Stay On Top of Your Diabetic Foot Care at Home!

Posted on 05.01.20 | Yuko Miyazaki, DPM |

Less than two months ago, COVID-19 turned life upside-down for most of us here in the Bay Area—and the rest of the country, for that matter. Maybe it’s only now that you finally feel like you’re starting to settle into a new “normal” routine.

Well, if you have diabetes, make sure that your daily foot care doesn’t get lost in the shuffle!

As you probably already know, diabetes can cause major problems and complications for your feet, especially if you develop an ulcer. And while there’s never a good time to require emergency care, this might be one of the absolute worst.

Fortunately, disciplined daily attention and care is by far the most effective way to prevent diabetic foot complications—and it doesn’t have to be difficult, either! You just have to stick with it.

Here are the most important insights.

Inspect Your Feet Every Day

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Hopefully, you were already doing this before COVID-19 became a pressing concern—and you’ve continued to keep the habit!

A quick recap on why this is so important:

If you have diabetes, chances are high that in time you will develop some level of impaired nerve function and circulation in your feet. This means you might not notice cuts and other injuries when they happen (due to reduced sensation), and your body is less equipped to heal those injuries and fight off resulting infections.

Physically inspecting your feet each and every day is the best way to ensure that small problems never have enough time to become large ones. And developing this habit as early as possible—even if you have no previous history of foot problems—is the best way to safeguard against future issues.

To help set a routine, choose a consistent time of day to do your inspection—perhaps right after your morning shower, or right before bed.

If you find anything that isn’t “normal” for your feet, please call our office immediately for our recommendations. Even “minor” injuries can become major ones, faster than you might think, if you don’t take the correct actions quickly.

Stay Active

Regular, healthy exercise is an essential component to regulating blood sugar levels. And the better you keep your sugar in check, the lower your risk of developing future complications with your feet (and throughout your body, for that matter).

This is one area where stay-at-home guidelines have really disrupted healthy routines, especially if you used to get most of your exercise from a job you can no longer go to, or from hobbies that are on hiatus (shopping, for example).

If your primary sources of exercise are no longer possible or advisable, it’s important to find new outlets for activity.

Just one caveat, though—if your feet are already weakened by diabetes, certain vigorous and high-impact activities (such as distance running) might be inadvisable due to increased risk of injury to the feet. Lower-impact outlets, such as brisk walking or riding your bicycle, may be wiser choices.

If you’re looking to build a new exercise plan that’s safe—both for your feet and for your overall health due to COVID-19—please reach out to our office or your primary care physician first for recommendations.

Wear Shoes (Even Indoors)

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This isn’t new information: most people with diabetes are encouraged to wear their shoes even while indoors. This provides an extra layer of protection against accidental cuts and scrapes.

However, it’s fair to say that not everybody follows this guideline as closely as they should. And now that we’re all spending a lot more time at home, you might hardly be wearing shoes at all.

This is a problem for a couple of reasons. First, it’s a problem for the same reason not wearing shoes if you have diabetes has always been a problem: lack of protection against injury.

But it’s also a problem because you’re no longer getting the daily assists of cushioning, arch support, and shock absorption that your shoes provide. As a result, more weight and pressure get transferred directly to your feet, which also leads to increased pain, injury, and fatigue.

Maintain Good Personal Hygiene

With no place to go, and several days in a row cooped up at home, it can be tempting to skip the daily shower or other once-daily hygiene and skin care routines. Unfortunately, if you have diabetes, this can result in increased risk of cracked heels, skin and nail infections, and other conditions that are at best irritating and at worst dangerous.

Make sure you wash your feet daily with warm (NOT hot) water and mild soap. When you’re done, pat your feet dry thoroughly and apply a moisturizing cream or lotion. (Just skip the areas between the toes.) Finally, put on a clean pair of socks.

Other important hygiene tips:

Change socks and shoes immediately if they get damp.
Keep your toenails neatly trimmed, but never cut them too short or curve the corners in. (This increases the risk of ingrown toenails.)
Avoid the temptation to self-treat a corn or callus unless we’ve specifically given you permission to do so. The risk of accidentally damaging your feet, especially with medicated pads or “bathroom surgery,” is usually far too high.

