6 Practical Foot Care Tips for African Diabetics 

By: Rukhsar Jabbar. M.Sc. Physiotherapy. Freelance Health Writer and Datelinehealth Africa (DLHA) volunteer. Medical review and editorial support provided by the DLHA Team.

Close up of the feet of a black woman following pedicure. Credit: Freepik.

 

Highlights

• In diabetes, blood flow to the feet can decrease and nerve damage can occur.
• By prioritising foot care, African diabetics can minimise their risks and maintain their mobility and quality of life. 
• Here are some practical tips to know and use for good foot care
  • Inspect your feet at least once a day and check for sores, blisters, and cuts etc.
  • Keep your feet clean without removing their natural oils.
  • If you wear socks, make sure they fit properly, are clean and gently cushioned.
  • Cut your toenails regularly and see your healthcare provider early if you notice any problem.

 

Introduction

If you have diabetes, you likely know the importance of taking care of your feet. But are you aware why foot care is necessary and how to engage in effective self-care of your feet? 

Well, here is why! In diabetes, blood flow to the feet can decrease and nerve damage can occur. Both conditions can lead to an increased risk of foot ulcers, infections, or amputations in severe cases. These complications of diabetes can impact the quality of life.

These concerns are especially relevant in Africa, where diabetes is on the rise and accessing healthcare resources can be challenging. The good news is that many foot care concerns in diabetics that occur due to nerve damage and reduced blood flow [1] can be prevented with consistent and effective foot care. 

This blog will guide you with practical tips for keeping your feet healthy. It will also educate you about how to inspect your feet, moisturise your skin, cut your nails and choose suitable footwear. 

Read on to be informed and take that first step toward healthier feet and a better quality of life!

 

Who's a Diabetic?

A diabetic is a person, regardless of race, gender, and nationality, whose body fails to control blood sugar levels adequately, either because it doesn't produce enough insulin (type 1 diabetes) or because it can't effectively use the insulin it produces (type 2 diabetes).

Insulin is a hormone that helps to get blood glucose (sugar) obtained from food into cells of the body for storage as well as for for energy. When this process is disrupted, blood sugar levels can become too high, leading to diabetes and various health problems. 

 

Why Foot Care Is Crucial for Diabetics

Diabetes damages your body's blood vessels and nerves, particularly in your feet. It increases the risk of infections and injury. These may develop into major problems if left untreated.

By prioritising foot care, African diabetics can minimise their risks and maintain their mobility and quality of life. Here are some practical tips to know and use for good foot care.

 

6 Practical Foot Care Tips for Diabetics

1. Daily Foot Inspection

 

A close-up view of a healthcare professional wearing white gloves examining the sole of an African adult's foot, highlighting skin texture and natural lines. Image is AI generated using ChatGPT.

 

According to the International Working Group on the Diabetic Foot, you should inspect your feet at least once a day. 

Even though your feet aren't hurting, you can have foot issues. You may identify issues early and prevent them from getting worse by checking your feet every day. Checking your feet every night when you take off your shoes is a smart method to keep in mind. 

Ask someone else to examine your feet if you have problems bending over to see them. You can also try looking at your feet in a mirror.

Here are things to do when you inspect your feet [2, 3]

• Check for blisters, cuts, sores, and areas of irritation on your foot surfaces and between the toes.
• Check for ingrown toenails, a condition where the nail's edge grows into your skin. 
• Check for corns or calluses, which are rough skin patches brought on by excessive pressure or rubbing on the same area. 
• Check for plantar warts, which are flesh-coloured growths on the bottom of the foot; and 
• Check for athlete's foot warm spots.
• Dry between the toes and avoid wetting them
• Make note or take photos with your phone camera of any changes that you observe from time to time.
• Talk with your healthcare provider if you notice any concerning issue.
• Remember not to walk barefooted. 

 2. Maintain Proper Hygiene and Moisturise Regularly

 

                       

A close-up of dark brown hands applying white moisturising cream to the sole of an African person's foot, resting on a soft beige towel. Image is AI generated using Chatgpt.

