having an infection and poor blood flow can lead to gangrene. That means the muscle, skin, and other tissues start to die. If you have gangrene or a foot ulcer that does not get better with treatment, you may need an amputation. This is a surgery to cut off your damaged toe, foot, or part of your leg. It may prevent a bad infection from spreading and could save your life. The best way to protect your feet is by controlling your blood sugar levels every day. This will help keep nerve and blood vessel damage from getting worse. The next step is to keep the skin of your feet healthy. Serious foot problems can develop quickly. See your health care provider right away if you notice:. Remember, controlling your blood sugar and caring for your feet every day are the best steps you can take to prevent serious diabetic foot problems. The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health. Diabetic Foot. On this page Basics Summary Start Here Learn More. Learn More Living With Related Issues. See, Play and Learn Images. Research Clinical Trials Journal Articles. Resources Find an Expert. For You Patient Handouts. What is diabetes? How does diabetes cause foot problems? But there's a lot you can do to prevent a foot wound from becoming a major health problem. How can I protect my feet if I have diabetes? Good foot care for people with diabetes includes: Checking your feet every day. Look for cuts, redness, and other changes in the skin and toenails, including warts or other spots that your shoes could rub. Make sure to check the bottoms of your feet too. Washing your feet every day. Use warm water and soap. Don't soak your feet because that can dry out your skin. After you dry your feet, you can use talcum powder or cornstarch between your toes. They soak up moisture that can cause infection. If you use lotion, don't apply it between your toes. Asking your doctor how to remove corns and calluses safely. Thick skin on your feet can rub and lead to sores. But removing it the wrong way could damage your skin. So you don't want to cut the skin or use medicated pads or liquid removers. Trimming your toenails straight across with a clipper. If it's hard for you to trim your own toenails, or if they're thick or curve into the skin, have a podiatrist foot doctor do it for you. The ADA offers online support through its website. If you find yourself feeling depressed, it may help to talk to a counselor or therapist. If you don't already see a specialist in treating metabolic disorders and diabetes endocrinologist , you'll likely be referred to one if you start showing signs of diabetes complications. You may also be referred to a specialist in brain and nervous system problems neurologist. On this page. Self care. Alternative medicine. Coping and support. Preparing for your appointment. Your health care provider typically checks your: Overall muscle strength and tone Tendon reflexes Sensitivity to touch, pain, temperature and vibration Along with the physical exam, your health care provider may perform or order specific tests to help diagnose diabetic neuropathy, such as: Filament testing. A soft nylon fiber monofilament is brushed over areas of your skin to test your sensitivity to touch. Sensory testing. This noninvasive test is used to tell how your nerves respond to vibration and changes in temperature. Nerve conduction testing. This test measures how quickly the nerves in your arms and legs conduct electrical signals. Called needle testing, this test is often done along with nerve conduction studies. It measures electrical discharges produced in your muscles. Autonomic testing. Special tests may be done to determine how your blood pressure changes while you are in different positions, and whether your sweating is within the standard range. More Information. Electromyography EMG. Diabetic neuropathy has no known cure. The goals of treatment are to: Slow progression Relieve pain Manage complications and restore function. Slowing progression of the disease Consistently keeping your blood sugar within your target range is the key to preventing or delaying nerve damage. Relieving pain Many prescription medications are available for diabetes-related nerve pain, but they don't work for everyone. Pain-relieving prescription treatments may include: Anti-seizure drugs. Some medications used to treat seizure disorders epilepsy are also used to ease nerve pain. The ADA recommends starting with pregabalin Lyrica. Gabapentin Gralise, Neurontin also is an option. Side effects may include drowsiness, dizziness, and swelling in the hands and feet. Managing complications and restoring function To manage complications, you may need care from different specialists. The treatment you'll need depends on the neuropathy-related complications you have: Urinary tract problems. Some drugs affect bladder function, so your health care provider may recommend stopping or changing medications. A strict urination schedule or urinating every few hours timed urination while applying gentle pressure to the bladder area below your bellybutton can help some bladder problems. Other methods, including self-catheterization, may be needed to remove urine from a nerve-damaged bladder. Digestive problems. To relieve mild signs and symptoms of gastroparesis — indigestion, belching, nausea or vomiting — eating smaller, more frequent meals may help. Diet changes and medications may help relieve gastroparesis, diarrhea, constipation and nausea. Sexual dysfunction. Medications taken by mouth or injection may improve sexual function in some men, but they aren't safe and effective for everyone. Mechanical vacuum devices may increase blood flow to the penis. Women may benefit from vaginal lubricants. Request