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Diabetes Foot Care

Medically Reviewed by Michael Dansinger, MD on May 18, 2021

You're more likely to have foot problems with diabetes because it can damage your nerves and lessen blood flow to your feet. The American Diabetes Association estimates that it's the reason 1 in 5 people with diabetes who seek hospital care do so. One of the best things you can do for your feet is to keep your blood sugar levels under control.

Small cuts or sores don't heal as well, and they can take longer to recover.

If your blood sugar isn't well-controlled, you can also have poor or no feeling in your feet. You might not even realize you have a minor injury. Diabetes can also dry the skin on your feet and make your heels crack.

The big risk is infection. Germs or fungus can get into small cuts or cracks.

You have to take care of your feet when you have diabetes. If you think you've gotten an infection, tell your doctor right away. Early treatment can keep it from spreading. And that makes you more likely to avoid bigger problems.

 Poor foot care may lead to amputation of a foot or leg.

Your doctor will check yours each year for problems. If you take good care of your feet, you can prevent most serious problems related to diabetes.

Wash and Dry Your Feet Daily

Keep your feet clean. But don’t soak them for a long time. This can dry your skin.

Use mild soaps and warm water.

Pat your skin dry; do not rub. Thoroughly dry your feet.

After washing, put lotion or petroleum jelly on them to prevent cracking. But not between your toes -- this can lead to an infection! Sprinkle on a nonmedicated powder before putting on your socks and shoes to help keep your feet dry.

In winter, cold weather and central heating can dry out your skin. Take extra care to moisturize your feet and keep them warm. Wear socks to bed if your feet get cold.

Check Your Feet Every Day

Look carefully at the tops and bottoms of your feet. Use a mirror or have someone else do it if you can't see them.

  • Set a specific time each day to do this check.
  • Use good light so you can spot any problems.
  • Check for dry, cracked skin on your feet, toes, and heels.
  • Look at your feet, toes, and heels for blisters, cuts, scratches, bruises, scrapes, or other sores.
  • Check between your toes for cuts or fungus that might cause athlete’s foot.
  • Check for redness, increased warmth, or tenderness when you touch an area.
  • Watch for ingrown toenails, corns, and calluses.

If you get a blister or sore from your shoes, don't "pop" it. Put a bandage over it, and wear a different pair of shoes.

Take Care of Your Toenails

Cut toenails after bathing, when they are soft. Trim them straight across, then smooth with a nail file. Avoid cutting into the corners of toes. Don't let the corners of your toenails grow into the skin. This could lead to an ingrown toenail.

You may want a nail technician or podiatrist (foot doctor) to do it for you. If you get pedicures at a nail salon, bring your own nail tools.

Don't cut cuticles. Don’t use anything sharp to clean under your toenails or to remove calluses. You don’t want to accidentally get a cut that could let an infection set in. You can use a pumice stone to gently smooth your heels after taking a shower or bath. Don't rub too harshly.

Be Careful When Exercising

Exercise regularly to keep your blood flow healthy. Aim to move your body for at least 30 minutes a day.

Walk and work out in comfortable shoes. Don't exercise when you have open sores on your feet. Ask your doctor what type of activity is best for you.

Protect Your Feet With Shoes and Socks

Never go barefoot or only in socks. You don’t want to step on rocks, tacks, or small pieces of glass that could cut your feet. Always protect your feet with shoes, hard-soled slippers, or similar footwear. Wear shoes/boots that will protect your feet from weather conditions like cold and moisture. Wear slippers at home.

Don't wear shoes with high heels and pointed toes. Avoid shoes that leave your toes or heels unprotected, like open-toed shoes, flip-flops, or sandals. They leave you vulnerable for injury and infections.

Change your socks daily. Wear natural-fibers: cotton, wool, or a cotton-wool blend. Don’t use socks with seams that might rub against your skin and cause blisters. Avoid tight socks.

Try on new footwear with the type of socks you usually wear. Don't wear new shoes for more than an hour at a time.

Look and feel inside your shoes before putting them on to make sure there's nothing irritating in them or rough areas.

Wear special shoes if your doctor recommends them. Replace your shoes when they show signs of wear, such as heels that are worn down on one side or lining that is torn.

