Diabetic foot ulcers and gangrene are among the most feared manifestations of chronic diabetes. It could lead to serious lacerations, infections and even loss of limbs if not dealt with and managed at the earliest. It is important to take precautions for diabetic foot during monsoon. People with diabetic neuropathy and those already diagnosed with diabetic foot ulcers must be extra careful during the monsoon season to ensure that their wounds do not get exposed to infections leading to further complications.
For people with diabetes, the feet are a source of early infection and the heel can become dry and cracked. “It can get much worse during monsoons. Because of excess rain, water and dirt, the chances of developing fungus, ulcers and infections could increase as it might be difficult to take care of the feet,” highlights Dr Abhijit Bhograj, consultant endocrinologist, diabetes and thyroid, Manipal Hospital Hebbal, Bengaluru.
Precautions for diabetic foot during monsoons
1. Do not walk barefoot
It often gets wet and dirty during the rainy season, so people with diabetes are advised to wear covered footwear. Dr Bhograj explains that dirty rainwater can cause foot infections.
Diabetic neuropathy (diabetes-induced nerve damage) is another issue to watch out for. Moreover, people may have poor circulation in the feet (peripheral vascular disease). “Neuropathy leads to loss of sensation; hence, they are advised to not walk barefoot,” says Dr Sarika Jambhulkar, podiatry practitioner, V-Care Ankle and Foot Specialty Clinic, Mumbai. She adds that even if someone has an external injury, they might not realise it immediately as they could be unable to feel the pain due to nerve damage. This could, in turn, lead to non-healing ulcers because of diabetes and circulatory issues.
2. Check your feet for any cracks, sores, or wounds regularly
Diabetic neuropathy can cause dry skin in the legs and feet. Experts recommend examining the feet and soles for wounds, cuts and ulcers. “To examine your feet, sit on a steady chair and look under the feet with a mirror,” says Dr Bhograj.
If someone has an ulcer on their feet, they should do proper wound management. “Use offloading footwear [while standing and walking to prevent the ulcer from touching the ground] and get proper guidance from diabetic surgeons”, emphasises Dr Jambhulkar. She adds that it is important to moisturize the feet and legs every day, especially before sleeping.
3. Always keep your feet dry as a precaution for diabetic foot
During the monsoon, there are higher chances of your feet coming in contact with stagnant and flowing water. This also means an increased risk of developing fungal infections because of the moisture and dirt. Experts highlight that keeping the feet dry and hygienic is crucial. It is best to avoid wading in water if you already have cracks or wounds in your leg as they could get infected.
Dr Jambhulkar suggests that if someone gets wet in the rain, they should wash their feet with clean water and wipe them dry completely as soon as possible. “You should keep your feet dry after washing and bathing. Make sure to clean in between the toes after a bath and keep the feet dry,” stresses Dr Bhograj.
4. Opt for comfortable well-fitting shoes
“Always wear protective footwear during monsoon, as the chances of getting an infection or getting injured will be less”, says Dr Bhograj.
It is very important for people with diabetes to wear well-fitting and protective footwear during the rainy season. Dr Jambhulkar explains that apart from protecting the feet from water, closed footwear will also stop any dirt and germs from getting into their feet.
5. Watch out for toe and foot fungus
Many people wear closed or formal shoes right after a shower. This increases the chances of developing fungus as moisture remains between the toes. “You should wipe in between toes if wet, and apply an antifungal powder as required,” informs Dr Jambhulkar. She adds that narrow shoes don’t give the toes enough space to move, which can also cause fungal infection.
6. Trim your toenails carefully
It is important to not over-trim or under-trim your nails. Experts recommend trimming the toenails straight, and not cutting the corners too much as this could cause bleeding. Dr Bhograj explains that cutting toenails too deep could damage the skin underneath.
“In case of any changes in the growth of a nail or a fungal infection, people should get professional help for trimming,” suggests Dr Jambhulkar.
7. Always check and keep your blood sugar levels under control
People with diabetes should get their blood sugar levels checked regularly. Dr Jambhulkar explains that if someone has an infection and their blood sugar levels are high simultaneously, wound healing will be delayed.
Uncontrolled sugar levels for long durations might lead to imbalances, too. “It is important to check blood sugar levels at different times of the day, and not only fasting sugar”, reminds Dr Bhograj.
