Regular checker consisting of:
1. Visual inspection of
2. Fungus around perimeter of foot
3. Fungus between toes
4. Fungus under toenails
5. Visit to podiatrist every 9 weeks for toenail trims
6. Nerve conduction tests by podiatrist periodically
Anti-fungal used for skin is Ketoconazole 2%. Treatment for under toenail fungus is extremely vexing. ( ͡> ⏏ ͡<)
I walk a lot. The feet may well give out before I do.
I’m only 6 years in with T1D, excellent control. No sign of diabetes-related peripheral neuropathy.
My routine turns out to be buying expensive shoes. I started with Addidas Superboosters and also have ASIC shoes
The extra protection under my feet has stood me in very good stead
I’m in my 57th year of T1D so my feet are in remarkably good shape
This response seems to fit me the best. My feet are in good shape and I wear very good shoes that fit my varying needs. But I’m only at 43 years of T1D.
I find ASICS to be the most comfortable shoe (sneaker) on my feet. I occasionally wear Addidas. I cannot wear Nikes, they are too narrow for my feet.
Every evening note the level of neuropathy when I get into bed
After showering ensure no athletes foot
Wear good shoes
I check my feet daily, either when I’m washing my feet in the shower or when I’m just putting on my socks and shoes.
Just normal foot care for me: keep my toenails clean and short ; sunscreen until I get a good base tan wearing my flip flops and occasional lotion. #BeWell
I wash my feet daily, apply medication if I notice athlete’s foot starting, have a pedicure every few weeks, get checked by my doctor at each visit.
I picked other because I wasn’t sure what was meant. I visually check my feet every day when I wash them. I haven’t had any trouble with athlete’s foot. I guess I don’t know what else I am supposed to be doing. Endo checks for neuropathy.
Mine has changed as my foot needs has changed. Usually check for red areas twice a day now, due to having no feeling in my feet (combination of beginning diabetic neuropathy and neuropathy from Taxotere – chemo drug for breast cancer). Have custom orthotics and recently thought I had some how broken my right foot but x-ray was normal. Saw my endocrinologist the next day, who is sure I have Charcot foot. Waiting to hear back from her.
Does anyone here have Charcot foot?
I do. It is a very common condition amongst PWDs, particularly those with longer duration diabetes, and unfortunately it is relatively unknown amongst many HCPs especially in early stage development. Initially the PWD may present with a foot that is slightly swollen, reddish in color, warm to touch, mild to moderate discomfort, with intact skin.
It is not uncommon for an unaware HCP to assume it is a sprain or strain injury, or even a gout flare-up and will do a work-up and treat that, then send the patient home with generic instructions. In general most HCPs are more familiar when they see a Charcot foot that is misshapen and has progressed with ulcerations and swollen up like a football.
Serious diabetes foot problems often stem from from an innocent and undetected injury in one or both feet going untreated as it progresses into bone, joint and tissue causing internal structural damage defined as Charcot arthropathy. It develops insidiously. There are many factors – including diminished nerve sensation in the feet from peripheral neuropathy, vitamin D deficiency causing brittle bone syndrome, wearing improperly fitting shoes that do not support the weight of the body during certain activities, such as protecting the feet from repetitive pounding action, plus just daily life wear and tear on the feet as people age. Another factor is that PWDs with peripheral neuropathy and diminished nerve function may not feel any pain or discomfort when they innocently twist an ankle or jam their foot on a trip & fall and stub a toe or toes.
Subtle changes can be initiated by and happen progressively from repetitive activities in otherwise healthy PWDs who are physically fit and active on their feet – like runners, dancers, restaurant workers & servers, mailman, truck drivers, store clerks, warehouse workers, nurses, athletes, gym teachers, or folks who engage in hobbies like tennis, hiking, dance activities, trampoline jumping to name a few examples.
I am a RN and T1 PWD since 1962. In 2005, when I was finally informed (after 4 months of being misdiagnosed by several MDs) that the painful swelling in my R foot that wasn’t healing was something called “Charcot” arthropathy I had never heard of it. I started doing research on Charcot foot and found that very little had been written about it in nursing journals or literature, or even in diabetes care publications available to both professionals and the general public. I wrote a paper about it for nurses and other health care professionals to “WAKE UP and SMELL the COFFEE” about Charcot Foot in People with Diabetes. Eventually I wrote about it for AADE publications, gave professional presentations about it at AADE Annual Meetings, and co-authored a published booklet about Chronic Complications and Comorbidities in People with Diabetes, along with two other RN, CDE colleagues who also have life-long T1D and have suffered with some of the unique and not always well-known challenges of living with TID.