Make Sure Your Shoes Fit

Are your shoes too narrow? Is your foot crammed into the shoe? If you have neuropathy (nerve damage), you may not notice that your shoes are too tight.

Use this simple test to check:

  • Stand on a piece of paper in bare feet. (Make sure you're standing and not sitting. Your foot changes shape.)
  • Trace the outline of your foot.
  • Put your shoe on and stand on another piece of paper.
  • Trace the outline of your shoe.
  • Compare the tracings.

The shoe should be at least 1/2 inch longer than your longest toe and as wide as your foot. It’s best to shop for shoes at the end of the day, when your feet are usually at their largest.

Good Shoe Choices

Shoes that are too tight or too loose may lead to blisters. People with diabetes should wear shoes that have:

  • Closed toes and heels
  • An outer sole made of stiff material
  • Leather uppers without a seam inside, canvas, or suede. Look for a cushioned sole to absorb pressure. Pick shoes with laces over loafers, because they provide better support.
  • Insides that are soft with no rough areas
  • Have at least two pairs of shoes so you can switch pairs.
  • Break in new shoes slowly. Wear them for about an hour a day the first few days.

Diabetic Socks

Well-fitting, quality shoes are necessary, but you also might want to think about wearing diabetic socks. They can:

  • Improve blood flow to your feet
  • Keep your feet dry
  • Keep fungal infections off your feet
  • Provide cushion

All of these things help keep your feet healthy and injury-free.

There’s no one standard for what makes a diabetic sock, but the best ones have things like:

Flat or no seams to prevent rubbing and blisters

  • Stretchy cuffs that don’t constrict blood flow
  • Moisture-wicking materials to keep your feet dry
  • Softness, with extra thickness in the heel and ball of your foot
  • A light color to spot blood or other fluids that might signal injury or infection
  • A foot-conforming fit with no wrinkles or bunches

Don't wear stretch socks or socks made of nylon.

Cuts, Bumps, Sores, and Burns

Don't wait to treat a minor foot problem if you have diabetes. Report foot injuries and infections right away. Follow your doctor's guidelines and first aid guidelines.

Don't self-treat your corns, calluses, or other foot problems. Go to your doctor or podiatrist to treat these conditions.

Check water temperature with your elbow or a thermometer, not your foot, to make sure it’s not hot (over about 90 F). Don't wash your feet in hot water, which could cause burns.

Don't use a heating pad, water bottles, or electric blankets on your feet, because they could cause burns.

Don't cross your legs or stand in one position for a long time. This can block blood flow to your feet.

Help Prevent Infections

Watch your blood sugar levels and follow your diet as your doctor directs. If you keep your blood sugar and weight under control, you may have fewer foot problems.

Don’t smoke. Smoking can narrow your blood vessels and raise your chance of getting foot problems.

Also, note any cuts, scratches, scrapes, blisters, corns, or calluses, even if they're small. Let your doctor or podiatrist know in case you need medical treatment.

When to Talk to Your Doctor

Your doctor should look at your feet during each visit. Give them a call when you notice problems such as:

  • Athlete's foot (cracking between the toes)
  • Sores or wounds on your feet called ulcers. They often develop on the balls of your feet or the bottoms of your toes.
  • Ingrown toenails
  • Increasing numbness or pain
  • Calluses, warts, or corns. Don’t try to treat them yourself with over-the-counter pads or liquids. Don’t try to cut them off your skin. Ask your podiatrist or doctor to remove them safely.
  • Redness, swelling, or drainage that could be a sign of an infection.
  • Nails that seem thicker, yellow, changed in shape, striped, or not growing the way they usually do. This could be a sign of an injury or infection.
  • Blackening of skin
  • Bunions
  • Infection
  • Hammer toes (when the middle joint of toes is permanently bent downward)
  • If your foot, ankle, or toe is swollen, red, hot to the touch, changed in shape or size, or hurts when you move it, you may have a sprain or fracture. Damage to your nerves can raise your chance of a serious condition called Charcot foot, which causes a change in the shape of the foot.
WebMD Medical Reference

Sources

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