A Guide to Diabetic Foot Care

Why protect your feet?

Approximately 60%-70% of people with diabetes have a complication called diabetic neuropathy (nerve damage), most commonly in the feet. Diabetes also reduces blood flow to your feet making it harder for sores to heal. These are the primary reasons why diabetes is the leading cause of foot amputation. The good news is that amputations have decreased by 50% over the past 20 years due to improved foot care. Follow these steps to protect your feet!

11 Steps to Caring for Your Feet

1. Start by checking your feet every day. You might have an injury that you can’t feel. Look for cuts, sores, blisters, warm spots, ingrown nails, and other differences. Inspect your whole foot including between your toes. If you can’t see everywhere, use a mirror with a long handle to check.
2. You should also wash your feet daily. Use warm water, not hot or cold, and test it before washing using a thermometer or your hand. You could use the long sponge brush in a diabetic foot care kit to reach your feet more easily. Afterward, be sure to dry your feet well, especially between the toes. You could also apply talcum powder or cornstarch to prevent an infection between the toes where the skin tends to stay moist.
3. After washing and drying your feet, cut your nails as needed. Trim them straight across using a toenail clipper. Then smooth each nail using an emery board or nail file. This helps prevent cuts and keeps your nails from growing into your skin. If you can’t reach your toes, use a long handle nail clipper or have a foot doctor cut them. If you get a pedicure, bring your own tools to prevent infections and talk to your doctor for more suggestions.
4. If you have corns or calluses (patches of thick skin) on your feet, talk to your doctor to prevent them from becoming ulcers. If your doctor approves, you might be able to use a pumice stone to smooth the area. Don’t cut them, use medicated corn plasters, or apply liquid corn or callus remover because these methods can all lead to an infection.
5. Moisturize your feet for smooth skin. The long handle of a lotion applicator can help you apply lotion to the tops and bottoms of your feet. This keeps your skin from becoming dry and cracked. Just don’t apply it between your toes. You want to keep that area dry to avoid an infection.
6. Swelling feet and ankles are another possible diabetic complication caused by venous insufficiency (poor blood flow in your legs). Talk to your doctor about wearing diabetic compression socks or stockings to help. It’s not the right choice for every person with diabetes so a professional medical opinion is important. If you do wear them, think about getting a compression stocking aid so they are easier to put on.
7. Wearing socks and shoes at all times is another important part of foot care. Otherwise, you could step on something and not realize you’re injured. Diabetic gel socks help protect your feet from blisters when wearing shoes. It’s recommended that you wear shoes at all times as well, even indoors. You could add a orthotic insole to your shoes for additional protection. A clinical study found that using orthotics reduces the rate of re-ulceration and amputation. There are a variety of options from top of the line orthotics to lower cost orthotics. If you would really prefer slippers while at home, choose a pair with flat seams, a soft inside, and warmth to relieve pressure points and protect your skin.
8. Keep your feet protected from excessive warmth and cold. Following these tips will keep your feet from getting burned if you have a loss of feeling due to nerve damage. Apply sunscreen to the tops of your feet to prevent sunburn, wear shoes at the beach, and don’t put hot things, like a hot water bottle or heating pad, on top of your feet. Keep them warm by wearing socks to bed if needed and wear waterproof boots in the winter. Don’t put your feet near a heater or fireplace to warm them.
9. Control your glucose level to protect your feet. If your diabetes is well controlled, it can reduce symptoms of neuropathy by 64% as found in a 2006 study by the National Institute of Diabetes and Digestive and Kidney Diseases. Without these neuropathy symptoms (pain, numbness, tingling) it’s easier to tell if your feet have been injured and take the proper steps right away.
10. Improve blood flow to your feet to keep them healthy. You can wiggle your toes and move your ankles throughout the day and start exercising with activities that are gentle on your feet (walking, swimming, yoga…). Put your feet up when sitting to keep the blood flowing. Don’t wear tight socks as they can reduce circulation and quit smoking because it also lowers your blood flow.
11. Get a foot check at each doctor’s visit so they can examine your feet. This is especially important if you have changes in the shape of your foot, loss of sensation, or if you’ve had ulcers or an amputation in the past. The doctor will inspect your foot, check its pulse, and offer you additional tips on caring for your feet.

Contact a medical professional if you have any questions about caring for your feet. Your doctor might refer you to a podiatrist, a doctor who specializes in caring for feet.

Call your doctor right away if you notice any of these signs:

• Cuts, blisters, and bruises that don’t start healing after a few days
• Red, warm or painful skin (this could be an infection)
• Calluses with blood inside (another sign of infection)
• A black and smelly foot infection (a sign of gangrene)

References
Center for Disease Control. (2017, November). Diabetes and Your Feet. Retrieved from http://bit.ly/2krFd7v
Dansinger, M. (2017, March). Diabetic Nerve Pain: 10 Foot Care Steps to Protect Yourself. Retrieved from http://wb.md/2EJwrfc
Gonzalez Fernandez, M. L., Morales Lozano, R., Gonzalez-Quijano Diaz, M.I., Gonzalez Jurado, M. A., Martinez Hernandez, D., and Beneit Montesinos, J.V. (2013). How Effective Is Orthotic Treatment in Patients with Recurrent Diabetic Foot Ulcers?. Journal of the American Podiatric Medical Association. Retrieved from http://bit.ly/2EIhnTl
“How to Protect Diabetic Feet”. (2017, March). Retrieved from http://bit.ly/2ofY4GA

Medical Disclaimer: The information provided on this site, including text, graphics, images and other material, are for informational purposes only and are not intended to substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other healthcare professional with any questions or concerns you may have regarding your condition.

Recommended Care Kit: