Don't Be Sidelined By Diabetic Foot Complications This Holiday Season

Don't Be Sidelined By Diabetic Foot Complications This Holiday Season


The California Podiatric Medical Association Offers Healthy Tips to Help Keep Diabetics on Their Feet During the Holidays

'Tis the season for family, festivity, food and fun! Temptation abounds, and parties and travel can disrupt daily routines. That means it's also the season when eating healthy, staying active, and taking medication and doing daily foot health checks (a must for those living with diabetes) on schedule is harder to do.

"Shopping trips, parties and family gatherings can take their toll on our feet during the hustle and bustle of the holiday season. For those with diabetes, this increase in activity can place the foot at increased risk for complications like ulcers and infections," says Diane Koshimune, DPM, a podiatric physician and surgeon on staff at Kaiser Permanente, San Jose, California.

According to Dr. Koshimune, people with diabetes must pay special attention to their feet.

"Diabetes puts tremendous strain on the vascular system, which often leads to a narrowing of the blood vessels,significantly decreasing circulation in the    lower  part of the legs and feet.  Poor circulation contributes to  diabetic foot problems by reducing the amount of blood, oxygen and nutrition supplied to the feet resulting in increased injuries and hard to heal wounds. In addition to poor circulation, diabetics often suffer from diabetic neuropathy (loss of sensation in the feet).

"The lack of feeling in their feet means that diabetics can unknowingly put themselves in danger,” Dr. Koshimune continued. "The loss of sensation means the inability to feel pain, heat and cold in the feet, which creates higher possibilities for diabetics to have minor cuts, scrapes, blisters, burns or frostbite of which they might not be aware. If these injuries are left untreated they can quickly cause infection and ulceration. The leading cause of hospitalization among those with diabetes is foot ulcers and infections. Complications for infection and ulceration can result in partial or full amputation of the foot and lower leg.

“According to the American Diabetes Association those with diabetes are far more likely to have a foot or leg amputated than other people. Most amputations are preventable with proper foot care, appropriate footwear and regular visits to a podiatric physician. With a little planning, there is no reason that those with diabetes cannot enjoy traveling to be with loved ones during the holidays,” said Dr. Koshimune, a member of the Board of Directors of the California Podiatric Medical Association.

The California Podiatric Medical Association offers the following healthy foot care tips for diabetics during the holidays:

"1. Maintain healthy eating habits and monitor your blood glucose levels frequently.

“2. Maintain daily foot care routines. Meticulously inspecting feet, toes and toenails on a daily basis is imperative. Remember to use a mirror or to ask a family member to check the bottom of the feet.

Check for:

  • Swelling
  • Injuries like blisters and cuts
  • Redness or any other change in the color of the skin – for example, pale, bruised, or purple skin
  • Fungal buildup
  • Fluid coming from any wound
  • Pain, especially if there is usually little or no feeling in the area

“3. Clean feet daily with warm (not hot) water and mild soap, but don't soak them for more than three or four minutes. Skin submerged for too long will become macerated (the softening of tissue by soaking) and more vulnerable to fungus and bacteria. Be sure to dry feet gently but thoroughly, and don’t forget in between the toes.

"4. Keep your feet warm. Wear padded socks if you will be outdoors in very cold weather for an extended period of time. Warmth is important because cold feet can become frostbitten if you're outside too long.

"5. Keep your feet dry. Wear socks made with wool/synthetic fiber blends that wick moisture away from the feet, reducing the possibility of blisters and fungal infections and other foot conditions. Wear boots or galoshes in wet or snowy conditions. Take off wet shoes and socks as soon as possible. Dry your feet thoroughly and put on a fresh pair of dry padded socks and dry shoes.

"6. Moisturize. If the skin becomes dry and cracked, apply a moisturizing lotion to the tops and bottoms of your feet. Do not put lotion between the toes, since it can cause friction that may cause lesions and infection.

"7. Give your feet a break. A hard day of power shopping keeps you on your feet on hard surfaces such as concrete, asphalt, hard wood floors and tile. Pressure, impact and shear forces work against your feet in the department stores, on the sidewalks and in the parking lots, so take a break every couple of hours. Sit down; if possible put your feet up and have a cup of coffee or a snack and relax before hitting the stores again.

"8. Avoid or limit the time spent in high heels. They contort the foot into an unnatural position which alters how the foot functions. Human beings are designed to walk heel-to-toe, not on their toes. In high heels the weight distribution on the ball and heel of your feet is all wrong. Your posture and gait change, setting the stage for injury to your arches, Achilles tendons and the muscles in your feet and your lower legs.

“9. Prepare for airport security. Airport security procedures require taking off shoes and sending them through the x-ray. Make sure to wear shoes that are easy to remove. If wearing prescription shoes or a device and a wound is present, do not remove them. Ask to speak to a TSA supervisor or bring a letter from the doctor. Be sure to wear socks to avoid feet coming in direct contact with the floor – do not go barefoot.

“10. If traveling for long periods of time, keep feet and legs moving. Sitting for a long time can cause feet to swell, which will make shoes tight and may cause them to rub. Get up and walk around as often as possible to keep leg muscles warm and working.

"11. Wear shoes that are comfortable and broken in, especially if you're traveling. Don’t pack a brand new pair of shoes and hope they’ll feel comfortable when you arrive at your destination.

"12. Use shower shoes. Showers can pass along all sorts of bacteria and viruses, some that even cause warts. Use plastic sandals in the shower to protect your feet. They are also a good idea for going through security in airports.

"13. Prepare for complications. Accessing qualified care for a diabetic foot complication may be difficult while traveling. Those with diabetes should keep their doctors’ numbers handy. Treatment for foot injuries or infections should be sought immediately; don’t wait until back at home.

“Happy holidays from the California Podiatric Medical Association”

To find a licensed podiatric physician in California visit

Founded in 1912, the California Podiatric Medical Association (CPMA) is the leading and recognized professional organization for California’s doctors of podiatric medicine (DPMs). DPMs are podiatric physicians and surgeons, also known as podiatrists, qualified by their long and rigorous education, training and experience to diagnose and treat conditions affecting the foot, ankle and structures of the leg.

CPMA - Keeping Californians on their Feet – Healthy, Active and Productive.