 

To avoid issues, diabetics need to take extra care of their feet. You should keep your feet clean without removing their natural oils. After washing and drying your feet and in-between the toes, moisturise the tops and bottoms of your feet. Use a mild moisturiser suitable for people with diabetes to maintain moisturised and soft skin. Don't use lotion in the space between your toes because too much moisture there can encourage the growth of diseases. [4]

3. Wear Proper Footwear

 

Close up image of the lower extremity of a black man wearing comfortable blue-coloured loafer shoes. Credit Freepik.

 

Be aware that wearing comfortable footwear is very important for you as a diabetic. Although wearing stockings or socks with shoes may feel uncomfortable in the hot and sometimes humid weather that occurs in many African countries, doing so will help prevent blisters and sores. Make sure your socks fit properly and are clean and gently cushioned. Seamless socks are ideal.

Put on footwear that fits properly and shields your feet. The following advice will help you choose the appropriate style of shoes:

• Walking and athletic shoes are appropriate for daily wear. They support your feet and let them "breathe."
• Since plastic and vinyl shoes don't "breathe" or stretch, stay away from wearing them.
• Make sure your shoes fit your toes comfortably and have appropriate room. Purchase shoes at the end of the day, when your feet are at their largest, for the finest fit.
• If you have a bunion, hammertoes, or toes that curl under your feet, you might need extra-wide or deep shoes.
• Avoid wearing high heels and pointy toe shoes since they place too much tension on your toes.
• You may need orthotics (shoe inserts) if you have Charcot's disease (i.e., a condition that affects the shape of the feet), bunions, hammertoes, or other foot problems.
• To break in new shoes, wear them for a few hours at first. After that, check your feet for any sore regions.
• Protect your feet from the cold and heat. [3]

4. Keep Your Feet Warm

 

A young black man seated on a sofa with a laptop computer on his lap, and feet up on a centre table in front of him. Image credit: Freepik.

 

Diabetic nerve damage might cause you to burn your feet without even recognising it. Wear socks while sleeping to avoid cold feet. When outdoors during the winter months in certain regions of Africa, wear lining-equipped waterproof boots to keep your feet comfortable, warm and dry. Keep the blood flowing to your feet. You can use the following tips to improve blood flow to your feet: [3]

• Raise your feet when seated.
• Spend a few minutes twitching your toes throughout the day. Move your ankles up, down, and in and out to increase blood flow to your legs and feet.
• Steer clear of tight socks or elastic stockings. Don't use rubber bands to keep loose socks in place.
• Become more physically active. Choose activities that are easy on your feet, including yoga, stretching, dancing, swimming, riding, or walking.
• Quit smoking.

5. Trim Nails Carefully

 

A close-up of dark brown hands using a silver nail clipper to trim the toenails of an African client whose foot is resting on a soft beige surface. AI generated using Chatgpt.

 

Nail abnormalities are fairly common among diabetic patients, particularly those with chronic and poorly controlled diabetes.  This is due to the fact that patients frequently disregard their nails. [5]

• Use toenail clippers to clip your toenails when your feet are clean and dry.
• Avoid cutting corners of your toenails. This technique helps you avoid cutting your skin and prevents the nails from growing into it.
• Each nail should be lightly smoothed with an emery board or non-sharp nail file. 
• Have a podiatrist (foot care specialist) trim your toenails if they are thick or yellowed to the point where you can't see, feel, or reach your feet. 
• If you decide to have a pedicure in a salon, you should bring your own nail equipment to prevent infection. Ask your healthcare professional what extra measures you can take at the salon to prevent infection.

6. Address Issues Promptly

 

Close up mages of hands grabbing the toes on flexed feet of two individuals that are sitting opposite each other Credit: Freepik.

 

You should check for signs that need attention and address them promptly to avoid complications. Never disregard notable changes in appearance or chronic foot pain, as these could be signs of more serious issues. 