Call Us with Any Questions or Concerns

At a time like this, it’s vital that you are still able to access professional advice and high-quality care when you need it most.

Our hope is that, by following the guidelines above, you and your feet will stay in top shape for as long as the current situation lasts—and beyond! However, we know that, even despite your best efforts, further medical attention may be required for an emerging diabetic foot concern.

Our office is still open during the COVID-19 pandemic, and we’re carefully following all recommended guidelines to keep our office as safe as possible. Should you develop a diabetic foot problem, you are better off coming to us instead of taking your chances at urgent care or the ER!

If you discovered a problem in your daily foot check, or just need our guidance about a question you have, be sure to call our office at (510) 647-3744, or connect with us online. We are here to help you!

How to Celebrate During Diabetes Awareness Month

Posted on 11.27.18 | Yuko Miyazaki, DPM |

November is Diabetes Awareness Month. It’s a very important commemoration to make, but let’s be honest: the fact it comes right as the holiday season is revving up serves as a bit of a wet blanket.

You know how crucial it is to keep your blood sugar in check, both for your general health and the lasting health of your feet. And that includes making certain choices over others.

However, while Diabetes Awareness Month should be about recognizing the challenges of diabetes, it should also be about celebrating the ways in which those challenges are overcome. Every time someone accomplishes their goals or does what they love in life despite having diabetes is something worthy of commemorating!

You don’t have to let having diabetes make you sit out of celebrations. A little forethought can keep the party rolling, and even let you indulge some.

Make Some Preparations Before the Party

When you know a celebration is coming up, you can make arrangements in your diet to allow yourself to indulge in a dish or dessert you love.

Now, what this does not mean is trying to stock up all your allowed carbs intake in a day to spend it lavishly at the event. Playing with extremes that way can make your blood sugar plummet while you’re fasting and rise too high if your starving self gorges on too much food when you allow it.

You will have much more overall success if you take a broader picture of your situation. Let’s say you love the pie your co-worker always brings to the office holiday party. Instead of drastically cutting your food intake on that day, make more reasonable cuts during the days before or after. That pie can take the place of the scones you tend to have at the café each weekend, for example.

Don’t Wallow Solely in Sugar-Free Foods

There are some sugar-free options that are delicious. Let’s be honest, though: many of them can leave something to be desired.

When you focus entirely on being sugar-free, it can distract from keeping track of carbs and calories, which are also very important. Sugar-free options aren’t always available at all celebrations, either.

Instead of being laser-focused on these sometimes disappointing options and overdoing them, shift a bit more focus on evening out your sugar intake, as mentioned earlier. You might think you can chow down on a bunch of a sugar-free options, but a small amount of the real thing might be much more satisfying and better for you in the long run.

Live Outside the Moment

Attending an event doesn’t necessarily mean you are locked into enjoying their spread only during the event window.

If there’s something you’d like to have but it just doesn’t feel like it’s going to work that day, politely ask to take some of it home with you. Hosts tend to be a bit flush with food after most parties, so they’ll likely be more than happy to oblige you. Then you can enjoy things when it’s the best time for you.

Mind Your Drinks

Soft drinks and alcohol are quick ways to amass a ton of carbs and calories. Keep a tight check on how much you’re drinking, and stick with water for the best option.

If you want to have an alcoholic drink, the American Diabetes Association suggests limiting it to one for women and two for men. Drink with food to slow the processing of sugars, and make light beers and spritzers a preferred choice over anything heavy or made with syrup.

Fill Your Plate Section by Section

When it’s time for a main meal, it can be a big help to think of your dinner plate divided into sections, and filling each section accordingly. Half your plate should contain veggies, one-quarter should have protein, and the rest should be your carbs station.

If you’re at a buffet style dinner, you could make an early sweep and decide on what you want on your plate and what you might choose to skip. That way, you don’t get to the end of the line and experience the crushing defeat of not fitting that one thing you love on your plate.

