In this 'Health For You' episode, Dr. Pavan Belehalli discusses the importance of diabetic foot care, debunking myths, sharing precautions, and emphasising early intervention to prevent complications like ulcers and amputations
Published Apr 04, 2025 | 7:00 AM ⚊ Updated Apr 04, 2025 | 7:24 PM
Synopsis: In this episode of ‘Health For You,’ Dr. Pavan Belehalli, a diabetes care expert, discusses the critical yet often overlooked aspect of foot care for diabetics. He highlights common myths, necessary precautions, and the importance of podiatry in preventing serious complications like ulcers and amputations, stressing the need for early intervention and changing the perception of foot care in India
In this week’s episode of our podcast ‘Health For You’, Dr Pavan Belehalli, a leading expert in diabetes care, speaks about the often-overlooked yet crucial aspect of managing diabetes—foot care. With diabetic foot problems affecting a significant number of patients, several even having to amputate their toes, feet etc, Dr Pavan walks us through the common myths, necessary precautions, and best practices for maintaining healthy feet. Excerpts from the interview here:
Q. Foot care is often neglected in India. Many associate it with cosmetic procedures like pedicures. What are your thoughts on this?
A. That’s absolutely true. Many people believe that foot care is merely about aesthetics, ignoring serious medical conditions like diabetic foot ulcers, infections, and deformities. Awareness about preventive foot care is minimal, and most people seek medical attention only when the problem escalates. This mindset needs to change, and podiatry as a specialty can play a pivotal role in ensuring timely intervention.
Q. At what age should one start prioritising foot health?
A. Foot problems can arise at any age. We see children with flat feet and adolescents with improper footwear-related issues. Adults, especially diabetics, are at high risk of foot ulcers and infections. It is crucial to adopt good foot care habits from an early age, including wearing appropriate footwear, maintaining hygiene, and regularly inspecting feet for abnormalities.
Q. Given India’s high diabetic population, what are some critical foot care tips for diabetic patients?
A. Diabetic patients are highly prone to foot complications, which, if neglected, can lead to amputations. Some essential foot care tips include:
Regularly checking feet for cuts, sores, or infections.
Wearing well-fitted, cushioned footwear to prevent pressure points.
Avoiding walking barefoot, even indoors.
Keeping feet clean and dry, especially between the toes.
Seeking medical advice at the earliest sign of foot trouble.
Q. Dr Pavan, there are many myths about diabetic footwear. Could you shed some light on the key factors diabetics should consider when choosing footwear?
A. Absolutely. One of the most common misconceptions is that MCP and MCR footwear are the best options for diabetic patients. In reality, these are only recommended when there are no better alternatives available. Ideally, a diabetic patient should undergo a pedoc scan to assess pressure points on their feet and opt for customised footwear tailored to their needs.
However, if customisation isn’t feasible, there are essential guidelines to follow when selecting diabetic footwear:
Avoid narrow toe boxes – Shoes that compress the toes can lead to pressure sores.
Shop for shoes in the evening – Feet tend to swell throughout the day, so buying footwear later in the day ensures a better fit.
Choose soft, cushioned interiors – The inner lining should be seamless to prevent irritation or friction.
Opt for proper sole strength – The footwear should provide adequate support without being too rigid.
Wear cotton socks – Many patients overlook the importance of socks. Cotton socks help reduce friction and prevent blisters inside the shoe.
Q. That’s very insightful. Now, what about obese individuals with diabetes? Do they need additional considerations when choosing footwear?
A. Yes, obesity combined with diabetes, presents unique challenges. Many obese patients experience swelling in the lower limbs, especially if they have a sedentary lifestyle. For such individuals, I recommend the following:
Adjustable Footwear – Shoes with straps or Velcro fastenings allow flexibility in case of swelling.
Avoid tight, restrictive shoes – These can exacerbate swelling and lead to foot ulcers.
Use compression socks if necessary – Under medical supervision, compression socks can help manage edema (swelling).
Regular movement – Prolonged sitting or standing can worsen foot problems. Regular foot exercises and walking help maintain circulation.
Foot Selfie– Ensure you take a picture of your foot using a selfie stick or a mirror placed at foot level to see if there are any wounds on the foot.
