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Managing diabetes can be a challenge. There are so many steps—from monitoring high blood sugar levels and counting carbs to following an exercise routine. What the average person may not expect? A diabetes action plan also includes daily diabetes foot care to prevent serious complications from the condition.
Why is foot care so important for people with diabetes?
Nearly 50% of people with diabetes have nerve damage, according to the U.S. Centers for Disease Control and Prevention (CDC). Called diabetic neuropathy (or peripheral neuropathy), it can occur anywhere in the body, but it’s most common in hands and feet. It can cause numbness or tingling, but also limits your ability to feel pain. While that might seem like a good thing, at first glance, pain is part of your body’s communication system. It lets you know when something is wrong.
People with diabetes are at an increased risk of developing foot problems such as injury or infection, according to the American Orthopaedic Foot and Ankle Society. When a small issue, like a cut or a blister, goes unnoticed, it can quickly become a more serious problem. The good news is proper diabetes management combined with consistent care and exams can prevent minor foot injuries from resulting in medical complications.
How to examine your feet
People with diabetes should maintain regular, daily foot exams. Start each exam by inspecting your feet and proceeding to check your toes (including in between your toes) and soles of your feet, says Susan Besser, MD, a primary care provider at Mercy Medical Center in Baltimore, Maryland.
Francisco J. Oliva, DPM, owner of Oliva Podiatry in Coral Gables, Florida, encourages his patients to “use a hand mirror to carefully check the bottoms of the feet.”
What are the signs of diabetic feet problems?
During your daily foot exam, look for:
- Cuts
- Cracked skin
- Sores
- Bruising
- Skin discoloration
- Calluses
- Nail changes
- Changes in the way feet feel when you touch them
These could all be signs of a problem, according to Drs. Besser and Oliva.
Of particular concern are diabetic foot ulcers that can form on the bottoms of your feet. The American Podiatric Medical Association (APMA) says these sores occur in approximately 15% of patients with diabetes, often due to poor blood flow (another diabetes complication). Of those patients who develop a foot ulcer, 6% will be hospitalized due to infection or ulcer-related complications and 14% to 24% of patients with diabetes with a foot ulcer that doesn’t get better with treatment, will require amputation to prevent the infection from spreading.
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Treatment for foot ulcers
The good news is foot ulcers are largely preventable and daily self-exams can identify them early when they can be effectively treated. If you do develop a foot ulcer, Dr. Oliva says it’s important to seek out professional health care.
You may need antibiotics or help to disinfect the area. “Once a foot ulcer has formed, the best care comes from a wound care specialist,” Dr. Oliva says. “It’s not appropriate to self-care for an ulcer.”
11 tips for diabetic foot care
With vigilance and daily routines, you can prevent many issues, like ulcers—using these steps to take care of your feet.
1. Check feet daily.
Daily foot care is important for people with diabetes in order to avoid medical complications.
2. Wash feet every day.
“I advise my patients to wash their feet daily with warm soap and water and pat dry thoroughly, especially between the toes,” Dr. Besser says. Don’t use hot water. Decreased feeling can make you more susceptible to accidental burns.
“Since skin can become rough and dry with diabetes, it’s fine to use an emollient lotion to hydrate and smooth skin,” explains Dr. Besser. Just don’t apply moisturizer between your toes as too much dampness can lead to infection, according to the American Diabetes Association.
RELATED: Is it just dry skin? Or could it be eczema? Or psoriasis?
3. Always wear shoes.
Those with diabetes should never go barefoot since doing so can increase the risk of foot injury, according to Dr. Besser.
4. Choose the correct footwear.
Wearing comfortable shoes and dry socks can also help prevent complications for those with diabetes. Studies show that cotton and wool socks are more absorbent, keeping feet warm and dry, protecting feet from fungal infections (like athlete’s foot) and bacteria.
“Commercially available double woven socks are available without a prescription, but are not covered by insurance,” Dr. Oliva says. “Diabetic in-depth shoes with shock-absorbing materials are specially-designed shoes that can help reduce the risk of skin breakdown in those with diabetes.”
5. Make sure you have the right fit.
Before buying new shoes, have your foot measured to ensure you’re choosing the correct size shoe. Improperly fit shoes can cause blisters to form.
6. Keep your blood moving.
“Specially designed shoes offer protection for diabetic feet and can also promote healthy circulation,” explains Dr. Besser. Diabetic shoes are often covered by Medicare Part B and other health insurance programs when prescribed by a podiatrist.
Consider taking breaks to put your feet up, and make a point to wiggle your toes whenever you’re seated to encourage blood flow to your feet. Avoid smoking—it can constrict your blood vessels and result in poor circulation.
7. Schedule regular checkups with a podiatrist.
In addition to conducting daily self-care, Dr. Oliva recommends those with diabetes visit their podiatrist at least once a year for professional foot checks. A podiatrist can help develop a care plan to prevent foot complications and keep patients healthy and mobile.
During your annual foot exam, your physician will check your circulation to see if you’re developing peripheral neuropathy, which makes it harder to feel a foot injury. There is no cure for peripheral neuropathy, according to the American Podiatric Medical Association, but there are treatments that can reduce or relieve symptoms, including ibuprofen, steroids, or immunosuppressants. Your podiatrist will also look for hammer toes, bunions, corns, calluses, and other foot changes.
8. Take care when trimming your toenails.
Consult with your podiatrist on the correct way to trim your nails. Cutting them too short, or diagonally can lead to an ingrown toenail or nail infection. After cutting properly, smooth rough edges with an emery board.
While it can be tempting to head to the spa, and let them take care of it, check with your healthcare provider first. “Once a patient has been evaluated by a podiatrist, a determination can be made as to whether they can safely get a salon pedicure, which isn’t recommended if they have circulation issues, or if they should see a podiatrist to have them regularly perform their nail care,” says Dr. Oliva.
9. Don’t try to remove corns and calluses on your own.
A podiatrist can also treat and remove any calluses or corns without damaging the skin.
“Although calluses might not seem like a big concern, sometimes the layers of callused skin can separate and fill with fluid,” Dr. Oliva says. “When the fluid becomes contaminated and infected, the result is a foot ulcer.”
10. Be kind to your feet.
Part of managing your diabetes is maintaining an active lifestyle to boost circulation and keep weight in check. Make sure you’re choosing exercise that doesn’t put undue stress on your legs and feet—like swimming or biking.
11. Know when to call your healthcare provider.
Good foot health begins at home, but there are certain circumstances that warrant a call to your healthcare provider. “Report blisters, open sores or wounds, tingling, burning, and lack of feeling in your foot, to your doctor right away,” Dr. Oliva says. “Also, corns, calluses, and ingrown or thick toenails should always be treated by a podiatrist who is knowledgeable in diabetic foot care.”
