Foot Care Guidelines for People with Diabetes

The slightest footsore, blister, or bug bite in people with diabetes can quickly result in long stretches of hospitalization with a dangling end result of an amputated limb. Diabetic foot problems are characterized by neuropathy, infection, and ischemia.   

Foot ulcer is common, estimated to affect about 15 percent of all patients with diabetes, with about 20 percent of the cases proceeding to amputation.  Peripheral sensory neuropathy and peripheral vascular disease are the two largest factors of foot ulcer risk.   

The reason why amputation counts are high, is because of late presentation of foot problems by diabetes patients and ignorance of diabetic foot care. Circulation problems, infections, and nerve damage can also cause serious foot problems in diabetics. For this reason, experts recommend daily foot care for people with type 1 and 2 diabetes.   

Maintain a Healthy Lifestyle 

Following a proper foot care regimen and observing a healthy lifestyle can help your feet to stay healthy. That includes: 

• Monitoring your blood sugar every day 
• Regular medical exams 
• Daily foot checks 
• Monitoring your ABCs (A1c, blood pressure, and cholesterol)
• Regular exercise 
• Eating a balanced diet 

If you have diabetes and your feet are cold, numb or prone to infections or your toes are sore and tingly, you could be suffering from a diabetes-related foot problem.  

Daily Foot Care Routine 

The following are some of the foot care habits people living with diabetes need to adapt to ensure their feet are in good health 

1. Foot Check Regimen

Take off your shoes and socks and inspect every part of your feet including the top and bottom of your toes. If you have trouble seeing the back of your feet, ask a friend to hold the mirror for you. Check for the following: 

• Dry cracking skin 
• Calluses and corns 
• A change of temperature or color 
• Athletes foot or rashes 
• Signs of infection, pain, or swelling 
• Ingrown toenails, blisters, or a rubbed area by your shoe 

Should you discover any redness, blisters, cuts, bruises, or sores, and suffer from diabetes type1 or 2, report to your doctor immediately.  

2. Protect your Feet and Toe Nails

The feet of a diabetic person should be washed every day with warm water and mild soap. Harsh soaps and hot water can damage your sensitive skin. Dry your feet gently including between your toes using a soft towel. Before dipping your feet in the water, test its temperature using your elbow or fingers. Diabetes can result in neuropathy which can make it hard for you to determine the heat of the water with your feet.  

Identify a moisturizer brand right for your skin and rub it in gently after drying your feet. The moisturizer should prevent cracking and drying. However, do not use any lotion between your toes. Lotion can trigger athlete’s foot infections in people with diabetes.   

With the help of enough lighting, trim your toenails slightly above the skin without rounding the corners to prevent the risk of an ingrown toenail. However, if you are not confident about cutting, your doctor can help you trim them including calluses and corns. Understand that nerve problems, visual incapacity, and circulatory issues in the feet may make it unsafe to trim your toes.  

Foot Habits to Observe 

The right foot care habits can help you maintain the health of your feet in a diabetic condition. Some of the healthy ideas to observe include: 

• Avoiding a heating pad, electric blanket, and hot water bottle to keep your feet warm 
• Keeping off antiseptic solutions without the approval of your healthcare provider 
• Protecting your feet from cold and hot conditions 
• Avoiding walking barefoot 
• Not sitting down with your legs crossed or standing in one position for extended periods

Find the Right Shoes and Socks 

Your shoes must fit comfortably. Avoid wearing flip flops, open-toe and pointed–toe shoes, high-heels, tight shoes hoping they will stretch with time, and walking barefoot. Your feet can only be protected from damage if you wear shoes that fit well together with dry socks. When looking for footwear, choose comfort. Your feet should be measured carefully in an athletic or comfort shoe store.  

Materials that do not allow your skin to breathe, such as plastic should be avoided. The best choices for a diabetes patient are natural fibers and leather. Your footwear must be inspected before wearing for a torn lining, stuck nails, and tacks. A podiatrist specializing in diabetic foot care may be recommended, or your doctor could advise you to wear special shoes for cases with advanced foot problem.  

Diabetes socks should help in creating an extra layer of soft protection. They should, however, be dry, clean, or non-binding pantyhose. The best socks for a person living with diabetes have no seams. Seams cause additional pressure points and tend to rub the skin, causing the skin to tear. If your feet are cold at night, you can wear regular socks but avoid compression stockings. Compression socks should only be worn during the day and taken off when going to bed. 

Early Warning Signs of Foot Problems 

• Lost sensation to cold, touch, or heat 
• Painful or tingling feet 
• Loss of hair in the lower legs 
• Change of color in the feet 
• Ingrown toenails, red spots, sores, and blisters 

Should these signs be noticed, consult your doctor immediately to prevent the occurrence of serious foot problems. Your doctor will inspect your feet for nerve damage, deformations, skin changes, and circulatory problems.  

Diabetes Complications

Diabetic people are at risk of developing foot problems resulting from neuropathy and poor circulation. Neuropathy (nerve damage) results in a lack of feeling in the feet, meaning a diabetic patient with this problem does not feel pain and lacks the ability to detect an injury. Elevated blood glucose levels can damage the nerves creating callused pressure points which could then injure soft tissue, joints, bones, and the skin.   

With poor circulation, the healing process is delayed making it tough for the feet to resist infection. Your doctor should, however, help in the prevention of amputation. Today, many surgical techniques can be applied, including wound healing technologies and joint reconstruction to save your feet. Seeking immediate medical attention the moment you notice a problem with your feet can halt the advancement of small foot problems.  

People living with diabetes are at a high risk of developing foot complications including bunions, gangrene (death and decay of tissue), and other foot deformities ranging from a surface wound to deep infections. Even a simple problem, such as a cut could quickly get worse and lead to amputation. Sometimes, even with prompt treatment and preventative care, infections and serious complications could occur. The complication could result the removal of the infected tissue, or even an amputation to save a limb.