Don’t Punish Yourself if You Eat Too Much

If you end up eating more carbs than you planned, it’s not something you should beat yourself up about.

The best response is to adjust. Cut carbs on meals over the next couple days or, if the party’s not over, cut what you had been planning to eat carb-wise, right there.

Another great response is to make up for it with some extra exercise. You can do so the next day, or even take a small break from the party for a quick walk with a friend.

Of course, if it’s a big party, there might be a dance floor, too…

Keep that Celebratory Mindset

It can be difficult at times to feel like a well-followed diabetic diet is restrictive and disappointing, but there’s a very real truth that tends to get overlooked:

A good diabetic diet is a good diet for just about everyone.

Managing your carbs and calories is something everyone should be doing, and you are benefiting your whole body in many ways when you eat right. Trust us; we’ve seen how dietary choices have had both positive and negative effects on the foot health of many—and that’s just one part of you!

Diet is just one of many steps in living your best life with diabetes. When it comes to managing and preventing foot problems that can threaten to impede your progress, Berkeley podiatrist Yuko Miyazaki is here to help.

Call our office at (510) 647-3744 to schedule an appointment. If you have any questions or prefer to interact with us through email, simply fill out our online contact form.

Tips for Keeping Diabetic Feet Healthy and Comfortable

Posted on 10.16.18 | Yuko Miyazaki, DPM |

A diabetes diagnosis changes many things.

Many parts of your day that you never had to put much thought into may now require stricter attention. What choices should you make in your diet? When should you check your blood sugar? Do you have everything you need when you go somewhere? Will events get in the way of your management?

It can all seem incredibly daunting; at least initially. The silver lining is that, after some initial challenge, humans are good at turning behaviors into habits. What initially feels foreign and interrupting can eventually become simple and commonplace.

We bring this up because a part of diabetic care that sometimes gets overlooked deals with your foot health. The effects of diabetes can be harmful throughout the body, but the feet are at especial risk.

Even if your feet currently feel fine, it is well worth incorporating diabetic foot care into your life now. Developing habits that allow you to take diligent and preventative care of your feet now will pay dividends. Good care now can help keep complications from happening in the future.

The simple truth is that there are very real risks of developing severe problems in the feet. We do not want to see anyone potentially lose their mobility or even their limb if we can help it.

While scheduled foot checkups are a good part of proper care, there are still a great many things you can do for yourself daily, no matter where you may be.

The Best Thing You Can Do

The first and arguably most important routine you should develop for your foot care is inspecting your feet every day.

The best way to set this as a habit is to a steady, reliable time for yourself to do so. After you get out of the shower? Right before bed? Make sure it’s a time you won’t feel too rushed or tired to skip out on the inspection.

A good daily foot inspection checks both the tops and bottoms of your feet for signs of injuries, cuts, discoloration, bumps, or anything else that isn’t supposed to be there. Catching these abnormalities and monitoring them is how you keep them from turning worse.

Why is this daily check so important? Diabetes tends to damage both circulation and nerves over time—especially in the feet. This means that not only might injuries to the feet heal more slowly over time, you might start not even feeling them at all! Small cuts can turn into big ulcers, and even the structure of the foot can begin to collapse—all without you noticing it.

If you can’t see your whole foot, do not be afraid to feel along with your fingers, or acquire the help of a mirror, selfie stick, or loved one. If you do see something out of the ordinary, keep track of it over a few days. If it shows no signs of improving or starts to look worse, give us a call.

Other Tips for Home

Here are some additional routines and reminders when you’re relaxing at home:

Trim Your Toenails Regularly. Trim properly, straight across, and gently file the edges with an emery board or nail file. Keeping your toenails from growing too long can help prevent accidental cuts against your feet or toenail injuries from snagging against a sock.

However, don’t go overboard. Cutting your nails too short can increase their chances of becoming ingrown. Always make sure there is at least some white at the end of your nails.

