Sugar Matters
April 9, 2010
Diabetic Foot Commandments 4 and 5 Do not soak your feet – Keep them dry!

LIKE last week, we will tackle two commandments at once since they go together. Let me remind you of Commandment 4: Do not soak your feet !!! And Commandment 5: Keep feet dry especially between the toes.{{more}}

This issue of not soaking feet came as a surprise to me actually, because I was under the impression that soaking feet was a good thing. The vascular team where I work is made up of the nurses and doctors who operate on patients with dying limbs, among other things. I trust their direction when it comes to foot care, and they are the ones who told me that diabetics soaking their feet could really lead to disaster.

Their concerns are several. First, we touch on commandment number 5 about keeping your feet dry, especially between the toes. One of the major issues with diabetic feet is infection, and let me tell you that a happy fungus is one that has found a home in a warm, moist place. That place can easily be between your toes, and it can later lead to serious infection in your feet. Therefore, when you wash your feet carefully every day, PLEASE BE SURE TO DRY THEM THOROUGHLY BETWEEN THE TOES AND EXAMINE CLOSELY FOR FUNGUS. Often fungus looks like white, cheesy stuff between the toes-appetizing, isn’t it? Not really, I agree. So one step that will help is to keep between those little toes dry.

Now let’s get back to that foot soaking issue. One issue is leaving your foot moist (including other parts of the foot), as I just discussed. Another is not noting the temperature of the water. NO joke here: I have seen many patients who simply did not realize how hot the water was when they put their feet in because diabetes had affected their sensation. Think about it: when you get ready to soak your feet how often do you test with your hands? Not often I would guess, and rather you test with your foot, right? Hence the problem. Oh, the burns I have seen on people’s feet, all because of this foot-soaking in hot water.

If you are concerned about getting dead skin off your feet, which is often why diabetics soak their feet, please remember that the dead skin is NOT hurting your feet. Dead skin is just a normal part of skin regenerating itself and contrary to what you may think, being overly aggressive about peeling skin off can actually HURT your feet.

That brings us back to the basics: wash your feet everyday, be gentle about scraping off dead skin) in fact please try to do that as rarely as possible), dry feet well, examine them everyday carefully, and use a thin coat of cream to keep them moisturized but not slippery and damp. Then put on some sensible shoes as we discussed before, right?

Until next week, stay safe and healthy, Vincies! We’ll complete the commandments next week in anticipation of our medical trip to St. Vincent. I look forward to seeing you all then!

Anita Ramsetty, MD
Medical Director Endocrine Care Group
Tel: 843-798-4227