Diabetes and going barefoot, what is the real deal?

Type 1 and LADA
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I am recently diagnosed, can’t drink alcohol the way I like too anymore and that impacted my enjoyment of boating and fishing, this all new diet to follow ect

Anyway before the diagnosis I became one of those people who rarely wears shoes, I go days without them. Now I am supposed to give that up too ? : (

Several years ago I just decided to do an experiment to see if I could adapt after clicking on a web ad for barefoot shoes leading me to reading web pages on the shoes vs barefoot running debate. I am not a runner but in a few just weeks going barefoot was as natural as going bare handed, that awkward feeling like I was missing something when barefoot disappeared. That extra effort it took in the beginning to watch my step turned into an automatic function. I swear that “earthing” bare-footing is an anxiety reducer and mood elevator My feet absolutely changed and got healthier after I ditched shoes. That is what makes me question this.

I read all these web pages telling me no more bare feet. I get that the real deal is going barefoot is more risky but like how much ?

I would think like anything else progressive (if that is how it works) at first cuts would progressively take a little longer to heal and I would know when the time comes to give it up. I am in my 40s but I have only been diagnosed T1 for a few months. Many people here have been doing diabetes for decades and know better then me what happens, whats the deal ? I worry about the future.

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The standards of care for diabetes proscribe behavior for the average person with diabetes. None of us fit as the average person so that means that we need to use our common sense as well as consider the perspectives of our doctors and other experts.

The problem with diabetes is that over time, if control is not normal, as a group we tend to lose circulation to our feet. This loss of circulation will often lead to loss of sensation. If we injure our feet, our body may not be able to deliver the usual built-in protection of our immune system. If our feeling in our feet is impaired, we may not even feel a problem.

This can lead to an infection that gets out of hand and possibly lead to amputation. This threat of amputation is probably the single biggest motivator that people with diabetes respond to when their doctors say to never go barefoot.

Now, if you take meticulous care of your diabetes, maintain a normal A1c, and religiously inspect your feet every day then you may choose to roll the dice and enjoy going barefoot. I think the right person in the right circumstances could make that work. Most of us, however, don’t gather the joy of bare-footing enough to risk an amputation.

I don’t believe everything that the doctors tell me about my diabetes. I choose my own path but I must accept the consequences of my actions.

Welcome to TuDiabetes!

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The advice to not go barefoot is a good one. The question is not what will happen. The question is what may happen.

Not everyone with diabetes will have foot problems but the chances are elevated, how much risk you wish to take is up to you. The chances are individual but no one has a crystal ball. Foot issues are a secondary complication that is usually preceded by other diabetic complications such as neuropathy or decreased circulation. There is no rhyme or reason as to who will have complications and who doesn’t, there are too many factors involved.

What is in store for you in the future cannot be adequately accessed at this time. You may suffer no complications or your complications may be severe. You can lessen your chances as @Terry4 explained but you cannot guarantee you will not have problems.

Even if the chances are small that bad things will happen you must weigh that against the fact that diabetic foot problem can be devastating.

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As Terry mentioned the issue comes with poor control, which in turn results in vascular and sensory problems, which mean you can get injured or infected and not feel it, and any injuries may heal slowly… or not at all.

If you can have excellent control there should be no reason to be concerned about feet, other than common sense and avoiding injuries. Excellent control does not mean following ADA guideline of Hba1c of 7 - 8 (this gives average sugar levels of about 170 - 200, which are more than 2x normal non diabetic levels, which should be an average blood sugar less than 100, and will lead to complications), it does mean getting your levels as close to truly normal (Hba1c of 5) as you safely can.

Btw. why can’t you enjoy reasonable amounts of alcoholic beverages? I eat low carb, which means lots of meats, veges, occasional low carb treats. I eat well and enjoy it greatly. I certainly do drink wine, very occasionally spirits, and luckily beer in moderation doesn’t seem to be a problem for me.

