Thorough and careful foot care is very important if you have diabetes. Higher-than-normal blood sugar levels increase the risk for three conditions that can seriously affect your feet:

  • Nerve damage called diabetic neuropathy.
  • Reduced circulation of blood.
  • Higher risk of infection.

It is essential that you check your feet every day and take special steps to keep them healthy. See your healthcare provider to monitor your diabetes and for regular foot check-ups. Foot wounds, including foot ulcers, are the most common cause of hospitalization for people with diabetes. About 1,000 amputations are performed every week as a result of these foot wounds. If you see anything odd on your feet, call your healthcare provider promptly.

Diabetic Neuropathy

In diabetic neuropathy, the nerves of your legs and feet become less sensitive to feeling pain, as well as to hot and cold temperatures. This means that you might not feel a corn, callous, blister, small cut, or ingrown toenail right away and keep walking on it. Any pressure can lead to a foot ulcer or a deeper sore that can pose serious risks. Seeing any small change during your daily foot inspection and having it treated by your healthcare provider is very important for the prevention of foot ulcers.

Reduced Circulation of Blood

People with diabetes can have reduced blood circulation. This limits the ability of your blood vessels to bring a fresh supply of blood, oxygen, and nutrients to your legs and feet. When circulation is poor, even small injuries cannot heal.

Increased Risk of Infection

Diabetes increases your risk of infection. If a tiny callous, bruise, cut, or toenail problem grows to a foot ulcer and becomes infected, your body will have trouble fighting the infection.

Foot Ulcers

Foot ulcers caused by diabetes frequently start as a painless sore on the top or bottom of a toe or on the ball of your foot. Pressure or rubbing makes foot ulcers worse. They often develop underneath a callus or corn that has built up a thick covering. Other causes of foot ulcers include stepping on something sharp, wearing poorly fitting shoes, or simply rubbing against the seam of a stocking or sock over and over. You might not feel any discomfort because the nerves are less sensitive. You continue to rub the area by walking. This makes the ulcer worse. The best defense against foot ulcers that lead to amputation is keeping your blood sugar levels within normal range, performing daily foot inspections and regularly following up with your health care provider.

Caring For Your Feet

Daily Foot Inspections

Every evening, sit down under a strong light and look at each foot carefully. Use a mirror to help you see every part of your feet, including the soles and heels. If you have difficulty bending over to do your daily foot inspection, ask someone to help you or use a mirror to assist. Look for any swelling, shiny skin, redness, cuts, blisters, bleeding, cracking (especially on your heels), corns, calluses, or ingrown nails or thickening of your nails. Look between your toes for redness or peeling skin. Remember that even a bruised or redder-than-normal area on your foot can easily break down into an ulcer. Have your healthcare provider check and treat anything out of the ordinary as soon as possible. Foot problems that are not treated can turn into ulcers that can lead to amputation. Preventing ulcers is your best defense against them.

Daily Foot Baths

If you have diabetes, your feet deserve pampering. In fact, they require it. In addition to a daily foot inspection, wash your feet every day.

  • Use lukewarm (never hot or cold) soapy water. Do not soak your feet.
  • Dry you feet well, especially between your toes.
  • Do not rub your skin; blot it dry gently with a soft towel.
  • Apply cream or lotion all over both feet to keep them smooth, especially your heels, which can become cracked.
  • Do not use any lotion between your toes.
  • Dust between your toes with cornstarch or talcum powder to keep the area dry and free of fungus and infection.

Toenail Trimming

Trim your toenails after a shower or bath, when they are soft. Cut straight across the top of the nail to prevent them from growing into the skin at the edges of the toe. Do not cut the edges of your nails because this encourages ingrown toenails. Tell your healthcare provider if you have problems cutting your own toenails. Some people with diabetes have their nails trimmed regularly by a professional.

Corns And Calluses

Corns and calluses can grow more quickly in people with diabetes. Never use scissors, a razor blade, or any drugstore products to remove them. Do not try to remove corns or calluses yourself, unless your healthcare provider has given you specific instructions on doing so. Ask your healthcare provider who should treat them, and how often. Purchase two pair of low-heeled, comfortable shoes. Make sure they are wide enough and long enough for your toes so that no part of your foot is pinched. Many athletic shoes are a good choice because they are made of leather or other breathable fabrics and are well cushioned. Wear them with well-padded socks without seams. Always check your shoes before putting them on. Any rough spot on the inside of your shoe—even a tiny pebble or stick—can rub against your skin and start a foot ulcer. Don’t ever go barefoot outside or inside. Always wear slippers at home.

What to Do

  • Put your feet up when you’re sitting. Do not cross your legs because that cuts off circulation.
  • Do not wear sandals. They can expose your feet to injury and to hot or cold temperatures.

What Not to Do

  • Do not ignore any change in your feet such as any swelling, redness, numbness, calluses, or a sore.
  • Do not smoke. It reduces the circulation in your feet.

Things to Remember

  • Remember that controlling blood sugar, eating well, and exercising daily also helps keep your feet healthy.

What We Have Learned

  1. You should inspect your feet every day, in the evening.
    True or False
    Answer: True
  2. The most common cause of hospitalization for people with diabetes is foot wounds.
    True or False
    Answer: True
  3. If you find a corn or callus building up on your foot you should never treat them unless your healthcare provider has given you specific instructions on doing so.
    True or False
    Answer: True

The contents of wired.MD are for informational purposes only. Nothing contained in wired.MD is intended to substitute for medical advice, diagnosis or treatment. If you have health care related concerns or questions, please seek the advice of your physican or other qualified healthcare providers. You should never disregard professional medical advice or delay in seeking it because of something you have read or seen on wired.MD.

Special Thanks to Medtronic for their help in the making of this production.

Copyright 2004 wired.MD, Inc. All Rights Reserved