Q. What are the red flags to look out for when it comes to foot health, especially for patients with diabetes?
A. The red flags include:
Any colour changes in your feet, such as in your toes or the upper or plantar aspects of your feet.
Sudden increases in pain, fever accompanied by swelling, or the development of small ulcers are also concerning signs.
It’s a good habit to check your feet before going to bed. If you notice any changes like color or texture changes or something that wasn’t there the previous day, it’s best to consult a doctor. Early intervention can help prevent serious complications.
Q. How often should people with diabetes get their feet evaluated?
A. Even if you don’t experience any symptoms, it’s essential to get your feet evaluated at least once a year. Many people don’t realise that changes might already be happening in their feet, even if they feel fine. An evaluation can help detect any issues early, preventing further complications.
Q. Can you share some simple foot care tips for people with diabetes or pre-diabetes?
A. Here are a few essential tips:
After your bath, make sure to dry your feet thoroughly, especially between the toes.
Always check the temperature of the water before entering. The best way to do this is by using your elbow, as your hands may also be affected by neuropathy.
Keep your shoes and socks hygienic by washing them regularly. Aim to wash your socks every two days and your shoes once a week.
Never walk barefoot, and always use proper footwear both indoors and outdoors. By following these simple routines, you can significantly reduce the risk of foot complications.
Diabetic patients should cut their toenails as short as possible to avoid infections.
False – Toenails should be cut straight across and only the edges should be filed. Cutting nails too short or digging into the corners can increase the risk of injury and ingrown toenails, which can lead to infections.
Patients wtih diabetes can go to a parlor for pedicures without any special precautions.
False – It is advised that diabetic patients avoid parlors due to the risk of unsterilized instruments, which can cause infections. If they do visit, they should ensure the instruments are properly sterilized and inform the pedicurist of their condition.
Walking barefoot on grass is beneficial for people with diabetes.
False – Many patients have peripheral neuropathy, which reduces sensation in their feet. Walking barefoot, especially in uncontrolled environments like parks, increases the risk of injury from sharp objects, leading to serious infections.
Acupuncture shoes are the best for diabetic patients.
False – Some diabetic patients who have used acupuncture techniques have developed severe foot infections, leading to serious complications. It is essential to follow medically recommended footwear advice rather than unverified treatments.
Applying moisturiser between the toes helps prevent dry skin and infections.
False – While moisturizing the feet is necessary for patients with diabetes, applying lotion between the toes can trap moisture, creating a breeding ground for fungal infections. It is essential to keep the spaces between the toes dry to prevent intertrigo or fungal infections. Keeping the web spaces dry is crucial for foot health.
Patients with diabetes should ensure their feet are checked regularly, even if they have no symptoms.
True – Many foot complications in diabetes develop without noticeable symptoms. Regular foot examinations help detect early signs of problems, reducing the risk of severe complications like ulcers and amputations.
Diabetic patients can soak foot in hot water to relax
False – Extremes of temperature can damage diabetic feet due to reduced sensitivity and circulation problems. Hot water soaks can cause burns, and extreme cold can lead to frostbite or worsen circulation issues.
Patients with diabetes should wear well-fitted footwear indoors and outdoors to prevent injuries.
True – Proper footwear protects the feet from injuries, ulcers, and infections. Walking barefoot, even at home, can increase the risk of cuts, wounds, and infections.
Diabetic foot complications are more difficult to treat in smokers.
True – Nicotine use worsens blood circulation, increasing the risk of peripheral arterial disease (PAD). This makes foot ulcers and infections harder to heal, leading to severe complications.
Diabetic neuropathy occurs only in people who have had diabetes for many years
False. Diabetic neuropathy can occur even in people with pre-diabetes or those who haven’t been diabetic for long. In fact, some patients only discover they have diabetes when they experience foot symptoms or develop a foot ulcer. It’s crucial to manage your diabetes well to avoid complications, but it’s not just long-term patients with diabetes who are at risk.
Q. What final piece of advice would you give to diabetic patients?
A. Foot problems in diabetics can escalate quickly if not addressed early. Regular foot inspections, proper footwear, and maintaining foot hygiene are essential. Most importantly, patients should seek medical advice at the earliest sign of trouble instead of waiting until complications arise. A podiatric specialist or diabetic foot surgeon can provide valuable guidance tailored to individual needs.
(Edited by Ananya Rao)
