Steps Valley Diabetics Can Take To Prevent Foot Ulcers

By Valerie Chapa, NP-C, CWON | Arizona Wound Healers

Foot ulcers can be a devastating complication in those who have diabetes, a condition causing uncontrolled high sugar levels in blood.

Contributing factors to diabetic foot ulcers include undetected minor injury to the foot, long-term nerve damage and loss of pain sensation, foot deformities, foot callouses and clogged leg arteries.

Some feared consequences are wound and bone infections as well as amputation of toes, foot or leg. As many as a third of diabetics will suffer from a foot ulcer, increasing their five-year risk of death by a factor of 2.5 times. Here are six ways to prevent foot ulcers:

Keep blood sugar levels in check 

Maintaining stable blood sugar levels can help reduce risk factors for diabetic foot ulcers. I recommend eating more soluble fiber in foods like vegetables (broccoli, sweet potatoes, carrots, green peas), oatmeal, beans, lentils, chickpeas, and fruits (apples, blueberries, oranges).

Smaller, more frequent meals with more protein and less refined sugars (carbs) can prevent blood sugar spikes and increased ulcer risk. Patients also should add foods high in chromium and magnesium, two minerals linked to better blood sugar control, through consuming broccoli, green leafy vegetables like spinach, avocados, eggs, turkey and beef, tomatoes, bananas, whole wheat and oats, and nuts (almonds, cashews, Brazil nuts.)

Perform frequent foot inspections 

Diabetics with nerve damage, also known as neuropathy, should check their feet every day for cuts, blisters, red areas, swelling or bruising. They may not feel any pain due to this damage.

Use a mirror or ask someone to help by checking the soles of the feet for callouses, corns, red areas or openings in the skin. Pay careful attention to friction points of the feet, such as areas that shoes can rub. Look between the toes and where toes might overlap when walking.

Diabetics also should get their feet checked by a podiatrist one to six times annually, depending upon personal risk factors like neuropathy, clogged arteries and poor blood sugar control. It is important that patients and caregivers advocate for a primary care provider to perform annual foot exams, in which the PCP will assess pulses, sensation, foot structure and function, as well as keeping toenails trimmed short. Patients should contact their doctor if they notice a foot problem rather than attempt to treat it themselves.

Proper skincare for feet

Supple, healthy skin is less likely to break down. Moisturize feet daily using cream or ointment rather than lotion. Products containing urea, lanolin or glycerin can be most effective. Avoid excess moisture between toes.

To treat cracked heels, cover the skin with 20% urea cream covered with thick ointment like petroleum jelly, then cover your feet with white cotton socks. Avoid using hot water and common alkaline soaps to cleanse; they can weaken the natural skin barrier.

Wear proper footwear

A consultation with a podiatrist can be helpful to assess individual foot needs. Some general guidelines include a wide toe shoe, breathable material like leather or mesh, seamless interior to avoid foot friction and irritation, cushioned sole with good traction, appropriate insole cushions when needed, and adjustable closure bands to accommodate swelling.

It is also advisable to gradually wear and break in new shoes, which can cause friction and blisters.

Trim toenails carefully 

Nails should be trimmed straight across — avoid cutting into corners, which can lead to ingrown toenails. Nails should be trimmed short enough to prevent snagging on materials like socks or blankets. Long toenails can cause scratches. While seemingly innocuous, these cuts to the skin could go unnoticed and get infected. A podiatrist should handle foot trimming for higher-risk diabetics and those who have difficulty with trimming nails.

If you are experiencing a diabetic foot or leg ulcer, or need more information on proper skincare and wound prevention strategies, connect with a medical professional like those at Arizona Wound Healers.

Editor’s note: Valerie Chapa, NP-C, CWON is a nurse practitioner with Arizona Wound Healers, a mobile wound care team serving Maricopa County. Please send your comments to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.