My goal was, and is, to educate people about early signs and symptoms of Charcot Foot in diabetes to recognize it, treat and stabilize at EARLY onset to prevent progressive damage from collapsed internal bone, joint, and ligament tissue structures of the foot and subsequent external tissue breakdown – which is often where the serious damage that requires amputation happens. From inside out – not the other way around.
Sure you need to keep your feet clean, moisturized to prevent dry skin that can crack and cause fissures, and watch out for blisters from ill-fitting shoes or puncture wounds from stepping on broken glass or a rusty nail or thumbtack. But that’s not all there is.
Be mindful of subtle structural changes in your feet and seek prompt therapeutic medical attention from a qualified professional – preferably a podiatrist who knows what to do with diabetes foot issues. Sad to say it is still not unusual for many primary care providers, or even some orthopedic and endocrinologists to not recognize an early stage Charcot foot process – which is when it needs to addressed and treated properly NOW. Of course prevention is the best intervention, which is why we all are told to practice diligent self-care to our feet.
My motivation was, and still is, that no other PWD has to go through the clinical inertia and barking up the wrong diagnostic tree that I went through.
Thank you for taking the time to read through this. I did try to post a slide from one of my presentations with a visual example, but was unsuccessful. For those of you who wish to know more I encourage you to google images of Charcot Foot to educate yourself. Once I learned what it was called, that’s how I began to educate myself about it.
We are all in this boat together!
Connie, thank you! I was hoping you would see my answer. As a RN, I started researching, again, as soon as I got home. There isn’t a lot on it, I know none of the other nurses I worked have a clue what is. I’m just happy my endocrinologist is on top of it.
It’s become more difficult as my left hip has become problematic making it extremely difficult to even put on a sock. As a medicare patient I’ve been waiting for 9 weeks to see am ortho PA to try to determine if the growing numbness is diabetic or orthopedic related, Trimming my toe mails ain’t very high on my list right now.
If taking a shower and washing between my toes would be considered “diabetes-related” than that’s something I do on a daily basis. I buy shoes that are comfortable and support my feet. That’s daily life, not anything special.
Every day when showering I pay particular attention to my feet, making sure there are no blisters, sore places etc. Then make sure they are mosturized and completely dry. The other thing I think is important is to wear shoes that are fitted properly and well supportive.
Regular care. Sixty years and my feet are fine. Podiatrist every three months at Kaiser. Used to go to nail salon but gave that up as too expensive. Have never used toenail polish as podiatrist told me long ago it was bad for my feet. Haven’t worn high heels since 1972. I hike and walk the dog. Never wear sandals as podiatrist said no no in 1990……. So compliant!
I am repeatedly receiving treatment for diabetic foot ulcers. I see a podiatrist every 2 weeks … regular podiatrists and the lead podiatrist in between.
I developed a skin condition, called pyoderma gangrenosum years and years ago and spent just over 3 months as a hospital in-patient, and was repeatedly being informed by medical professionals that I MAY need to have my foot amputated, but that didn’t happen.
The skin condition healed up, but it left me with a lot of scar tissue on the sole of my left foot. This, unfortunately, repeatedly ‘breaks down’ causing ulcers to occur, even though I’ve been regularly applying foot cream in an attempt to keep the skin ‘supple’. (I don’t, of course, apply foot cream whilst I have a foot ulcer present.)
The current foot ulcer has been with me for just over 2.5 years now. That’s not the longest I’ve had one, though. I did have a previous foot ulcer that lasted a little over 4.5 years. (I DO wear orthotic shoes, by the way, which are an attempt to prevent foot ulcers forming.)
I have always had super sensitive feet even before diabetes never went barefoot as a kid I massage my feet every night and make sure after a shower they are dry between the toes I see a podiatrist maybe once a year I don’t wear nail polish and I take care of my toenails not to let them get too long that’s about it I always wear good shoes and with socks when needed
I have calluses on both of my big toes, from years of playing football and running. I put moisturizers on my feet daily. On occasion, I have to use Compound W, to take some of the calluses off. I have good feeling in my feet, no neuropathy. All is good, still running regularly.
Oh yeah, I wear ASICS running shoes, which have a nice soft, wide toe area. They are the most comfortable brand for me.
Pauline M Reynolds
Wear orthotics in my shoes. Need podiatrist to trim toenails because they have decided to gradually grow into curves. For this reason, I only wear sandals (thank God I live in southern CA). Make sure feet are dry, especially between the toes after shower. Beginning to use moisturizer. I never walk barefooted, ever. I am so careful because my husband had the toes of one foot amputated. ‘nuf said.
