Diabetes and Your Feet

About 25 percent of diabetics develop foot problems as a complication of their disease. Daily attention may prevent you from being one of them.

Most people with diabetes are well aware that, without good glycemic management, their condition can lead to heart, vascular, eye and kidney disease. Less well known is the importance of foot care, even though 25 percent of diabetics eventually develop significant foot problems as a complication of their disease.

The causes of foot problems are twofold, says Dr. Robert C. Parajon of Premier’s Podiatry Division. People with diabetes often develop neuropathy, nerve damage that may impair feeling in the legs and feet. As a result, a diabetic may not feel a pebble inside his sock that is causing a sore or feel a blister caused by poorly fitting shoes. Diabetes also frequently leads to peripheral artery disease and the impaired blood flow can slow or prevent healing of these seemingly small injuries, putting the diabetic at risk of developing infections and foot infections in particular. Heightened blood glucose tends to “feed” the infections, making them worse. Untreated infections can become life threatening and in some cases necessitate amputation.

Cold, wet weather further complicates matters. The cold increases foot numbness and damp feet increases the risk of developing dry and cracked skin vulnerable to infection.

“I advise my diabetic patients to check their feet regularly,” says Dr. Parajon. “That means daily visual inspection. Patients should remember to set aside time at the end of the day when they take off their shoes and socks to inspect their feet for cuts or breaks in the skin. If necessary, use a mirror to see the bottoms of feet, or ask for help from a spouse or partner. Also check for redness around nail beds and for potential calluses. Doing this on a daily basis prevents years of problems from developing.”

Dr. Parajon’s prescription for foot health includes keeping toenails trimmed and straight, with no corners that may cut the skin or become ingrown. He tells his patients to “Wash your feet every day and dry them carefully, especially between the toes. Keep the skin soft and smooth with lotion, but don’t apply it between the toes, as excess moisture can encourage fungal growth and infection.”

Proper footwear is also crucial. “Do not walk barefoot,” Parajon advises. “Always wear socks and select comfortable shoes that do not chafe or have protruding seams, and always check inside your shoes for objects before you put them on.”

Of course, foot care is just part of an overall diabetes manage-ment plan, in which blood glucose control is the most critical. “Work with your health care team to keep blood glucose levels within the target range of 80 to 120 milligrams/deciliter,” Parajon says. “Being active physically helps control blood sugar, and keeping the feet moving helps keep the blood flowing.”

Premier Medical Group takes a comprehensive approach to diabetic care, he says, as it strives to combat this growing epidemic. “Unfortunately, diabetes is becoming ever more prevalent in our society. Today, there are approximately 45 million diabetics in the U.S., with another 20 million in the prediabetic stage.”

“Due to the developments in diabetes care, it is almost impossible for one physician to comprehend and employ all aspects of treatment. A team approach involving the primary care physician, endocrinologist, podiatrist, ophthalmologist and ancillary physicians is the best approach.”

Perhaps Dr. Parajon’s most important piece of advice is that patients be proactive about their care. “Learn about your disease,” he says. “Many people with diabetes tend to go into denial about their condition. This is the worst possible approach someone could take. Having diabetes does not mean the person cannot live a healthy and normal lifestyle. But denial and not seeking proper treatment will ensure a poor lifestyle and outcome.”



Robert C. Parajon, D.P.M., FACPSDr. Parajon is a board certified podiatrist that specializes in all aspects of podiatric care. He attended Dr. William A. Scholl College of Podiatric Medicine in Chicago, IL where he was awarded his doctorate in Podiatric Medicine. Dr. Parajon has been practicing in Dutchess County for over 25 years.

Dr. Parajon is currently accepting patients at our Poughkeepsie and Fishkill locations. For an appointment, please call 845.451.7266