Diabetes is a chronic disease that affects how the body processes blood sugar (glucose). In diabetes, either the pancreas cannot produce enough insulin or the body cannot effectively use the insulin it produces, leading to high blood sugar levels. Over time, uncontrolled high blood sugar can damage nerves and blood vessels, increasing the risk of complications like foot problems.
Soaking the feet may seem like a relaxing way to unwind, but for people with diabetes it can be quite dangerous. There are several reasons why diabetics should avoid soaking their feet, which will be explored in detail throughout this article.
Nerve Damage (Neuropathy)
One of the most common complications of diabetes is nerve damage, also known as diabetic neuropathy. High blood sugar levels over many years can damage the nerves in the body, including the nerves in the feet and legs.
Neuropathy causes loss of feeling in the feet, often beginning with the sensation of pins and needles or numbness. As it progresses, it can lead to complete loss of feeling in the feet. This numbness makes it hard to feel heat, cold, pain, and other sensations.
Soaking feet can scald or burn the skin without the person realizing it. The hot water may feel comfortable at first, but it can quickly cause burns. Even short soaks of 5-10 minutes in hot water above 98°F can damage skin. The nerve damage prevents the sensation of pain that would normally alert someone to move their foot away from the uncomfortable or burning water.
Preventing Foot Burns
To help prevent hot water foot burns, diabetics should:
- Test water temperature with an elbow or thermometer before soaking
- Limit soak time to less than 5 minutes
- Check feet carefully for any redness or skin injury after soaking
- Use lukewarm water instead of hot water
Poor Circulation (Peripheral Arterial Disease)
Along with neuropathy, poor circulation is another common complication of diabetes. Over time, high blood sugar damages blood vessels and makes them narrower. This restricts normal blood flow, especially to the extremities like the feet and legs.
This condition is known as peripheral arterial disease (PAD). Symptoms include cramping, pain or tiredness in the leg or hip muscles while walking or exercising. PAD greatly increases the risk of foot ulcers and infection, since limited blood supply impairs wound healing.
Soaking the feet can further decrease circulation and blood flow for a temporary period. The warm water causes blood vessels to dilate and draw blood flow away from the extremities and towards the core. This leaves the feet and legs depleted of oxygen and nutrients needed for healing.
Improving Circulation to the Feet
To help improve circulation in the legs and feet, diabetics should:
- Stay active with walking, cycling or swimming
- Perform calf raises, ankle circles and other foot exercises
- Elevate legs above heart level when sitting
- Avoid constrictive socks and clothing around calves/knees
- Quit smoking to improve blood vessel function
Increased Infection Risk
Diabetics have an increased risk of developing foot infections, especially foot ulcers. Ulcers are open sores on the skin that can become easily infected if not properly cared for. Several factors make infections more likely.
First, the high blood sugar found in uncontrolled diabetes impairs immune function. This makes it harder to fight off bacteria and other microbes that can infect the wound site.
Second, poor circulation from PAD limits blood flow to deliver white blood cells and other infection-fighting agents to the area.
Finally, numbness from neuropathy allows wounds to go unnoticed. Small cuts or irritations caused by tight shoes or objects in the shoe can remain unfelt, eventually worsening into sores or ulcers.
Soaking the feet dramatically increases the risk of introducing bacteria into these open wounds. The moist, warm environment is ideal for microbes to thrive. Even tap water can harbor contaminants that can lead to a serious foot infection.
Preventing Foot Infections
To avoid infected foot wounds, diabetics should:
- Check feet daily for any cuts, sores or irritated skin
- Clean and cover any foot wounds with sterile bandages
- Wear clean, dry socks and well-fitting shoes
- Never walk barefoot, even indoors
- Avoid soaking feet or using chemical agents on skin
Ingrown Toenails
Ingrown toenails are another potential foot problem for some people with diabetes. When the corners or edges of the toenail grow into the surrounding skin, it creates a wound prone to infection.
Like foot ulcers, ingrown toenails are more common in those with neuropathy. The lack of sensation prevents awareness of any pain or discomfort from the growing nail. Poor circulation also limits healing of the puncture wound in the skin.
