Diabetic Foot Care: Daily Checks, Shoes and Signs to Call About

What it involves

MedlinePlus explains that diabetes can damage the nerves and blood vessels in the feet, causing numbness and reduced feeling, so injuries are more likely and may not heal well. Even a small sore or blister can become a big problem if it gets infected and turns into a diabetic foot ulcer.

Who this is for

• Patients with diabetes or prediabetes who want a routine for checking their feet
• Patients who notice numbness, tingling, or burning in the toes or soles
• Patients with a sore, crack, or blister on the foot that is slow to heal
• Family members who help an older relative with diabetes look after their feet

What to expect

• A look at both feet, including between the toes, for dry skin, sores, calluses, and color changes
• Questions about numbness, burning, pain at night, and the shoes you wear
• A review of your blood sugar control and other diabetes care
• A plan that may include foot-care teaching, treatment of a sore or infection, and a referral to a podiatrist

Why feet are at risk

MedlinePlus says foot ulcers are a common reason for hospital stays among people with diabetes, and that untreated ulcers are the most common reason for toe, foot, and leg amputations in people with diabetes. The risk comes from lost feeling combined with slow healing, so a problem can progress without pain to warn you. Good blood sugar control, which the diabetes management page explains, is the foundation.

Check your feet every day

MedlinePlus advises looking at the tops, sides, soles, heels, and between the toes every day, asking someone else to check if you cannot see well. It lists the things to look for:

• Dry and cracked skin
• Blisters or sores
• Bruises or cuts
• Redness, warmth, or tenderness, which may be absent because of nerve damage
• Firm or hard spots

Washing, moisturizing and nails

Wash the feet daily in lukewarm water with mild soap, testing the temperature with your hand or elbow, and dry gently between the toes. MedlinePlus says lotion or petroleum jelly can go on dry skin but not between the toes. Toenails should be cut straight across, and thick, discolored, or hard-to-reach nails are better left to a podiatrist. Corns and calluses are best treated by a foot doctor, as the calluses and corns guide explains.

Shoes, socks and what to avoid

MedlinePlus says to wear shoes at all times, check inside them for stones or rough spots, and never buy tight shoes expecting them to stretch, since you may not feel pressure. Break in new shoes slowly. Avoid flip-flops, stockings with seams, walking barefoot on hot pavement or sand, and heating pads or hot water bottles on the feet, because skin that does not feel normally can burn. Stopping smoking helps, because smoking decreases blood flow to the feet.

Call the same day if

MedlinePlus says to contact your provider right away about any foot problem and not to treat these problems yourself. Examples include redness, increased warmth, or swelling, sores or cracks, a tingling or burning feeling, and pain. A toe infection and a red, hot area are covered in the ingrown toenail guide and the cellulitis guide.

Fungus and wound care

A cracked, scaly foot rash gives germs a way in, and the athlete's foot guide explains it. Wounds of any size that are slow to heal can be looked at under the practice's wound care page, and numb toes are described in the numbness and tingling guide.

Sources

• MedlinePlus — Diabetes: taking care of your feet
• MedlinePlus — Diabetic Foot