By Dr. Mark Tramontozzi
For people with diabetes, the winter months are a time when more attention than usual should be given to the feet. Diabetics are at risk for having reduced blood flow to the lower extremities, and the cold weather compounds this problem.
The dry weather from being inside also makes the skin more susceptible to drying and cracking. Also, diabetics have decreased sensation to the lower extremities, which makes for a decreased awareness of issues that may be of concern with their feet. Fortunately, there are steps that diabetics can take during the winter to minimize foot problems.
Many people during the winter months use heating pads and warming blankets. Because of the decreased sensation or neuropathy of diabetes these devices can cause significant foot injuries and should be avoided. If they are used, the temperature of such devices should be checked with the elbow as the sensation is not decreased as it is in the fingers and toes.
Winter shoes should be checked for proper fit to avoid tightness. Clean dry socks of a natural fiber such as cotton should be worn to reduce irritation from socks made of synthetic fibers. Moisturizing lotion used for the feet can be of great comfort to help exfoliate rough skin and help avoid skin cracking which may result in ulceration.
Also, the feet should be patted dry and not rubbed after bathing or showering. As with any time of year, diabetics need to exercise great caution when trimming nails to avoid trimming them too short. If you must clip, work on toes that have been soaked in warm water for a few minutes and are softer. Hard dry nails can split and lead to problems.
Routine exercise can be difficult during the winter months, but is important for diabetics because it increases circulation. Lack of exercise and activity can cause havoc with blood glucose levels, and extra weight is not good for your feet. It is also important for diabetics to avoid going barefoot in the house and to own a good fitting pair of slippers.
Diabetics should remember to check their feet daily, especially after being outside and exposed to the cold, paying particular attention to any changes in color and shape, cuts, swelling and infected toenails. If a sore develops that doesn’t heal in a couple of days, or you have tingling in your feet that doesn’t stop or have no feeling in your feet, call your doctor for an appointment.
Dr. Mark Tramontozzi is Medical Director of the Wound Care Centers at Backus and Windham hospitals.
To learn more about Wound Care at Hartford HealthCare, click here.