While some might assume that summer is the most difficult season for the diabetic foot ― people tend to walk barefoot, which increases the chance of injuries ― it is in fact the winter months that are the most dangerous for patients with diabetes.

Health experts say people with diabetes must take special care of their feet during the winter to avoid foot infection and injury, as winter moisture, cold and dryness increase the risk of a diabetic foot problem.

About 15 to 20 percent of patients with diabetes worldwide end up seeking medical treatment for a foot ulcer or other type of infection. In severe cases, such foot problems may lead to amputation.

According to Lee Hye-jin, a doctor at Ewha Womans University Mokdong Hospital, all diabetes patients should check the condition of their feet every day.

Diabetes can reduce the blood supply to one’s feet and this can cause a loss of feeling. This means foot injuries do not heal well, and one may not even notice if one’s foot is injured.

One should check for any breaks in the skin of their feet, discharge, and changes in odor and color, Lee said. She also suggested inspecting one’s socks for stains. Patients who find any changes should let their doctor know immediately.

One of the most dangerous risk factors for diabetic foot problems is poor blood circulation.

Most diabetics already suffer from poor circulation due to high blood sugar levels having damaged the blood vessels. In the winter, the cold weather causes blood vessels to constrict even more, and this can increase the risk of a foot ulcer.

Heath experts say it is important to choose shoes that provide warmth and protection from snow and ice. The shoes shouldn’t be too tight, as this could constrict blood flow to one’s feet.

Lee said it was also important to keep one’s feet away from winter moisture to prevent skin infections. Breathable fabrics help keep the feet dry, while warm socks can improve one’s blood circulation. One should remove one’s socks immediately when they are wet.

After getting the feet wet from bathing or being outside, one should dry them gently and completely, including between the toes.

But diabetics should avoid getting their feet too dry, as dryness ― especially dry heat from the heater in cars or houses ― can lead to skin damage.

It is recommended that a diabetic consult a doctor to recommend a good moisturizer for diabetes foot care, as some must use antifungal products. It is also important to avoid leaving too much moisturizer between one’s toes.

Meanwhile, infected or untrimmed toenails are a common cause of foot infections and ulcers. It is recommended that a diabetic gets his or her toenails properly trimmed, and seek professional help when nails are discolored or crumbly.

Lee also advised diabetics to avoid visits to saunas and soaking in hot water in order to prevent possible burns. As many patients with diabetes may not be able to feel pain or heat in their feet, it is possible for them to experience foot burns without realizing it.

“For patients with diabetes, it is very important to do everything to prevent foot problems every day,” Lee said. “Since many of them have a dysfunctional immune system, it is harder for their foot wounds or infection to heal than those who don’t have diabetes. I cannot stress enough the importance of precautions.” 

By Claire Lee (dyc@heraldcorp.com)