Heather Little-White, Ph.D., Contributor

Everyone wants to have a sexually rewarding relationship, whether he or she is diabetic or suffering from other diseases. You may wonder why the foot is so important in establishing healthy sexual relationships. Simply put, some people have a 'foot fetish', that is, they are sexually aroused by the lower limb or anything that covers portions of them. In the equation, if you are diabetic and refuse to take care of your feet, you could easily miss out on attracting a soulmate. Diabetics already in a relationship should be aware that feet not well cared for could be a turn-off for their sexual partner.

Foot fetishists are eroticised by the feet and they enjoy kissing, licking and caressing their partners' feet before, during and after sex. They may play out their fetish in any creative way. It may mean having their partners parading in pantyhose and high-heeled shoes, or they may act as masseurs and manicurists, giving special attention to the feet of the person to whom they are attracted. Generally, the straight male foot fetishist may prefer neat, female feet with high arches. For an exception to the rule, there are others who are attracted to smelly feet, with calluses and corns.

Intimacy and trust

Since feet have tremendously sensitive nerve endings, they are easily incorporated into lovemaking and can foster intimacy and trust.

For a foot fetishist, attraction to the feet may rest in the shape, size, odour and general condition of the feet. Why are the feet so important in diabetic care? It is well established that diabetics suffer from impaired circulation, reduced sensation and the tendency to develop skin problems, especially on the lower legs and feet. Therefore, it is important that the diabetic has regular professional evaluation and care of the feet to prevent diabetic complications.

Problems related to the feet include diabetic arthropathy (diabetic arthritis), peripheral neuropathy (loss of feeling), vascular complications, and ulcerations. The podiatrist will examine the feet to make sure that there is adequate blood supply and sensation (feeling) to the feet. A decrease or loss in one or both can lead to infection and potentially more serious problems. In many cases, the podiatrist will involve, by referral, other medical specialists to participate in the total team approach to managing the existing diabetic problems of the feet.

Regular examination

According to local podiatrist Joan Bogle of Body and Soul, "It is important for diabetics to have regular examination and care of the feet by professionals trained in diabetic foot care. There are special techniques, for example, in trimming nails to prevent ingrown toenails or infection. Special foot care is critical because the skin of the diabetic is thinner and more prone to injury than people without the disease."

Diabetics cannot fight skin infections as well as non-diabetics. Ms. Bogle added that it is common for calluses to build up over the bony prominence of the feet. When this happens, the skin may break down and cause an ulceration. If immediate attention is not given, the ulcer can become infected and possibly lead to more serious consequences, including amputation.

Be responsible

If the diabetic wants to maintain 'sexy' feet, they should take responsibility to prevent foot and leg damage by controlling blood sugar levels and practising good foot care. Body and Soul Foot Care Centre offers some basic strategies for diabetic foot care:

Examine feet daily for scratches, cuts, sores, breaks in the skin or any swollen areas. Be sure to check between toes.

Wash feet with warm water and soap every day and dry them carefully.

Do not attempt to soak feet on your own, as this could result in cracking of the skin because of dryness.

Massage feet with a moisturising cream to prevent dryness and reduce the risk of the skin cracking, which could lead to skin infection.

Care toenails to avoid them becoming ingrown. If this problem results, seek professional help to remove them. Never try to remove the nail on your own.

Visit a podiatrist or other foot-care professionals to treat all calluses, corns, warts or anything unusual that may appear on the feet.

Wear clean socks or stockings every day.

Comfortable shoes are a must. While you may want to be fashionable, wear well-fitting shoes specially designed for persons with foot problems.

Avoid going barefooted to reduce the chances of injury to the feet.

If you have a wound that is difficult to heal, seek professional help immediately.

High fashion

Jamie, 46, diabetic since age 32, complains that because she had corns and ulcers on her feet early in her diabetic life, because of high fashion shoes, her feet are in no condition to attract a man. She laments, "I would love to wear sandals like my friends but I am so conscious of my feet that I wear close-up shoes." Jamie credits the Diabetes Centre in Kingston for enlightening her about foot care, and she is taking care of her feet regularly to keep them healthy.

As a diabetic, there is no reason why your feet should not attract a foot fetishist, especially with today's fancy sandals to enhance the feet. Do not kill the prospects of attracting a lifelong partner by ignoring the care of your feet. You never know where a foot fetishist may be lurking and you would not want to turn him/her off with ugly feet as a result of poor diabetic foot care.

Name changed for privacy