Keep an eye out for symptoms including:

• Persistent pain or discomfort, 
• Wounds that don't heal, 
• Unusual warmth or redness, 
• Swelling, smelling and other pus-like infection indicators. 

These warning indicators might point to underlying problems that need immediate medical care. Consult a healthcare provider right away if you encounter any of these symptoms, since early management can guarantee better results and prevent problems.

 

Challenges of Diabetic Foot Care in Africa and How to Overcome Them

The following challenges and more contribute to poor foot care outcomes in low income countries like many in Africa.

• Patients and healthcare providers are less aware of foot care issues in diabetics
• There is a shortage of qualified professionals with required skills for diabetic foot care
• There is a lack of properly funded podiatry (foot care) services in especially rural primary care settings 
• The long travel times for patients to the clinic discourages attendance
• Patient delays in seeking timely medical attention, due partly to culturally based ignorance and also lack of money
• Failure of inexperienced healthcare providers to refer patients with serious complications promptly.
• Poor awareness of the need for a combined comprehensive management in diabetic foot care. 
• Low level of instruction programs for medical personnel. [1]

To tackle these challenges, it is necessary for governments, public health and healthcare managers to undertake as applicable to each:

• Adequacy of fund provisions for diabetes care in primary care settings.
• Provision of well-trained community health workers and primary care personnel to manage diabetes and its complications within primary care centres in rural communities.
• Provision of transport subsidy for means tested low income earners to attend clinics.
• Provision of community-centred general diabetes preventive programs that should include health education. These should be simple, straightforward, and culture appropriate. It should also be aimed at both patients and healthcare professionals. 
• Provision of specific diabetes foot care education
• Encouragement of diabetics to keep timely appointments with their healthcare providers and also take personal responsibility for their foot care and overall well-being.

 

Preventing Problems

The key to avoiding diabetes complications, including problems with the feet, is blood sugar control. So, monitor your blood sugar regularly and ensure that you keep it under control by taking your medications as prescribed, adopting a healthy lifestyle that includes frequent exercise and a balanced diet. Lastly, keep your regular appointments with your healthcare provider. Remember, prevention of diabetic foot is better than its treatment and its potential complications.

 

Conclusion

Diabetic foot problems can be avoidable with the right care and education. African diabetics can safeguard their feet and enhance their general quality of life by adhering to these six useful foot care guidelines: daily examination, good sanitation, suitable footwear, keeping feet warm, meticulous nail care, and addressing problems early.

In many African communities, access to foot care may be limited, yet even little daily actions at home can have a significant impact. Prioritising education, prevention, and early intervention requires collaboration between patients, families, and healthcare professionals. Never forget that your feet are your lifeline; if you take good care of them, they will take good care of you.

You should begin implementing these guidelines right away if you or someone you know has diabetes. Talk to your doctor about maintaining the health of your feet and distribute this information around your neighbourhood. You can live a longer, healthier life by taking early action to avoid problems later on.

 

References 

1. Abbas ZG, Archibald LK. Challenges for management of the diabetic foot in Africa: doing more with less. Int Wound J  2007 Oct 24 4(4):305–13. Available from here 

2. Sertsu A, Nigussie K, Lami M, Bekele Dechasa D, Abdisa L, Eyeberu A, et al. Adherence to diabetic foot care recommendations and associated factors among people with diabetes in Eastern Ethiopia: a multicentre cross-sectional study. BMJ Open  2023 Oct 4,13(10):e074360. Available from here.

3. National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. [Cited 2024 Dec 14]. Diabetes & foot problems  Available from here.

4. Hirpha N, Tatiparthi R, Mulugeta T. Diabetic foot self-care practices among adult diabetic patients: a descriptive cross-sectional study. Diabetes Metab Syndr Obes 2020 Dec 4,13:4779–86. Available from here.

5. Vidyasagar P, Kumar BP. Toe nail changes in diabetes mellitus. IP Indian Journal of Clinical and Experimental Dermatology [Internet]. [cited 2024 Dec 14];7(1):40–6. Available from here.

 

 

Published: July 8, 2024

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