If you have diabetes, monitoring your health can be a lot to manage: checking your blood sugaropens CDC, making healthy food, finding time to be active, taking medicines, and going to doctor’s appointments. With all that, your feet might be the last thing on your mind.

“Poorly controlled diabetes can cause damage to the nerves and blood vessels going to people’s feet,” said Dr. Daniel Lamar, an internal medicine specialist with the 56th Medical Group at Luke Air Force Baseopens Luke AFB in Glendale, Arizona. “As a result, people can lose the sensation in their feet. This causes people to change the way they walk and may result in the development of sores on their feet that they don’t feel.”

Diabetes is the sixth leading cause of death opens CDCin the United States, with more than 11 percent of the U.S. population having the disease, according to the Centers for Disease Control and Prevention.

According to the National Institutes for Healthopens NIH, foot problems are common in people with diabetes. Checking and taking care of your feet every day can help lower your chances for diabetes-related foot problems. Managing your blood glucose levels can also help keep your feet healthy.

Due to nerve damage in feet, people can develop sores, which then can get infected and be very difficult to treat because of the damage to the blood vessels, according to Lamar. “The damaged blood vessels cause decreased blood flow which makes it hard for the immune system to respond and makes it difficult to get high levels of antibiotics to the area of infection. As a result, people can end up with amputations.”

When poorly controlled, Lamar notes that diabetes causes complications throughout the body. “It can damage all nerve cells including people’s retinas. Diabetes is the most common cause of nontraumatic amputations in the U.S, and is one of the two most common causes of people going on dialysis. It can also cause people to go blind.”

When Should You See the Doctor?

If you experience any of these symptoms, you should see your doctor right away:

• Pain in your legs or cramping in your buttocks, thighs, or calves

• Tingling, burning, or pain in your feet

• Loss of sense of touch or ability to feel heat or cold very well

• A change in the shape of your feet over time

• Loss of hair on your toes, feet, and lower legs

• Dry, cracked skin on your feet

• A change in the color and temperature of your feet

• Thickened, yellow toenails

• Fungus infections such as athlete’s foot between your toes

How to Keep your Feet Healthy

“Prevention is the best way to keep your feet healthy. Complications from diabetes are most associated with diabetes being poorly controlled. If a patient keeps their blood sugar under control, manages their weight, and has regular provider visits, it dramatically decreases the risk of long-term complications,” said Rachel Perkins Garner, a disease management nurse at Luke Air Force Base.

Tips to maintain your feet include:

• Check your feet every day for cuts, swelling and blisters.

• Wash your feet every day.

• Never go barefoot.

• Wear shoes that fit well.

• Trim your toenails.

• Get your feet checked with the doctor.

Not all Diabetes are the Same

There are two types of diabetes, each with its own set of causes and treatments:

• Type 1 diabetes: This is the rare form, making up about 5% of all diabetes. According to the CDC, Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. Treatment focuses on managing blood sugar levels with insulin, diet and lifestyle changes. Unfortunately, Type 1 diabetes cannot be prevented. It is an autoimmune condition in which the immune system mistakenly attacks and destroys the beta cells in the pancreas that produce insulin.

• Type 2 diabetes: This is the most common type. “Type 2 diabetes is caused primarily by genetic factors and fat tissue,” said Dr. Lamar. “As people have more fat tissue, people with a genetic predisposition for Type 2 diabetes will have worsening insulin resistance.” Being overweight is a leading cause of Type 2 diabetes, and it keeps your body from using insulin properly. “Many patients with Type 2 diabetes can cure it with weight loss, but even if weight loss doesn’t cure a person’s diabetes, it will still make it easier to control,” Lamar said.

Lamar noted that if someone is not properly controlling their diabetes, they may be thirsty all the time and will urinate a lot. “People with poorly controlled diabetes feel generally poorly.”

Staying Healthy and Creating Lifestyle Change is Important

According to the CDC, eating healthy, regular exercise and maintaining a healthy weight can help control your diabetes.

With over 130,000 Department of Defense beneficiaries worldwide affected with diabetes, according to Perkins Garner, the Defense Health Agency sees an urgency in combatting this chronic disease.

One example of this is the DOD’s focus on promoting and maintaining a healthy lifestyle. The U.S. Air Force has adopted Lifestyle and Performance Medicineopens AF Medicine to keep their airmen healthy.

According to Perkins Garner, “Lifestyle medicine is an evidenced-based lifestyle therapeutic intervention which is based on six pillars: a whole-food, plant-predominant eating pattern, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connections. These interventions practiced, can prevent, treat, and often reverse chronic disease, such as diabetes.”