Guidelines for diabetic foot and toe care
The American Diabetes Association recommends that any person diagnosed with diabetes should have a thorough foot examination annually. Depending on that examination, patients with diabetes may require more frequent foot exams if they have signs of complications in their feet from diabetes. A podiatrist is the best physician to assess your risk for diabetic foot complications.
How does diabetes affect my feet?
Diabetes causes blood sugar levels to be higher than normal and to fluctuate up and down. Over time, this can damage nerves, blood vessels, skin cells, and the soft tissue in your body. Your feet can develop serious ulcers or foot infections, leading to amputation of part or all of the foot. Diabetes can also cause other complications.
Download our diabetic foot care pdf for more information.
- Foot nerve damage may cause burning, tingling, pain and, in severe cases, complete numbness of the feet. This is called peripheral neuropathy. If you can’t sense pain in your feet, you’re much more likely to injure yourself without even knowing it.
- Blood vessels can be damaged from increased plaque that forms within the vessels of the legs. This is called peripheral artery disease or PAD. PAD leads to decreased blood flow of the feet, which can make wounds slow to heal.
- Peripheral neuropathy also may affect the muscles in the feet. Skin and soft tissue cells can become less elastic; joints can become rigid and have decreased motion. These complications lead to structural foot deformities. Structural deformities often create areas of increased pressure on the skin. These areas are the most likely to break down and cause an ulcer (wound).
If circulation in your feet is impaired, symptoms can include:
- Cold feet
- Foot numbness
- Hair loss on your feet
- Blue skin on your legs
- Dry or cracked skin on your feet or legs
- Brittle toenails
- Slow-healing wounds or sores
How can I avoid diabetic problems with my feet?
The most important step in preventing any kind of diabetes-related complication is keeping your blood sugar level as close to normal as possible. Follow your doctor’s advice on diet, exercise, and medicine.
Follow these tips to protect your feet:
- Inspect your feet daily. Check for blisters, cuts, redness, swelling, or nail problems. Use a magnifying glass or mirror if necessary to see the bottom of your feet. Have someone else inspect your feet if you can’t. Call your doctor if you notice any problems.
- Be extra gentle when caring for your feet. Don’t use any chemicals or strong antiseptic solutions on your feet. Iodine, salicylic acid, and corn/callus removers are dangerous. Don’t use any tape or sticky products such as corn plasters on your feet. They can rip your skin.
- Wash your feet in lukewarm (NOT HOT) water. Keep your feet clean by washing them daily, using only lukewarm water. Use the water temperature you would use for a newborn baby. You should check the water with your hands or elbow, or have someone else check the temperature if you have neuropathy. And ask your doctor before soaking your feet.
- Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting, and make sure to carefully dry between the toes.
- Never walk barefoot, not even at home. You could step on something and cut your feet.
- Moisturize your feet, but NOT between the toes. Use a moisturizer daily to keep the skin from itching or cracking. DO NOT moisturize between the toes. If you have questions as to which moisturizer to use, ask your podiatrist.
- Have your podiatrist cut your nails.
- Never trim corns or calluses. Home surgery may lead to injury, wounds, or infection. If you develop calluses, let your doctor take care of them.
- Wear clean, dry socks. Change them daily.
- Avoid the wrong type of socks. Avoid tight elastic bands because they reduce circulation. Don’t wear thick or bulky socks. They can fit poorly and irritate the skin. If you would like ADA-approved diabetic socks, ask your doctor. We have them for sale at our office.
- Wear socks to bed if your feet get cold. NEVER use a heating pad or hot-water bottle, as you could burn your feet.
- Inspect your shoes inside and out before wearing. Remember, you may not feel a pebble or other object in your shoe, so always shake them out before putting them on.
- Don’t smoke! Smoking restricts blood flow in your feet. Many people with diabetes already have decreased blood flow in their feet, and smoking makes it much worse.
- Take care of your diabetes. Keeping your blood sugar under good control helps reduce the incidence and delay the onset of all diabetes-related complications and helps protect your feet. You should know your hemoglobin A1c level. This allows your doctor to evaluate your blood sugar control. If you do not know yours, ask your endocrinologist or primary care doctor at your next visit.