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It’s all about the Socks That Diabetics Wear –
November is Diabetes Awareness Month!   

 

PODIATRISTS ARE THE PCP OF THE LOWER EXTREMITY FOR DIABETIC PATIENT:  I feel that as a podiatric doctor, we are the primary care physicians of the lower extremities, and that this is of such great importance for the diabetic patient.  From a preventive maintenance standpoint to that of education in regards to treating the diabetic patient not just with the proper shoe-gear and proper socks, but with how diabetics need to pay attention to their feet. Let them self -examine their feet or have a family member help them. If they see a small area of irritation or what they may consider to be a small issue, get to the podiatrist’s office to have it evaluated.  Let a small problem remain a small problem. The whole purpose of a preventive diabetic maintenance program is to save limbs, save lives, and to keep everyone healthy and moving.  –Marc Karpo, DPM, Newly Elected PPMA President, Norristown, PA.

CHECK FEET, SOCKS, AND SHOES TWICE DAILY: Patients with Diabetes Mellitus (DM) should be wearing socks that wick well—that is, they should move moisture away from the skin. They should not be constrictive, especially at the top, and there should be no seam at the toes.  DM patients should be checking their feet at least twice daily, as well as checking their socks and shoes.  Diabetics should be checking for any reddened areas, blisters, darkened areas, under and between toes, tips of toes, metatarsal heads (ball of the foot), and the heels. Look at the socks for any "wet, discolored spots"; look inside shoes for any "humps or bumps" or sharp spots.   –Stevan Anselmi, DPM, PPMA Board Member, Wellsboro, PA.

JUST USE EXTRA SOCKS FOR COLD FEET: I recommend high-quality sport socks, like those you would get in a sporting goods store, such as Dick's or Sport's Authority or Foot Locker.  Make sure they have little or no cotton, which is irritating as well as non-wicking.  Do not pay extra for "diabetic" socks; the sports socks are actually better. I also want to remind all diabetics to have their feet checked at least once a year, and to avoid putting heat near their feet.  No soaking in hot water. No warming up the feet when cold against a radiator.  Just use extra socks.  –Richard Rettig DPM, PPMA Parliamentarian, Philadelphia, PA

THROW THE OLD SOCKS AWAY: Socks are an important component of footwear for all patients, but more especially for the diabetic patient.  The type of sock may vary in weight depending on the time of the year. The Thorlos® sock is well-suited, as it is seamless. I like to recommend smart wool socks as they wick away moisture and will keep the foot dry; this is good in the winter months.  Always be sure to wear socks without holes in the toes. The days of darning socks is long gone with the disposable society we live in, so when they are worn out, get rid of them and buy new ones. Shoes fitting properly also need to be a consideration as to thickness of the sock one might wear, whether it is you bowling shoes, hiking shoes, or your going-to-a-meeting shoes. –Edwin Hart, III, DPM, Goldfarb Foundation Treasurer and Past PPMA President, Bethlehem, PA.

WHITE OR BEIGE PREFERRED COLOR OF SOCKS: Diabetics need to be very aware of the type of socks they wear.  A good pair of socks can make all the difference in the world, from how your shoes fit to proper cushioning for your feet.  I prefer my diabetic patients to wear a hiking sock or a sock designed for walking.  These socks tend to be man-made materials like acrylic or polyester or polypropylene.  These fabrics will wick moisture away from the skin and are antimicrobial.  They are very durable, and the hiking and walking socks offer a lot of cushioning.  White or beige is the preferred color, so that if a diabetic gets an injury (cut, abrasion, ulceration) to the foot, the drainage or blood will show up alerting them to the injury. The socks should not be too tight as to restrict circulation.  If you can find socks without a seam at the toe it is better.  –Pete Smith, DPM, PPMA Board Member, Lancaster, PA.

PODIATRIST CAN SEE FIRST SYMPTOMS OF DIABETES IN FEET As a podiatrist, we often are the specialist who sees the first symptoms of systemic changes in relation to diabetes.  We are in the unique position to improve patients' quality of life by saving them from grave consequences related to diabetes.  I advise those at-risk like the Hispanic population not to wait until the foot is bleeding and infected before addressing the problem. I also recommend that diabetics heed the signs, like changes in color—blanching or red/blue mottled appearance; cuts, bruising, or breaks in skin; and irritation between the toes.  –Maryann Hartzell, DPM, PPMA Board Member, Allentown, PA.

WHAT KINDS OF SOCKS SHOULD DIABETICS WEAR?  I like to recommend a sock of blended materials: polyester, rayon, nylon.  They tend to keep moisture away from the skin. During periods of high activity, this may prevent blisters.  A common misconception is that 100% cotton socks are preferred.  Cotton absorbs and holds moisture very well.  Not an ideal material for sock construction.  I also like to recommend socks that are well-padded in the heel and toe areas.  My two favorite types are Asics Diabetic Socks and Thorlos® Padded XJ Running socks.  Also, any sock for a diabetic should be free of any heavy seams at the toe area and should be void of any tight elastic band on top.  –Joseph Gershey, DPM, PPMA Board Member, Dickson City, PA.