Health Encyclopedia

Diabetes foot care

Alternative Names

Foot care for diabetics

Information

If you have diabetes you are more prone to foot problems, because the disease can damage your blood vessels and nerves. This, in turn, may make you less able to sense injury or pressure on your foot. You may not notice a foot injury until severe infection develops.

Diabetes also changes the immune system, decreasing the body's ability to fight infection. Small infections may rapidly progress to death of the skin and other tissues (necrosis). Amputation of the affected limb may be needed to save the patient's life. Improved blood sugar control can help prevent foot problems.

If you have diabetes, you are at higher risk for developing foot problems if you:

Are male
Have eye, kidney, or heart problems
Have had diabetes more than 10 years
Have poor blood glucose control

If you have diabetes, get a foot exam at least twice a year by your health care provider and learn whether you have nerve damage.

To prevent injury to the feet, check and care for your feet EVERY DAY, especially if you already have known nerve or blood vessel damage or current foot problems. Follow the instructions below.

DAILY CARE ROUTINE

Check your feet every day. Inspect the top, sides, soles, heels, and between the toes.
Wash your feet every day with lukewarm water and mild soap. Strong soaps may damage the skin.
Test the temperature of the water before putting your feet in, because the normal ability to sense hot temperature is usually impaired in people with diabetes. Burns can easily occur.
Gently and thoroughly dry the feet, particularly between the toes. Infections can develop in moist areas.
Because of skin changes linked with diabetes, the feet may become very dry and may crack, possibly causing an infection. After bathing the feet, soften dry skin with lotion, petroleum jelly, lanolin, or oil. Do not put lotion between your toes.
Ask your health care provider to show you how to care for your toenails. Soak your feet in lukewarm water to soften the nail before trimming. Cut the nail straight across, because curved nails are more likely to become ingrown.
Exercise daily to promote good circulation. Avoid sitting with legs crossed or standing in one position for long periods of time.
If you smoke, stop. It decreases blood flow to the feet.

TIPS ON SHOES AND SOCKS

Wear shoes at all times to protect your feet from injury. Otherwise, if you have poor vision and less ability to feel pain, you may not notice minor cuts or bumps.
Wear comfortable, well-fitting shoes. Never buy shoes that do not fit properly, expecting the shoes to stretch with time. Nerve damage may prevent you from being able to sense pressure from improperly fitting shoes.
Check the inside of your shoes for rough areas or torn pieces that can cause irritation.
Change your shoes after 5 hours of wearing during the day to alternate pressure points.
Avoid wearing thong sandals or stockings with seams that can cause pressure points.
Wear clean dry socks or non-binding panty hose every day. Socks may provide an extra layer of protection between the shoe and your foot.
Wear socks to bed if your feet are cold. In cold weather, wear warm socks and limit your exposure to the cold to prevent frostbite.

MORE HELPFUL TIPS

Avoid using antiseptic solutions on your feet since these can burn and injure skin.
Avoid applying a heating pad or hot water bottle to the feet. Avoid hot pavement or hot sandy beaches.
Report sores, changes, or signs of infection to your doctor immediately. Report all blisters, bruises, cuts, sores, or areas of redness.
Remove shoes and socks during visits to your health care provider. This is a reminder that you need a foot exam.
Make an appointment with a podiatrist to treat foot problems or to have corns or calluses removed. Never attempt to treat these yourself using over-the-counter remedies.
If obesity prevents you from being physically able to inspect your feet, ask a family member, neighbor, or visiting nurse to perform this important check.

References

American Diabetes Association. Standards of medical care in diabetes—2007. Diabetes Care. 2007; 30(Suppl.1):S4-S41.

American Diabetes Association. Standards of medical care in diabetes -- 2008. Diabetes Care. 2008;31:S12-S54.

Hunt D. Foot ulcers and amputations in diabetes. Clin Evid. 2006;(15):576-584.

American Diabetes Association (ADA). Standards of medical care in diabetes. IV. Prevention/delay of type 2 diabetes. Diabetes Care. 2007;30:S7-S8.

Inzuchhi SE and Sherwin RS. Type 2 diabetes mellitus. In: Goldman L and Ausiello D, eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 248.

Review Date:6/17/2008
Reviewed By:Elizabeth H. Holt, MD, PhD, Assistant Professor of Medicine, Section of Endocrinology and Metabolism, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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