You can check the effect of alcohol by using your meter. If you are interested in low carb approach you can check out Bernstein Diabetes University on Utube. Even if you don’t decide to go as low carb as he recommends, there are still lots of great learning opportunities there. “Think Like a Pancreas” and “Using Insulin” (books) are great ones for how to dose insulin and control well.

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I just searched barefoot + circulation. Found lots of stuff.

“Last month, we talked about how your shoes affect existing varicose veins. Varicose veins are largely due to poor circulation – and often due to footwear that’s overly constricting or puts undue pressure on your toes or the balls of your feet.”

“When you give your feet breathing – or really, walking – room outside of the confines of conventional sneakers, you also improve circulation in the veins in your legs. That means a reduction in existing varicose veins and lower likelihood of developing new varicose veins.”

I just typed in “minimalist shoes” and clicked on shopping.
Prio-3-4-Roll-300x169

I have to give in especially at night, it looks like the styles of these things have improved though still some major dorkyness in the list. I think what it is is that I have gotten used to using all the muscles in my feet so when I wear shoes they feel like 2x4s with laces. I should really send for a pair of these.

I can’t be the only one that doesn’t like shoes in a big forum like this.

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There are a lot of low carb drink options. You just need to watch your bs to make sure you don’t drop low. You shouldn’t drink in excess (diabetes or not).:stuck_out_tongue_winking_eye:

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I watched every single episode of Bernstein Diabetes University on Utube. They gave me that sliding scale, it was certainly a learning curve but it did not take that long to see carbs = sugar spikes and 120 = Humalog spike so I could eat.

That was great finding that I was worried that it was unhealthy mostly skipping carbs but Dr B is in his 80s :slight_smile:

What is moderation ? Last time out and as an experiment I did drink 3 Michelob ultra, that was just a tease. 8-12 was my pre diagnosis beer norm but 6 would do it for me now especially as it will be less often . 6 M ultras is only 4 or 5 regular beers. A 375Ml Gray Goose was usually adequate. 375 ml = 8½ drinks, I just looked it up the little ½ from the pasted. I guess I have to be somewhat Mr Scientist about this if I do it now.

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Is the lowering effect comparable to what happens from exercise ?

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Ok. First, I share your preference for barefoot or at least barefoot shoes. My endo has seen (and complimented) my barefoot sandals numerous times. I do not believe ANY endo I’ve seen has seen me wearing “normal” shoes. None of them have told me that I should change my shoe preference, though my PCP has at least recommended that I examine my feet daily (as I should). I do not have any signs of neuropathy or slow healing, so far, and circulation in my feet also seems normal (though this has not been tested). I pay close attention to any injuries, and see my doctor for anything that looks the least bit suspicious (I’ve only needed to see him about my feet once). Should the situation change, I will have to consider my options, but I’m good for now.

I, too, have seen my feet become healthier since mostly ditching “normal” shoes. I still feel like there’s a long way to go to full foot function, but I’m on the way. I also have a tendency to retain water from taking insulin, so “less” is more comfortable than “more” when it comes to footwear.

Regarding alcohol. I do have some “low carb” alcohol frequently (such as Scotch or Bourbon). What you have to be aware of is that alcohol can lower your BG in two ways. First, it tends to have a mild lowering effect immediately - nothing too concerning. The second time, however, can be more concerning: Around 6-8 hours after drinking, your liver will be busy removing alcohol from the bloodstream - as a result, it cannot trigger glucogensis or gluconeogenesis --Should you be going low due to other triggers (insulin, meds, exercise, etc.) at that time, the liver will NOT be able to assist, so the low will be more dangerous. All-in-all, it’s best never to drink without also eating something to be sure not to go low - and never to drink to excess.

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Yes you know what I am talking about. They absolutely change.
Look what I found searching: Use it or loose it muscle

"Investigators examined what happens to the muscles in younger and older men after a period of high inactivity, by way of so-called immobilization with a leg pad.

