Diabetes foot care: daily checks, footwear and when to call a doctor

Looking after your feet is one of the simplest and most useful habits for anyone with diabetes. Small problems can grow quickly when feeling is reduced or healing is slow. This article sums up what the NIDDK recommends, along with related points from the NHS.

Why feet need extra attention

The NIDDK explains that nerve damage from diabetes can cause tingling, pain or numbness, so you may not notice cuts, blisters or pebbles in your shoe. Reduced blood flow can make sores slow to heal and raise the risk of infection, gangrene and amputation. Rarely, nerve damage changes the shape of the foot, called Charcot's foot. The NHS lists foot ulcers and infections among the possible long-term complications of diabetes, and says to see a GP or diabetes nurse about blisters or cracked skin.

Daily foot care

The NIDDK suggests these steps:

• Check your feet every day, including between the toes. A mirror can help if you cannot bend over.
• Wash your feet daily in warm, not hot, water and dry them well. Do not soak them.
• Use powder between the toes to keep them dry.
• Moisturise the tops and bottoms of the feet, but not between the toes.
• Smooth corns and calluses gently, and only if your doctor advises it. Do not cut them or use medicated pads or liquid removers.
• Trim toenails straight across and smooth them with an emery board.
• Protect your feet from heat sources and sunburn.
• Help circulation by raising your feet, moving your toes and ankles, avoiding tight socks, staying active and not smoking.

What to look for

When you check your feet, the NIDDK lists these things to notice:

• Cuts, sores or red spots
• Swelling or fluid-filled blisters
• Ingrown toenails
• Corns or calluses
• Plantar warts
• Athlete's foot
• Warm spots, which can signal a developing blister or ulcer

Footwear

The NIDDK recommends:

• Wearing shoes and socks at all times, even indoors
• Checking inside your shoes for objects before putting them on
• Choosing well-fitting walking or athletic shoes that let your feet breathe, and avoiding vinyl or plastic shoes, pointed toes and high heels
• Buying shoes late in the day, when feet are largest
• Wearing clean, lightly padded, seamless socks
• Breaking in new shoes gradually

Foot exams

The NIDDK says to ask your health care team to look at your feet at every visit and to have a thorough foot exam, including checks of sensation and pulses, at least once a year. A thorough exam at every visit is advised if you have changes in foot shape, loss of feeling, peripheral artery disease, or a history of ulcers or amputation. The NHS says that foot checks form part of the regular checks for people with type 2 diabetes. Your own team will tell you how often they are due.

Exercise and your feet

The NIDDK's activity guidance advises wearing comfortable, supportive shoes and checking your feet before, during and after exercise.

When to see a doctor

The NIDDK advises calling your health care provider if:

• A cut, blister or bruise does not begin to heal within a few days
• Your skin becomes red, warm or painful, which can signal infection
• A callus contains dried blood
• A foot infection turns black or smells bad, which can signal gangrene

Do not wait if you notice any of these signs. A foot infection that turns black or smells bad needs urgent medical attention. In an emergency, call your local emergency number (112 in India, 911 in the United States).

This article is for education only and does not replace advice from your own doctor or foot care specialist.