Key points:
- If you have diabetes, it's especially important to take care of your feet. Diabetes causes nerve damage that puts you at higher risk of foot complications.
- Warning signals can include anything from redness, calluses and cracks to numbness and signs of infection.
- To avoid foot problems, check your feet daily, take care of any issues immediately, and involve your health care team.
If you have diabetes, your feet are at risk. Diabetes can reduce blood flow to your feet, and nerve damage may make it harder to feel an injury. This means that a minor injury may not heal properly and can become infected. While the responsibility for protecting your feet is yours, your team of health professionals must also be involved in preventing serious foot problems.
Good blood glucose control is the starting point in preventing foot injury and any other complication related to diabetes. Beyond that, knowing how to care for your feet will help prevent issues.
Daily foot checks
- To care for your feet, first look at them carefully.
- You can use a mirror to see the bottom of your feet.
Has your foot changed shape? Do you feel pins and needles or numbness in your feet? These early signs of diabetic neuropathy (change in sensation) indicate that you should have your sensation tested. A podiatrist (foot care specialist), foot care nurse or family doctor can do this for you. Lack of sensation confirms that you are at greater risk of injury.
Loss of feeling in your feet
If you do find numb areas, these actions can keep your feet healthy.
- Do not use a heating pad or hot water bottle. Reduced sensation in your feet means you might burn yourself and not realize it until an injury has occurred.
- Do not use your foot to check bathwater temperature.
- Avoid using chemicals like corn or wart removers. Your doctor should remove any corns or warts.
Socks and shoes
- Wear socks without elastic tops. Be careful that sock seams do not rub your feet, as this can cause blisters. Change into a clean pair of socks every day.
- Wear shoes and avoid walking barefoot. Always wear footwear, even in the house. If you step on something and cut yourself, you may not feel it.
- Pick up your shoes and shake them out before putting them on. This reduces the chance of walking with a pebble or object in your shoe that might cause injury.
- If the shape of your feet has changed, have your shoes fitted by a professional. Over-the-counter insoles are not a good idea. If they do not fit properly, they can cause blisters.
Mid-afternoon is the best time to be fitted. At this time of day, your feet will be slightly swollen and at their largest. You will be less likely to buy shoes that will pinch. Correct measurements are important. Your shoes should be long enough that your toes do not press against the end of the shoe. As well, leave enough room (depth) so your toes do not rub against the top of the shoe. Over time, people living with diabetes often find that their toes begin to curl upward. Be sure that the toe area of your shoe allows extra space.
If you need special shoes, check the internet, or look in your phone book for suppliers. Call ahead to be sure a pedorthist or orthotist in the store can professionally fit the shoes. Some provinces have government programs that offer this service at a subsidized rate. Ask your doctor, pharmacist, or diabetes care provider for more information, or look on your provincial health department website.
Regular foot exams
Look after your toenails.
- Regular trimming reduces the chance of injury and foot problems.
- Trim nails straight across to reduce the risk of ingrown toenails.
- If your toenails are thick, your care provider can use the right tools to cut your nails without having to soften them in water.
Do not soak your feet. This dries out the skin and increases the possibility of skin cracks, especially at the heels.
Diabetic foot care
A professional foot care provider can help with caring for your feet, especially if your eyesight is poor.
More tips
- Exercise moderately and regularly.
- Limit smoking, or quit if you can. Smoking reduces the blood flow to your feet. Talk to your doctor or pharmacist about methods to help.
A number of nursing agencies and service groups offer professional nail care. Ask your diabetes care provider, search the internet or consult your local phone listing for nursing agencies.
Looking carefully at your feet is the most important thing you can do to care for them. Remember, you are your own first line of defense against injury. Have any sores, cuts or cracks in your feet checked as quickly as possible by a health care professional. Have questions? A qualified health professional can provide answers about how to avoid diabetes-related foot problems.
For more information
Diabetes Canada
www.diabetes.caWounds Canada
www.woundscanada.caLower Extremity Amputation Prevention (LEAP)
www.hrsa.gov/hansens-disease/leap
WRITTEN BY: Donna Flahr, RN, BSN, MSc, a skin and wound educator, and consultant in the Saskatoon Health Region
Reviewed and updated by Joanne Mitchell, CDE, a community pharmacist from Sobeys in Marystown, NL
