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posted: 2/27/2012 6:00 AM

Diabetics must be on guard against foot infection

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Q. I've heard that diabetics need to take good care of their feet. But what do feet have to do with diabetes?

A. Why should keeping your blood sugar levels down have anything to do with your feet? It's an understandable question. The connection isn't obvious.

Both Type 1 and Type 2 diabetes raise blood sugar levels. When blood sugar levels are not kept under control, the nerves that extend into your legs and feet can be damaged. As a result, your feet become less sensitive to touch and pain. In this case, a sore on the skin of your foot could go unnoticed, worsen and get infected.

Of course, your body can heal sores: The immune system comes to the rescue. White blood cells direct the healing response. Most of those cells come to the sore by way of the blood.

Which brings us to the second problem often seen in people with diabetes: blockages in the arteries that bring a blood supply to your legs and feet. Put it together and this is what can happen: You get a sore. You don't notice it's there, because nerve damage keeps you from feeling it. Since you don't notice it, you don't do anything about it, and it gets worse. But your body can't heal it as well or as fast as it should because of the poor blood supply to your feet.

As a result, a simple cut or blister on the bottom of your foot can become so severely infected that a toe or foot must be amputated.

The adage "an ounce of prevention is worth a pound of cure" applies to many diabetes complications. Foot and leg damage is no exception.

We have a lot more information on preventing diabetes complications in our Special Health Report, "Diabetes: A Plan for Living." You can find out more about it at my website.

If you have diabetes, the best way to avoid or delay complications is to keep your blood sugar levels tightly controlled. In addition, practice good foot care:

• Examine your feet every day. Check for sores, cuts, scratches, breaks in the skin or swollen areas.

• Massage your feet with a moisturizer to reduce dryness and cracking, which can lead to skin infection.

• Wash your feet with warm water and soap every day. Dry them carefully.

• Keep your toenails well cared for to avoid ingrown nails. If this problem develops, have a podiatrist cut away the ingrown nail.

• Have a podiatrist also treat all calluses, corns, warts and other common foot ailments you may have.

• Wear clean socks or stockings each day.

• Wear well-fitting, comfortable shoes. If your doctor or podiatrist suggests it, consult an expert in fitting footwear for people with diabetes.

• Avoid going barefoot.

• Treat foot injuries immediately. See your doctor about any wound that seems unusual or doesn't heal.

In other words, simple daily self-care can protect someone with diabetes from foot sores -- and the amputations that sometimes follow.

• Dr. Komaroff is a physician and professor at Harvard Medical School. Go to his website to send questions and get additional information: AskDoctorK.com.

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