Keep Circulation Flowing to Your Feet. Don’t contribute to any circulation challenges that might be ongoing in your body. This means quitting smoking, absolutely. In smaller ways, this also means putting your feet up while sitting, whenever you can. It can also mean getting up and moving around during the day, wiggling your toes and ankles for a few minutes 2-3 times per day, and not crossing your legs for extended periods of time.
Moisturize Your Feet, If Needed. Keeping your feet smooth and moisturized can help prevent problems arises from dryness and cracks. A thin coat of lotion can often do the trick, with post-showering and before bed being good times to do so (and hey, it’s also a good time to inspect your feet, right?).

Make sure not to moisturize between your toes unless absolutely needed, however, and to not leave a lot of it between the toes if you do. Moisture trapped between the toes can lead to fungal infections and other skin problems. Also, be sure to dry thoroughly between the toes after bathing.

Be Careful Around Hot and Cold. Having trouble feeling pain also means having trouble feeling temperature. Wear shoes on hot sand or pavement (I don’t think we need to tell you not to go outside in snow barefoot), and test water before placing your feet in it. Many burns in diabetic patients happen without them realizing it at the time!

You Don’t Have to Go It Alone

Diabetic foot care shouldn’t have to be a solo endeavor. That’s why we’re here in your corner!

We can help you identify potential problem areas that might otherwise become overlooked, and take care of them before they become trouble. Custom orthotics and shoes, as well as suggestions for stretches, exercises, and changes around the home, can all have a huge preventative impact.

We also have the treatments and methods to handle any problems when they do arise. Being cautious and proactive is always going to serve you much better than holding out and waiting for something to potentially clear up. We promise there’s no question too small when it comes to diabetic foot health!

Our Regent Street office in Berkeley is always happy to hear from new and returning patients. Give us a call at (510) 647-3744 or fill out our online contact form to reach out to a member of our staff.

Healthy Living & Diabetic Foot Care

Posted on 11.10.17 | Yuko Miyazaki, DPM |

Every November is recognized as National Diabetes Month by the American Diabetes Association, which means it’s the perfect time to talk about diabetic foot care.

Of course, diabetes is a very common problem in the United States—more than 114 million adults are either diabetic or prediabetic, according to the U.S. Department of Health and Human Services—so it’s always time to talk about diabetes and foot health.

For context, the U.S. has a population of roughly 326 million people. If you do the math, it will show diabetes is a disease that either currently affects (or has the potential to affect) one-third of the general population. Clearly, this is a significant issue.

Today, we are going to look at how healthy living and diabetic foot care are related. To do so, let’s start by looking at how diabetes affects feet.

Diabetes is a disease marked by high blood sugar (glucose) levels. Excessive sugar can effectively impair the circulatory, nervous, and immune systems. These respective systems are essential for basically all areas of the body – including your lower limbs.

You probably don’t give this much thought, but your nervous system allows you to feel when you have problems in your feet. The pain you experience is important for recognizing issues on the parts of your body that are the farthest from your eyes (since sight is another way of realizing something is wrong). At the same time, your immune system plays a vital role in both healing wounds and fighting infection. And, of course, your circulatory system makes sure the tissues in your lower limbs receive the nutrients they need.

When those body systems are compromised by diabetes, you are at risk for serious medical complications. Charcot foot and diabetic foot ulcers are the primary concerns, and both could potentially require amputation.

That may be alarming, but the good news is diabetic foot care can help keep your feet safe!

To put it simply, diabetic foot care is a matter of taking measures aimed at both protecting feet from damage and identifying problems at their earliest, most treatable stages. This includes doing things like wearing diabetic shoes and inspecting your feet on a daily basis. Another important part of diabetic foot care is making healthy lifestyle choices.

As is the case with any human, the best lifestyle choices for optimal health if you have diabetes are centered on regular exercise and healthy eating.

Regular exercise is important, but it’s important to keep in mind you need to protect your feet when performing physical activity. This begins by making sure you choose the right kinds of activities. High-impact ones place excessive force on your lower limbs and put you at risk for injury.

A better path is to create an exercise plan consisting of low-impact activities. Walking, yoga, cycling, and swimming are all great options. When done correctly, weight-lifting is another exercise that can be beneficial. As with aerobic exercises, lifting weights can help improve blood flow down into the lower limbs.

