Diabetes Health Center

When you have diabetes, your feet need extra care and attention. Diabetes can damage the nerve endings and blood vessels in your feet, making you less likely to notice when your feet are injured. Diabetes can also interfere with your body's ability to fight infection. If you develop a minor foot injury, it could become an ulcer or develop into a serious infection. Ulcers can be found on the bottom of your feet, or on the top or bottom of your toes. With good foot care, you can prevent most of these problems.

Caring for your feet is easy. Most of the care can be done when you are bathing and getting ready for bed. Preventing injury to your feet is merely a matter of wearing properly fitted shoes and socks at all times.

These steps can help keep your feet healthy:

• Examine your feet every day. And have your doctor examine your feet during every visit.
• Check your shoes for any loose objects or rough edges before you put them on.
• Look at foot care as part of your daily routine. Soon it will become as automatic as brushing your teeth.
• Don't use home remedies to treat foot problems. Home remedies can hurt your feet. Over-the-counter medicine designed to remove calluses could contain chemicals that could burn your skin. Also, trying to cut corns or calluses yourself could lead to infections.
• Get early treatment for any foot problem, even a minor one.

Because you have diabetes, your feet need special attention. One important way to care for your feet is to prevent injury by wearing shoes at all times, even when you are indoors. You can develop the habit of being cautious with your feet, avoiding anything that can cause possible injury, pain, or discomfort.

Good foot care also involves getting medical help early if a foot problem develops. Getting help for minor problems can prevent serious complications, such as infections.

Good foot-care habits

Caring for your feet when you have diabetes involves:

• Inspecting your feet daily. Every day, wash your feet and carefully inspect the skin for blisters, corns, calluses, cuts, cracks, or sores. Rub lotion on your feet, but not between your toes. Make sure your feet are completely dry before putting on socks and shoes. Keep your nails trimmed and filed straight across.
• Protecting your feet. Wear properly fitted shoes at all times to protect your feet from injury. Don't use a heating pad or hot water bottle to warm your feet.
• Having your doctor check your feet during each visit. Avoid trying to treat an early foot problem at home. Home remedies or treatments you can buy without a prescription (such as corn removers) can be harmful. Most foot problems need to be treated by your doctor.
• Getting early treatment for foot problems. A minor irritation can lead to a major problem if it is not properly cared for early.

You need to care for your feet because having diabetes for several years can:

• Damage the nerve endings in your feet. That means that you may not know when your feet are injured. Also, if your shoes don't fit properly, you may not feel any discomfort (even a blister). This nerve damage caused by diabetes in some people can lead to deformed feet that may not fit well into standard shoes.
• Damage blood vessels throughout the body. Damage to the vessels that carry blood to the feet and legs decreases blood flow to the feet. Small cuts, sores, and even ingrown toenails take longer to heal and are more likely to become infected because of the decreased blood flow to your feet.
• Affect your body's ability to fight infection. Even a small cut may become seriously infected because your immune system may not work as well as the immune system of someone who does not have diabetes.

The best way to avoid foot problems is to prevent them. That means taking care of your feet every day so that infections don't develop. If you develop good foot-care habits before you have foot problems, you will find it much easier to keep up the habit when you do have a problem.

You may not feel it when you have a small blister, cut, or scrape on your foot. If you check your feet every day, you'll find minor problems earlier. Have your doctor treat minor problems to prevent more serious ones later on.

Here's how you can get started caring properly for your feet.

1. Inspect your feet at least once a day. This is the most important part of your foot care. You can use a handheld mirror or magnifying mirror attached to the bathroom wall near the baseboard to inspect your feet. If you can't see well, have someone assist you. Use the checklist for daily foot exams.
2. Wash your feet daily. Post the steps for foot-washing and nail care in your bathroom. Refer to the steps when you wash your feet so that they become a habit. Make sure you dry your feet and toes well before putting on shoes and socks.
3. Wear shoes and socks that fit well. Soft shoes that have good support and that fit well (such as tennis shoes) are best for your feet. Use the checklist for shoes that fit well when you buy new shoes. Break in new shoes slowly by wearing them for a few hours each day and increasing the number of hours you wear them each week. Wear socks that do not have seams.
4. Protect your feet from injury. Before you put on your shoes, check for objects (such as pebbles) or rough spots inside your shoes or objects pushing through the soles. Inspect your feet for blisters, cuts, or scrapes after activities such as hiking or skiing. If you can't see well, have someone do this for you. Post the list of precautions to protect your feet when you have diabetes in your closet near your shoes.
5. Ask your doctor to check your feet during each visit. Your doctor may notice a foot problem you have missed. Take off your shoes and socks while you are waiting for your doctor. This will help remind your doctor to check your feet. Use the foot problems card to write down any minor problems or questions you may have about foot care, and take the card with you when you visit your doctor.
6. Get early treatment for foot problems. Call your doctor even for minor foot problems, unless you have already learned from your doctor how to handle these problems. Your doctor may refer you to a podiatrist or orthopedic surgeon if special treatment is needed. A serious problem can develop from what seems like a minor irritation. If a foot problem develops, you need to seek care early.

Now that you have read this information, you are ready to start caring properly for your feet.

Talk with your doctor

If you have questions about this information, take it with you when you visit your health professional. You may want to mark areas or make notes in the margins where you have questions.

If after reading this information you think you may have a foot problem that needs treatment, call your health professional for an appointment.

Some communities have foot-care clinics. Ask your health professional about foot-care clinics in your area.