**“Our experiments reveal that inactivity affects the muscular strength in young and older men equally. Having had one leg immobilized for two weeks, young people lose up to a third of their muscular strength, while older people lose approximately one-fourth.**

**“A young man who is immobilized for two weeks loses muscular strength in his leg equivalent to ageing by 40 or 50 years,” says Andreas Vigelsoe, Ph.D. "_ ‘Use it or Lose It’ Is True for Muscle Mass**_ https://psychcentral.com/news/2015/06/29/use-it-or-lose-it-is-true-for-muscle-mass/86225.html

The same has to be true with foot strength with ridged or supportive shoes that could honestly be called immobilizing shoes. My feet got healthier after ditching shoes cause I started using them. I just don’t see how keeping my foot stuck in traditional shoes would do anything good for circulation or nerves.

I have no idea how long I was sick and had high sugar before the official diagnosis but around the time of the thirst blurry vision peeing stage I did get some nasty heal cracks and then after starting the insulin they healed pretty quick. Coincidence or related I don’t know. I would imagine all that peeing had me very dehydrated as I have never been THAT thirsty. After the hospital my legs and ankles swelled up huge, that was frightening. About a week to go down two weeks to be gone.

Even before the diagnosis I noticed if I wore socks the dents they made in my ankles from pressing took many hours to go away. Its still like that.

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Thanks, that is good to know. I will remember that.

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Hey, fellow barefooter here :).

I too had been told (and continue to be told by everyone who thinks they know better) that I couldn’t go barefoot because I had diabetes, but I never understood the reasons. About 10 years ago I met a guy who was a barefooter and he told me that wasn’t necessarily true and that he knew some other diabetic barefooters that were doing great, and in fact their foot health had improved. He connected me with the SBL (barefooters.org and the associated email group) which has all kinds of useful information, including some about diabetes. Also other group members with diabetes had advice.

Like other’s have mentioned, the problems come from poor control, which leads to poor circulation and/or neuropathy, which then leads to issues if you get a cut because you might not realize it and it could get infected and then due to the neuropathy and poor circulation the body can’t fight off the infection well and it may progress to amputation. That last bit being the only part of the story we ever seem to hear (if you get cut you will lose your foot!!!). The thing is, shoes aren’t always going to help. You can get foot injuries in shoes (blisters), and shoes are full of way more bacteria than the open air since they are the perfect breeding ground for fungus and bacteria (warm, damp, and dark), so say you get a blister or something from a shoe and your foot stays in that environment…that’s just going to compound the issue. Granted, unless someone has been going barefoot all the time on various surfaces and minimizing wearing anything (even those minimalist shoes) for a long time, they will likely have very soft and weak feet which will make the chance of injury greater, and if they can’t feel anything they will not have the feedback needed to adjust their step to avoid injury and such, so there may be no way around wearing shoes all the time. They would need to work on circulation and hopefully getting feeling back (which walking barefoot in a safe environment would help with), but that might not be possible.

Ditching shoes helps to improve the health of you feet and keep them healthy. Feet weren’t designed for shoes. Going barefoot, especially on more dynamic terrain like trails and such, strengthens your feet and improves circulation. When I started going barefoot everywhere 10 years ago, I never took that great of care of my diabetes, and hadn’t really since I was diagnosed. I still didn’t until about 3 years ago. Throughout that time I have had continual improvement in feeling, overall foot health (arches aren’t flat any more, and they are stronger overall), and circulation, both in my feet and lower legs. When I was in highschool I had a nerve test and they said I was starting to get nerve damage in my feet and legs. Well I just had a nerve test and a circulation test and had no signs of nerve damage and excellent circulation. For the first 3 years or so after I started doing it I was barefoot probably 95% of the time and there was a pretty dramatic positive change, but then for the last several years I had to start wearing boots/composite toe shoes for work for 8 hours a day which has unfortunately weakened them some. Thankfully in the office at work I can be barefoot, and outside of work I only wear shoes for specific circumstances where I truly need them, so I still have good circulation and feeling. Going barefoot also makes you more aware of your feet. I pay more attention to them now than I ever even thought of when I wore shoes all the time.