Wash, dry and lotion up. I can’t say I do any thorough inspection unless I feel a blister but I guess I do a quick look-over when putting on lotion. I also see a podiatrist once a year. It was funny years ago, I had a podiatrist who loved the condition of my feet as he said most of his diabetic patients had terrible feet. I literally think he had a foot fetish. LOL
I have always taken good care of my feet since childhood with diabetes because I danced from early childhood all the way into my 50s. Throughout my youth I studied and performed – ballet & ballet on point, jazz dance, tap dancing, musical comedy dance, modern dance and international folk-dancing. As an adult I continued to dance in folk dance circles and taught & performed creative movement belly dance. For some dance styles I danced in my bare feet, but usually wore appropriate & supportive dance shoes for whatever style I was studying or performing. Over the years my feet developed some wear and tear callouses from dancing and from being on my feet while living life in general and for the most part I never really had any problems of concern …
However, in my 50s I started noticing subtle structural changes in the shape of my feet and toes, along with intermittent weird sensations of numbness, tingling and electric shock shooting pains in my feet and certain toes. I consulted with several MDs, including my then endocrine MD and an orthopedic surgeon MD and they were both utterly clueless that I had progressive diabetic peripheral neuropathy (DPN) and was slowly developing early Charcot arthropathy (bone, joint, nerve damage) changes in my feet.
After 4 months of being misdiagnosed by 4 different MDs – saying I had a sprain/strain injury and/or tendonitis – the pain, inflammation, and swelling my R foot not getting any better, I finally consulted with a podiatrist who understood and recognized what was going on with my foot. He did x-rays, MRIs, and bone scans and determined it was Charcot changes going on. I went through two cycles of wearing an adjustable orthopedic boot to protect my R foot. Then a few years later my L foot sustained a stress fracture evulsion injury and I wore a boot for about 8 weeks during that healing process. Eventually, the subtle stress fracture damages in both feet healed, but did leave some residual structural changes in the shape of my feet. I have all my toes, have great circulation, partially intact and partially diminished sensory feeling, and strong pedal pulses in both feet. I no longer experience any painful neuropathy sensations.
As a young senior Baby Boomer I now see a diabetes
savvy podiatrist who understands the consequences of long duration T1 diabetes. I wear sensible, but attractive, comfort shoes with good structural support & custom insoles that allow me to walk and even dance. My go-to brand for shoes is Orthofeet as they have great styles for all seasons & activities and my Medicare plan pays for one pair plus three sets of insoles per year. I pay for the rest out-of pocket because they are well worth it and my feet deserve the best!!!
http://www.orthofeet.com for those of you who need a good resource on where to get shoes for diabetes feet issues
Retired professional ballet dancer here. My feet do not look attractive – hard-won calluses etc. I don’t have a particular T1D routine, but I have always paid attention to my feet – they were involved in how I made my living. Because of that history, I do know my feet. I have had to explain that I am not a “foot-abuser” to podiatrists in the past (they jump to the assumptions that PWD’s don’t take care of themselves or anything!).
I have a fairly regular routine looking and caring for my feet. I have never really thought this to be related to diabetes. I need my feet to be healthy for running and sports, but checking the feet out, will cover the diabetes related issues.
I chose regular.
Before the age of thirty and my diagnosis of T1D, I hated wearing shoes. Shoes made my feet feel hot and constricted. After diagnosis and reading the ADA book on diabetes, I decided barefoot was no longer allowed.
I have always washed / felt my feet thoroughly when I shower (@2/wk) and use moisturizer when needed. The need for moisturizer seems to be increasing with age. I also like to keep all my nails short.
I have not left the house in the last 25 years (Except when we had a house fire.) without using Vaseline Intensive Care cream on my feet after I do my daily foot inspection. I get excellent marks from Podiatrist.
I would call it a regular routine. I inspect my feet when I shower. Plus my endo inspects and tests my feet for feeling in them.
Have always given my feet top priority, but it has been difficult. The best foot care service was when I was unionized and the employer(s) truly understood the importance of their employees feet. I recently had to relocate because the province in Canada where I lived blatantly published a statement from the Health Care Ministry stating Type 1 Diabetics require no different foot care than a normal healthy individual and the province would not fund any foot care treatment, other than surgery, and only under special circumstances. In the same newspaper article it boasted about one of their local regional hospitals having performed the most foot / leg amputations in the province, with the majority being to Type 1 Diabetics. Their proud of it !
No difference then if I did not have D, I just look them over after a shower, and trimming bi-weekly.
I answered “other” because I’m not sure what a “typical diabetes-related foot care routine” is. I wash and dry my feet every day in the shower and I treat athlete’s foot when I get it. Other than that, I’m not sure what else I would/should do.
Change shoes and inserts often change socks every night and check for sores and dry spots use lotion oil on them and have the feet checked and nails clipped by doc every three months
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I apply miconazole nitrate ointment to my toenails and feet to control athletes foot. I change socks and shoes daily. I check my feet daily including between the toes. Wearing extra-depth shoes to accommodate my custom orthotics was a real big pain relief.