View Full Version : Type II Diabetes and Blisters
Thought I might try this.
I have had type II diabetes for 10 years now and know from two previous attempts of a A.T. thru-hike that blisters on the heals of my feet will take me off the trail.
I have done as much of the preventive stuff as I know of. Custom footbed in professionally fit for my feet footwear, got pack weight under 20 lbs, found the right socks for me, have the shake and bake foot powder rig, and doing hiking almost everyday with a full weight pack. So far only one small blister that healed relativly fast for me. Two weeks. I just changed the "hills" part of my hiking during this time to 3 times a week instead of 6 days a week. One can not do this on the A.T. ..
If you know of other preventive measures please fire away.
But my question is what can I do more effectively if I get blisters this time ? I have tried various tapes, moleskin, second skin, and blister blockers. The Blister Blockers seem the best so far, but I still can't get the blisters to heal while hiking.
Would really like to hear from someone(s) thats been there done that, or a real pro. thanks
You don't mention what kind of food wear you are using. Blisters on the heels are frequently caused by boots that are too large for you (giving your heel alot of room to move) or sometimes by boots that are just too stiff. They can also be caused by boots whose heel areas do not fit your heel profile. Boots will have differently shaped heel cups, some deep, some shallow. It is hard to tell if a boot will lock your heel in place or if your heel will slide around without going for a 10-15 mile hike.
What causes your blisters depends on your foot and your boot. Preventing them will be specific to the cause, but it sounds like you have done most of the usual, proper things. Perhaps you need a different set of boots.
I used to get heel blisters frequently when I wore hiking boots, although I could control them somewhat by wearing liner socks and the heaviest wool sock I could find. Combined with using athletic tape, I could frequently prevent a blister, unless I tried to hike more than 15 miles or my feet got wet, etc. I switched to trail shoes. No heel blisters in the last 18 months, over which I've tallied about 3500 miles of hiking. Not one on the heel. I have gotten one or two blisters around my toes from trail runners that were just a bit too narrow in the toe box. I wear ankle high running socks and use superfeet insoles, if that helps. I usually run between 15 and 30 miles a week, with hills, depending on the time of year, and I think this has helped toughen the feet quite a bit.
Not every trail runner fits every foot. You can either go to a running store to try to get the best fit possible, or you try to make an educated guess. Of course, you may be in trail shoes already. If so, maybe check out hiking sandals. I have no experience with them, so others will have to comment.
smokymtnsteve
01-30-2004, 17:42
Real Pro...LMAO.
Zzzzyd...you sound like you have thought this thru (pardon the pun)
one suggestion or should I say REMINDER..us older fellers have to slow down a little...
Now you have cut weight..but bring at least three pairs of socks(if not four) that way you are wearing one pair ..one pair is hopefully dry in your pack and one pair is hanging on your pack drying (hopefully) ....change your socks during the day...air those feet out..take off those boots and let them feet dry out and get a little sun and them boots dry out a little too.
"professionally fit for my feet footwear" also I really need info on the what do when I get a blister with the diabetes thing, but thanks
btw. my foot specialist put me in Montrail TRS's
the boots I got bad blisters in were vasque sundowners( a high volume boot) I have low volume feet, and Soloman light hikers, can't remember the style and my almost ex-wife has them....holding some of my stuff hostage. lol
just trying to learn something new here okay ....
doctor , doctor give me the news I got a bad case of the blister blues...
snuffleupagus
01-30-2004, 21:58
Thought I might try this.
I have had type II diabetes for 10 years now and know from two previous attempts of a A.T. thru-hike that blisters on the heals of my feet will take me off the trail.
Would really like to hear from someone(s) thats been there done that, or a real pro. thanks
You know Zzzzdyd, a lot of people don't realize the problems associated with diabetes. In some cases, if not most, the sedatary diabetic will have circulatory diseases associated w/the diabetes, which in severe cases can lead to such things as swelling feet, bad foot odor, ulcers, even gangreen if left untreated.
P.A.D. (peripheral arterial disease) is a vascular disease extremely common amongst diabetics. Those affected are not able to get good oxygen transfer to sensative areas like the feet. Oxygen plays a vital role in the healing process of blisters, especially those of us with diabetes.
Some of the things I do to keep my feet blister free are:
10 tips for preventing blisters.
1. Keep my feet clean. I use alcohol to clean my feet every night. It kills bacteria and really feels good before puting on fresh socks. In between your toes is the worst place for a diabetic to get a blister, because it just doesn't get the attention that a blister on the heel gets. In between your toes is quite like your belly button. When you're hard at work it gets slimy and starts to smell like your butt. :-? Not to make a joke out of it, but that's where foot odor comes from mostly, in between your toes. In between and under your toes there is a bacterial feast going on.
2. I treat my hotspots with duoderm or tagaderm as soon as I feel a hotspot coming on. I guess duct tape is another remedy, but it doesn't adhere as well as duo/tagaderm.
