Open footwear in summer dangerous for diabetics, experts say

As summer's first heatwave warnings struck this week, medical professionals on Wednesday urged individuals with diabetes to exercise greater caution against the increased risk of a severe complication of the condition called diabetic foot disease.

Diabetic foot disease encompasses a range of foot problems afflicting diabetics, with foot ulcers being the most debilitating, as explained by the Korea Disease Control and Prevention Agency.

Summertime coincides with a heightened risk of the disease due to the combination of open footwear, increased physical activity and perspiration that can cause bacterial and fungal growth as well as unexpected injuries. Diabetic foot disease causes the skin or mucosal tissues of the foot to break down, resulting in ulcers.

As the disease progresses, even if there is a wound on the foot, it may be difficult to feel. The disease stems from nerve damage or diabetic neuropathy and poor blood flow or peripheral vascular disease -- both of which are common complications of diabetes that can result in skin breakdown and ulcer formation.

Since a diabetic's immune system and bacterial resistance are weak, even minor wounds can progress rapidly and lead to serious complications such as ulcers and gangrene.

“Summer tempts us to go barefoot or try new footwear, but both are not recommended for diabetics,” Dr. Chung Chang-hee, an endocrinology professor at Asan Medical Center in Seoul was quoted as saying by Yonhap News Agency. "New footwear might be ill-fitting or rigid, creating unwanted pressure or friction on the feet. Open footwear or going barefoot can lead to unnoticed injuries due to reduced sensation from diabetes.”

According to the results of the 2012-2018 National Health and Nutrition Survey, one in seven -- 13.8 percent -- of Korea's adult population over the age of 30 suffers from diabetes. The higher one's age, the higher the prevalence of diabetes. In Korea, the prevalence of diabetes exceeded 10 percent among men in their 40s and women in their 50s.

Estimates show that 15 to 25 percent of individuals with diabetes will develop a foot ulcer at some point, with over half experiencing subsequent infection-related complications. In the most extreme scenarios, around 20 percent of moderate to severe infections require foot amputation.

"For diabetics, choose white socks to easily spot wounds and opt for sneakers over open footwear such as sandals or flip-flops, even at the beach,” Dr. Kwak Soo-heon, an endocrinology specialist at Seoul National University Hospital told Yonhap.

"Watch for any changes, such as reddening or blackening of feet, or the appearance of blisters or ulcers," warned Chung.