With regards to healthy eating, it is imperative for you to avoid sugar and refined carbohydrates as much as possible. Center your diet on fresh vegetables, whole grains, legumes, nuts, lean meats, fish, and low-fat dairy products. Choose beverages other than soft drinks or other sugar-laden options.

Perhaps one of the very best healthy lifestyle decisions you can make is to recruit the help of medical professionals – like coming to see us for a diabetic foot care plan! We can help you identify measures to keep your feet safe and take care of those minor problems that could become major problems over time.

For more information—or to request an appointment—simply give us a call at (510) 647-3744 and we’ll be glad to help you!

Tips to Care for Your Diabetic Feet

Posted on 03.29.17 | Yuko Miyazaki, DPM |

Diabetes can affect your body and health in numerous ways. It might be easy to think about issues like increased risk of heart attack, stroke, and blindness, but it’s important not to ignore issues that can develop in the feet. Specifically, diabetic neuropathy, Charcot foot, and ulcers are all serious problems for diabetic individuals.

This can certainly be a serious health issues, but the good news is that there are ways to care for your feet when you have diabetes that will reduce your risk of developing a major problem. Some of the lifestyle changes you should adopt include:

Better eating. If you are afflicted with diabetes, you likely know the disease is caused by elevated blood sugar levels. Because of this, one of the key parts of managing diabetes is to create a healthy diet plan.

Before we start discussing what should be entailed with your plan, a quick tip you may want to keep in mind to find success is to avoid labeling food as “good” and “bad.” Instead, when you think and speak about your new dietary habits, do so in the context of “I am choosing to/not to eat [this food].” This is an empowering frame of reference and will avoid negative feelings towards your diet. Also, thinking about certain foods as being “bad” can potentially be the start of a downward spiral if you do eat something outside of your new meal plan.

With regards to your choices in foods and beverages, begin with choosing meals that include whole grains, legumes, fresh fruit and vegetables, nuts, lean meats, and low-fat dairy products (all of which is a smart dietary plan for anyone, even if you do not have diabetes). You should also choose to drink lots of water and unsweetened tea, while passing on sugary beverages. As long as you do not use sugary syrups, coffee is fine. If you enjoy getting coffee from a place like Starbucks, be sure to ask for sugar-free options.

Exercise. It would be difficult to overstate exactly how important it is to exercise. The physical, emotional, and mental benefits are countless, and this includes managing a diabetic condition. The benefits to your cardiovascular system from regular exercise are especially necessary as you work to manage your diabetes and reduce the effects of poor blood flow.

Any kind of workout program must start with a consultation with your primary care physician and our office. This is especially true if it’s been a long time since you had last worked out. Medical professionals can determine if there are any potential or existing issues you need to know beforehand. We can also provide recommendations of exercises that will achieve your goals, and also keep you as safe as possible.

Foot care. Diabetes can cause both nerve damage (neuropathy) and weakened blood flow (peripheral arterial disease). In turn, these medical issues can lead to dangerous complications for your feet, like Charcot foot and diabetic ulcers.

Damaged nerves can leave you unable to feel damage that has been sustained to your lower limbs – including cuts, scrapes, ingrown toenails, and calluses. These might be fairly minor problems for someone with healthy nerve and immune systems, but issues like these can break down, become infected, and lead to gangrene if you are unaware of them. Unfortunately, the only treatment for gangrene is amputation. A proper diabetic foot care plan is based on prevention and protection for your feet and toes. In part, this is achieved with daily inspection to catch issues early. If you would like assistance putting your foot care plan together, we will be glad to help.

Regular appointments. If you aren’t doing this already, make sure you come in and see us every couple of months. Regular checkups are important so we can identify issues, like diabetic wounds, at their earliest, most-treatable stages. At these appointments, we can also review your daily foot inspection checklist and make sure everything is going well. This also gives you the opportunity to ask questions from a medical professional.

For additional information on diabetic foot care, the services we offer, or to request an appointment with our Berkeley, CA podiatrist office, give us a call at (510) 647-3744.