3. If a blister is inevitable hike in your sandals/tennis shoe's for a day or two. It may slow you down but it beats a worsening blister or infection.
4. For 15 minutes each night before sleep, elevate both your feet 45 degrees from your waist (at least above your heart). This reduces swelling in your feet and allows lactic acid (major source of generalized muscle pain and stiffness) to leave your legs.
5. Change your socks often!!!!!! Clean dry socks keep your feet almost bacteria free (bacteria like warm, moist, dark areas to breed and feast). The trick here is having enough clean dry socks to change everytime you take a break. When you hit town, clean your stinky socks with bleach.
6. Contrary to some people's belief it's not necessary to peel back the skin on a bad blister. If you realy feel it to be necessary let a doctor do it. If the skin covering the blister gets ripped off from friction that's ok. Clean the area well with alcohol and let it dry for a couple of hours. Then replace the duo/tagaderm and watch for infection. (Red, itchy, soar skin surrounding the blister can be a sign that an infection is on-comming).
7. Sometimes if you know where the blister is going to start. A small amount of medicated Vasoline, Basitracin, or Vitamin D ointment, can be applied to the area inside your boot adjascent to the hotspot or blister. This will allow your sock liner to slide against the boot with less friction on the skin. This might soil your sock but a good wash in the laundry machine will most likely clean it out.
8. Clip your toe nails straight across above the cuticle line. If you are prone to hangnails clean the cuticle very carefully to get that crud out from the sides. It's just dead skin and pieces of lint, but it builds up and creates another bacterial party for your feet.
9. Use a medicated powder like Goldbond in your boots with every sock change. This also helps keep odors down.
10. From time to time smell your feet. If something smells really bad, (like rotting flesh) see a doctor. Pain is not always associated with gangreen, but odor almost always is.
Just don't neglect your footcare needs. That's the biggest reason diabetics get infections.
Last year when attempting a thru-hike I clipped my toenails to close and ended up paying for it in the long run after a rather serious infection which required surgery. I thought I did everything I was supposed to but needless to say it took me off the trail. I'm not a doctor, and I don't even want to get into the legal bounds to which I may/may not be overstepping. I was in fact a Corps Man in the Light Infantry for 10 years, so I may not know anything about practical medicine, but I do know how to treat feet, as it's about the most prevolent medical training I got as a soldier. Looking at other peoples feet. Nasty job but someone had to do it right. I hope this post helps you. Take what you want from it. God bless
For most hikers, the rule is to stop & fix a "Hot spot" as soon as it is felt (Mole skin, duct tape, new socks, etc) As you may know, with many diabetics, the pain sensation becomes somewhat dulled, so one step towards preventing blisters is Pre treat the area where you usually get blisters as you may not notice that hot spot until it's too late. Then, stop frequently for a POBOB (Pack Off Boots Off Break) and check your feet for any reddning of the skin. During the POBOB, consider: changing socks, cleaning your feet (with rubbing alcohol?), changing mole skin, etc. Keep in mind that sometimes being Paranoid is a good thing, specially when it comes to your feet during a hike.
My preventitive measures is to put duct tape on the areas of my feet that I know from experieence I'll get blisters, it usually works. Remember to immediatly treat ANY wounds, anywhere, even more so than at home.
And as always: Talk to your doctor before heading out, let him/her know you will be doing (at least nearly so) about a marathon a day in excersize for the next few months, see if you will need to change your meds or check your blood sugar more often, etc. In my humble Opinion, if Doc says "You can't do that" get a new Doctor ASAP.
Plus, do all the things as mentioned above :)
Doctari.
Moon Monster
01-31-2004, 19:34
Tecnica is a great but sometimes hard to find shoe manufacturer that has low-volume models of low boots and trail runners. They fit my low volume feet much better than Salomons. I thru-hiked hiked the AT in sandals. Sandals are a radical idea but maybe just the thing if you find no other solution.
I have found tea tree oil to work magic on blisters once they are punctured and drained. The oil soothes, dries the skin inside and outside of the puncture (forms callouses quicker), and acts as an atiseptic. It's a folk remedy, but it's worked for me.
Controling your blood sugar should prevent a lot of foot wound issues on the trail. Unfortunately in a hyperglycemic long time diabetic the pressures of backpacking may be problematic. The wounds could actually form from the inside out.
The good news is the preceding posts are FILLED with great advice. The people that have done the miles know feet!! The only thing I might add is pretty obvious. You must take into account the health of the individual in question. Have they been compliant with their blood sugar checks, insulin administration and doses, diet and exercise, and colaberation with a good doctor? If they check out healthy and are up to the task then off ya go! Put aside time for to heal up and treat problems if they should pop up on the trail so you won't feel rushed and have plenty of time to enjoy the adventure. I bet a visit with a foot care specialist with a focus on diabetics would be a great help as well.