A few weeks ago on Twitter, I saw a request from the Book Department of the American Diabetes Association for bloggers who might be interested in reading and reviewing books. As someone who enjoys reading and is always looking for blog topics, I jumped at the opportunity.  Rather than being assigned a book, I was able to select the book(s) I wanted to review.  I decided that I would opt for books that were a bit outside my comfort zone: books that rightly or wrongly I might not normally read.  The books that I chose were provided to me free-of-charge, but my reviews, as always, are my own opinions.


Laddie_Head SquareMy first selection was a short book by Neil M. Scheffler, DPM, FACFAS titled 21 Things You Need to Know About Diabetes and Your Feet.

Why did I pick this book?  I chose it because I currently have no issues with my feet related to diabetes and I usually skip the chapter on foot care when reading diabetes books. By selecting this book, I wanted to force myself to read and learn everything that the podiatrist author deemed important. I also wanted to compare his recommendations to what is happening with my care team, my feet, and my diabetes.

The Book

Dr. Scheffler has written a concise guide to just about everything you need to know about having healthy feet and about the specific risks that those of us with diabetes face. Like every other discussion about diabetes and feet, he spells out the grim statistics on the first page and doesn’t take long to start talking about amputations. Fortunately he very quickly moves on to the good news as stated by the Center for 3D 21 Things-Feet_CroppedDisease Control (CDC) that “comprehensive foot care programs, i.e., those that include risk assessment, foot-care education, and preventive therapy, treatment of foot problems, and referral to specialists, can reduce amputation rates by 45% to 85%.”

The “21 Things” referred to in the title are the 21 chapters of the book. Topics include the Diabetes Foot Care Team, Diabetic Neuropathy, Foot Ulcers, Shoes and Socks, and Emergencies. One thing that I particularly appreciated was the discussion that foot care requirements are not the same for everyone.  Kind of a YDFMV (Your Diabetic Foot May Vary) attitude. (Thanks, Bennet of YDMV.)   Although the author states that everyone should check their feet daily, he is quick to concede that a recently diagnosed Type 1 in her twenties probably does not have the same needs as someone who is a senior citizen with 20 years of diabetes and numbness in his feet.

My Feet

So how do I measure up with the care of my feet which have carried me through 37 years of Type 1 Diabetes?

I’ll tell you the bad stuff first. By the third paragraph of Chapter 2, I’m already looking at a failing grade. Rather than an annual exam with a foot specialist, I have never seen a podiatrist in my life except for a free 5-minute exam at the ADA Expo in October. I wear sandals and thonged flip-flops frequently.  Last year I didn’t go to the doctor for a bloody toe from an extended downhill climb in wet hiking boots. My endocrinologist does not check my feet.

Before you take me into custody for a foot intervention, let me explain myself.  My feet have always been in good shape and the last time my endo saw them, she stated that she wished all of her patients had feet as well-cared for as mine. Although many endocrinologists check feet at every visit, the ADA Standards of Care only require an annual comprehensive foot exam that includes checking for pulses and sensation as well as a visual screening. For me that exam is performed at my annual physical by my internist and my endo questions me to ensure that it has been done.

I am fortunate to have no numbness in my feet.  I can feel the tiniest grain of sand and quickly respond to shoes or socks causing irritation. I use moisturizing foot creams daily to prevent painful heel cracks. My flip-flops are thick-soled with good arch support and I only wear them at home (okay, also at the beach).  I wear high-quality socks such as Thorlo and Smart Wool. When hiking I often put on dry socks at lunchtime and always wear gel protectors (they’re like toe socks) on my second toes to prevent the kind of injury I had last year.  I am still agile enough to inspect my feet and clip my nails.

Believe me, I take foot care very seriously even though I don’t follow every rule. I accompanied my father-in-law to many podiatrist appointments for wound care of foot ulcers resulting from Type 2 diabetes and congestive heart failure. One of my friend’s husband with diabetes had a leg amputated a few years ago. I have heard Kelly’s story of her continuing battle to save her foot as she fights various tissue and bone infections. There are others in the DOC who struggle with balance and numbness in their feet.

Two Feet

I’m not stupid. This is serious stuff. Although Dr. Scheffler would wish that I saw a podiatrist, I think that he would approve of how I care for my feet, work on achieving good blood sugars, and very importantly, don’t smoke.

I am getting older and have had diabetes for a long time. Just because I have never had a podiatrist appointment in the past doesn’t mean that I never will in the future. In fact I probably will.  And like everything with diabetes, what I do is not necessarily what you should do. Follow your good sense, the advice of your medical team, and take care of your feet.

If you would like to purchase this book or any other books in the American Diabetes Association Store, please go to this link:  http://www.shopdiabetes.org/