Bottom line, if you have good feeling and at least decent circulation, you are pretty much like everyone else without diabetes: Pay attention to what your feet are telling you, be mindful of your surroundings and the surfaces where you are or where you might go, train up to rougher surfaces, and don’t get too crazy as some environments just make shoes a necessity (chemicals, excessive heat, and unavoidable really sharp objects for instance). It sound like you endo isn’t harassing you so far so that is a good thing lol.

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Now alcohol wise…

I think it is less about the carbs and more about, like someone else mentioned, the possibility of a severe low. You mention Michelob Ultra. That is super low in carbs and alcohol really, so probably won’t be a huge issue. I like craft beers and some of the stouter ones have very noticeable carbs in them; just one can shoot me high if I don’t bolus early. Wine and liquor are pretty low carb, depending on the kind or what the liquor is mixed with.

In either case the biggest thing you need to worry about is dropping super low and not being aware. Liquor is usually worse for this in my experience. It has happened to me a few times where I had way over indulged. Even if the alcohol isn’t to blame for the low, if you are passed out drunk, or even just in a deep drunk sleep, you may not wake up for a low and it may drop fast if you over bolused. You may not even wake up from a CGM alarm.

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Hi Earthlingcat,
In my long association with T1, I had both the misfortune and the luck to be diagnosed before there were a lot of ideas about how we should live with the condition. I live in Southern California, where many people wear flip flops…zoris…thong sandals…go aheads, you get the idea. I usually only go bearfoot at the home, on the beach, or while daysailing. Why would you need to give up fishing and other activities you love? Just tailor your diet to keep your blood glucose under control, take your insulin (it will take a while to get the hang of your best dosages), remember to test before you drive, and get on with life. I highly recommend a continuous glucose monitor to help you with the process.
I do keep a close eye on my feet and always have a tube of Neosporin and bandaids nearby so that any problems are stopped before they start. Even a little nick or scrape deserves keeping an eye on until it’s healing up. If you do buy shoes, get what you like (BAH on “diabetes shoes”) but remember they should fit well with no rubbing- blisters are not your friends.
As for drinking, I like an iced Frescarita with salt.
Splash

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I often dont wear shoes. My feet are super callous from that. I would only warn that if they get callous, they can crack. Its a lot of work to get rid of callouses once they are there.

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I am putting those items in my test kit today, I always carry it anyway and it won’t take up much room.

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If I see a potential problem of a callous I use some sandpaper to lightly, very lightly ! sand off just a little of it. I say very lightly cause pre diagnosis when I got that idea I over did it and really messed up the skin. It did not seem like I over did it at all.

Its interesting though that when going barefoot almost full time I don’t seem to get callouses any more then anyone else. My skin got tougher but not rougher or calloused.

As far as I can tell callous formation has alot to do with cycling damp dry damp again back and forth between the damp environment in shoes then taking them off and the skin drying out.

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Lol , you get it.

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Who is that tipsy diabetic stumbling on the beach with only one shoe on? It is earthingcat, of course.

Welcome to our group!

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That would be pretty accurate. Many people say “oh you must have some really thick callouses from going barefoot everywhere”, to which I explain why that is not the case. Going barefoot doesn’t generally create the dry dead callouses that people think of, wearing shoes or even sandals does. People think that is what makes feet that stay bare tough enough to handle rough terrain, but it is really just the bottom of the foot that becomes thicker, stronger, and tougher, but also is very much still alive and not dead like a callous. You can have feet tough enough to run on rough gravel but still sensitive enough to feel small particles of dirt on a smooth floor.