Soaking the feet can worsen an ingrown toenail condition in a few ways. First, the moisture softens the surrounding skin, allowing the nail edge to dig deeper into the skin. Second, warmth and moisture enable bacteria to grow and potentially infect the wound. Third, soaking may loosen the nail corner from the nail bed, worsening the ingrowth.
Preventing Ingrown Toenails
To avoid complications from ingrown toenails, diabetics should:
- Trim toenails regularly in a straight line, avoiding rounded edges
- Wear wide, roomy shoes to avoid pressure on toes
- Treat irritated skin with antibiotic ointment and bandage
- See a podiatrist at first sign of ingrown toenail
- Avoid picking at or tearing toenail skin
Cracks and Fissures
Dry, cracked skin anywhere on the feet is dangerous for diabetics. But cracks and fissures between the toes can be especially problematic when soaked. This moist, warm environment promotes fungal and bacterial growth.
Fungal infections like Athlete’s foot thrive in damp, enclosed toe areas. Bacteria can also grow rapidly in cracked skin, leading to potential wound infections. And if nerve damage is present, these irritations again may go unfelt for some time.
For diabetics, small foot irritations can quickly escalate into major problems. For instance, a simple blister might go unnoticed until it becomes a portal for infection. What starts as a minor crack or callus can ulcerate and require hospitalization when proper foot care is not taken.
Caring for Cracked Feet
To prevent cracked skin from worsening, diabetics should:
- Moisturize feet daily, avoiding between toes
- Use a pumice stone gently on calluses after moisturizing
- Wear clean, dry socks with natural fibers like cotton
- Never go barefoot and always wear shoes, even indoors
- See a podiatrist for persistent cracks or fungal infections
Monitoring For Problems
For diabetics, monitoring foot health daily is essential to preventing major complications. Along with peripheral neuropathy, PAD, and improper footwear, soaking feet can significantly increase the risk of burns, wounds, ulcers and infections.
Some tips for daily monitoring include:
- Check both feet for any reddened, irritated or cracked skin, especially between the toes
- Inspect toenails for ingrown corners or thickening nails
- Look for discolored patches or wounds that do not heal
- Report any foot pain or discomfort immediately to a doctor
- Feel for any changes in skin temperature
- Use a mirror to check bottoms of feet if bending is difficult
Catching problems early and seeking appropriate medical care can prevent minor issues from becoming major complications requiring hospitalization. Keeping feet clean, dry and moisturized is key.
Alternative Foot Treatments
While soaking is not recommended, there are some safe foot treatments diabetics can enjoy:
- Foot massages – Gentle, therapeutic massages increase circulation and relax feet without moisture.
- Warm (not hot) packs – Warm, dry heat for 10-15 minutes can be soothing before bedtime.
- Epsom salt scrubs – Gently exfoliate dry skin with Epsom salts mixed with a carrier oil like olive oil.
- Foot elevation – Lie back and raise feet above heart level to improve circulation.
- Foot exercises – Stretching, flexing, and spreading toes promotes healthy foot mobility.
Diabetics should check with their podiatrist to determine which treatments are right for their individual condition. Maintaining foot health is vital for avoiding complications from diabetes-related foot problems.
When to See a Doctor
Consult a podiatrist promptly if any of the following develop:
- Changes in skin color
- Thick calluses or corns
- Cracked skin or fissures
- Any type of skin wound or ulcer
- Toenail fungus or ingrown toenails
- Unusual foot odor
- Swelling in one or both feet
- Skin temperature changes (hot or cold) in feet
Early intervention can help prevent minor problems from becoming complicated, infected, or life-threatening. Seek emergency care immediately for any signs of infection such as redness, swelling, oozing, foul odor, or fever.
Conclusion
Soaking the feet may be tempting after a long day, but diabetics should avoid this practice. The combination of neuropathy, poor circulation, and higher infection risk make soaking highly dangerous.
Proper daily foot care coupled with routine podiatrist check-ups are the best ways to monitor foot health. Be vigilant about inspecting both feet for any changes or irregularities. With cautious monitoring and prompt treatment when problems arise, diabetics can avoid severe complications and maintain their mobility.