From morning to night, your feet work hard. By the time you are 50, your feet will have taken you 75,000 miles. Whatever your age, if you have diabetes or are at risk for diabetes, you need to pay special attention to your feet. Even a small bump, bruise or scratch can escalate into a serious problem for those with diabetes. This is because diabetes can cause nerve damage in your feet, making it difficult to feel pain when you injure them.
Not only is nerve sensation compromised with diabetes, but also diminished circulation makes foot injuries difficult and slow to heal. Protect your feet by caring for them every day and taking special care to avoid injury.

About diabetic neuropathy

Diabetic nerve damage, called neuropathy, affects as many as 65 percent of people with diabetes. Diabetic neuropathy can cause many symptoms, including pins and needles sensation, numbness or a loss of pain sensation in the hands and legs, which can contribute to foot problems.
If you have nerve damage in your feet and can't feel pain, it's possible to walk around with a cut or injury and not even notice. A small, untended scrape on your foot can progress to a sore, which, in turn, could lead to a foot ulcer. About 70 percent of the foot ulcers that occur with diabetes result from a minor trauma in a numb foot with diabetic nerve damage, according to Robert Tanenberg, M.D., professor of medicine at the East Carolina University of Medicine.
If a foot ulcer gets infected and is not treated successfully, it may eventually lead to amputation. More than half of all non-traumatic lower limb amputations in the United States occur in diabetic patients. Nearly 54,000 people with diabetes have amputations each year.
The best way to prevent diabetic neuropathy is to diligently monitor and control your blood glucose level. You can reduce your risk of neuropathy about 70 percent if you maintain tight control of your blood sugar.

Preventing foot problems

Aggressive treatment of diabetes beginning when you are diagnosed reduces complications and prolongs health, including foot health. Feet need to be pampered and protected to keep them free from harm. Follow a routine of daily care and inspection to monitor the health of your feet.
Tips to keep feet healthy:
· Wash your feet daily, paying special attention to drying them thoroughly. Keep toenails trim and soften calluses and corns.
· Inspect your feet every day by using a mirror to look carefully at the bottoms of your feet. Check for red spots, cuts, blisters, bruises, sores or other changes that you may not even feel. If close inspection of your own feet is difficult, ask someone to help you.
· Wear comfortable shoes with leather or canvas uppers so feet can "breathe." Choose socks that are soft, thick and free from seams that can rub against your skin.
· Avoid going barefoot and keep feet covered with shoes and socks, even when indoors.

How to improve blood flow in your feet

To enhance circulation in your feet, make sure that you stay active. Try to exercise at least 30 minutes three times a week. Avoid any high impact activity such as running and jumping.
Walking is the best exercise for your feet. It also contributes to your general health by improving circulation, helping to control weight and promoting all-around well-being. Help your feet absorb impact whenever possible by walking on soft surfaces, such as grass or dirt instead of pavement. Dancing, swimming and cycling are other activities that are easy on the feet.
Other ways to improve circulation:
· Keep your feet elevated whenever sitting for long periods of time.
· Wiggle your toes and rotate your ankles for five minutes, two to three times daily, to stimulate blood flow.
· Don't keep your legs crossed for long periods of time.
· Make sure your socks are not tight around your calves; if they are leaving a mark on your leg, then they're probably too tight.
· If you smoke, ask your health care provider about ways to help you quit. Smoking reduces blood flow to your feet.
· Keep your cholesterol levels and blood pressure under control.

Working with your health care team

If you have diabetes, review your foot care routine with your doctor, nurse or diabetes educator. Also, ask if you might benefit from a referral to a foot care specialist. People with diabetes often benefit from nail trimming or callus care from an experienced foot expert.
Your doctor regularly tests your sense of feeling and pulses in your feet to evaluate circulation and possible nerve damage in your feet. Let your doctor know about any changes in how your feet look or feel. A persistent blister or bump, even if small, may require further care at the onset to avoid complications down the road.

Call your doctor:

· For guidance on caring for corns or calluses.
· If a cut, sore, blister or bruise on your foot does not begin to heal after one day.