an appointment. These measures can help you feel better overall and reduce your risk of diabetic neuropathy: Keep your blood pressure under control. If you have high blood pressure and diabetes, you have an even greater risk of complications. Try to keep your blood pressure in the range your health care provider recommends, and be sure to have it checked at every office visit. Make healthy food choices. Eat a balanced diet that includes a variety of healthy foods — especially vegetables, fruits and whole grains. Limit portion sizes to help achieve or maintain a healthy weight. Stop smoking. Using tobacco in any form makes you more likely to develop poor circulation in your feet, which can cause problems with healing. If you use tobacco, talk to your health care provider about finding ways to quit. For diabetic neuropathy, you may want to try: Capsaicin. Capsaicin cream, applied to the skin, can reduce pain sensations in some people. Side effects may include a burning feeling and skin irritation. Alpha-lipoic acid. This powerful antioxidant is found in some foods and may help relieve nerve pain symptoms in some people. This nutrient is naturally made in the body and is available as a supplement. It may ease nerve pain in some people. Transcutaneous electrical nerve stimulation TENS. This prescription therapy may help prevent pain signals from reaching the brain. transcutaneous electrical nerve stimulation TENS delivers tiny electrical impulses to specific nerve pathways through small electrodes placed on the skin. Although safe and painless, doesn't work for everyone or for all types of pain. Acupuncture may help relieve the pain of neuropathy, and generally doesn't have any side effects. Keep in mind that you may not get immediate relief with acupuncture and might require more than one session. Diabetic neuropathy and dietary supplements. To prepare for your appointment, you may want to: Be aware of any pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet. Make a list of any symptoms you're having, including any that may seem unrelated to the reason for the appointment. Make a list of key personal information, including any major stresses or recent life changes. Make a list of all medications, vitamins, herbs and supplements you're taking and the doses. Bring a record of your recent blood sugar levels if you check them at home. Ask a family member or friend to come with you. It can be difficult to remember everything your health care provider tells you during an appointment. Someone who accompanies you may remember something that you missed or forgot. Make a list of questions to ask your health care provider. Some basic questions to ask may include: Is diabetic neuropathy the most likely cause of my symptoms? Do I need tests to confirm the cause of my symptoms? How do I prepare for these tests? Is this condition temporary or long lasting? If I manage my blood sugar, will these symptoms improve or go away? Are there treatments available, and which do you recommend? What types of side effects can I expect from treatment? I have other health conditions. How can I best manage them together? Are there brochures or other printed material I can take with me? What websites do you recommend? Do I need to see a certified diabetes care and education specialist, a registered dietitian, or other specialists? What to expect from your doctor Your health care provider is likely to ask you a number of questions, such as: How effective is your diabetes management? When did you start having symptoms? Do you always have symptoms or do they come and go? How severe are your symptoms? Does anything seem to improve your symptoms? What, if anything, appears to make your symptoms worse? What's challenging about managing your diabetes? What might help you manage your diabetes better? By Mayo Clinic Staff. Apr 29, Show References. Ferri FF. Diabetic polyneuropathy. In: Ferri's Clinical Advisor
Foot Complications	Managing neuropathyy is important since high blood glucose Diabetic neuropathy foot care sugar Diabetic neuropathy foot care make it hard to fight infection. Digestive problems. Nsuropathy walk barefoot. Ofot, yellow toenails. Find a doctor. Efficacy, safety, and tolerability of pregabalin treatment for painful diabetic peripheral neuropathy: findings from seven randomized, controlled trials across a range of doses. Walking on an ulcer can enlarge it and force the infection deeper into your foot.
Neuropathy	Please turn on JavaScript and try again. Hyperbaric oxygen therapy facilitates healing of chronic foot ulcers in patients with diabetes. Footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in patients with diabetes: a systematic review. Two of the main motivations for screening for diabetic retinopathy are to prevent loss of vision and to intervene with treatment when vision loss can be prevented or reversed. In addition, rapid implementation of intensive glycemic management in the setting of retinopathy is associated with early worsening of retinopathy

Diaabetic play crae key role in Diabetic neuropathy foot care early nuropathy and treatment of Diabetic neuropathy foot care problems Clean energy practices people with diabetes. Neuropathy nerve damageneurropathy joint damagevasculopathy blood vessel damageand other complications can be avoided or delayed with annual comprehensive foot exams and treatment if needed. Annual exams include an evaluation of pulses, sensation, foot structure and function, and nails. People with diabetes are at higher risk of diabetes-related foot conditions. Yet, many do not get regular preventive care. In the United States:. At each health care visit, tell your patients with diabetes about the signs of foot problems.