Diabetes and Foot Care
Foot care amongst diabetics is incredibly important as foot related complications are common for those of us with diabetes.
Foot ulcers for example, which affect as many as 1 out of 10 people with diabetes, can all to easily develop from blisters and small wounds to posing a threat of amputation.
Even small ulcers on the foot can represent a serious risk: they may heal extremely slowly and need rigorous treatment to cure.
Ulcers can develop into serious lower body infections, with the possibility of amputation at an advanced stage.
Caring for your feet
Caring for your feet as a diabetic should not be difficult, and should be a prime consideration.
This section details complications that may affect the diabetic foot, and some methods and information about care.
Why should I be so careful?
The presence of high blood glucose levels over a long period of time may result in damage to the blood vessels and nerves of the feet which raises the risk of developing serious foot problems.
Diabetic neuropathy is the name for nerve damage that can develop over time as a result of diabetes. The feet are often the first part of the body to be affected and this can cause a loss of sensation (numbness) in the feet.
If nerves in the feet get damaged, it means that we can easily suffer damage to our feet and not know about it. An additional problem is that high blood glucose or reduced blood circulation can cause any wounds or damage to heal more slowly.
For this reason, if you do not regularly check your feet, you may not be able to feel foot problems until they have developed into a more serious problem.
Check feet every day
Foot care can be likened to dental care for our teeth in a way, as they should both be carried out each day.
The goal of foot care is to examine your own feet for the slightest sign of ulcers or problems.
This is important for all of us, particularly if you are suffering from poor circulation or numbness in your feet. If you spot any signs of damage or significant changes in your feet, it’s important to notify your doctor.
Ensure any cut, graze or break of skin is protected from possible infection and notify your doctor additional advice can be given where appropriate.
Dry skin is also another problem to be aware of as if dry skin starts to crack, it too can lead to foot ulceration.
- Read more on how to check your feet
Attend foot examinations
Making sure that you receive regular foot examinations from a health professional is essential as your doctor or podiatrist may be able to spot signs of or risk of damage and prevent foot problems from occurring, sometimes before they happen.
In this way, any problems will be detected at an early stage, and treatment should be relatively simple and painless.
Wear appropriate footwear
Our choice of footwear can be an important factor in whether our feet stay complication free. Badly fitting shoes are widely thought to be a cause of a number of the early stages of foot problems as they can cause problems ranging from blisters and corns through to increasing the risk of foot deformation and the development of foot ulcers.
In some cases, you may benefit from specialist footwear. Our guide to footwear for diabetes helps you through making appropriate footwear choices and explaining the different types of specialist shoes available.
Some socks are better than others for people with diabetes. The general rule is to avoid tight fitting socks and those with elasticated cuffs and/or prominent seams.
- Find out more about sock choices for diabetes
Cleaning your feet
It’s advisable to wash your feet every day as this will reduce the chance of infection should your feet suffer damage. Ensure your feet get washed with warm, but not hot, water and soap or a shower gel. Dry your feet well, particularly between the toes to prevent any fungal infections.
Caring for your nails
Your nails should be cut regularly. Use an emery board to file off any sharp corners. Do not use anything sharp to clear any dirt from under your nails as this could cause damage to your foot. Instead use a nail brush.
If you notice a change of colour in your nails or a thickening or deterioration of your nails, contact your doctor for advice.
If it is difficult for you to cut your own nails, your doctor or podiatrist can arrange for you to have your nails clipped.
When checking your feet you will be looking for signs of damage and looking for any signs that may indicate any loss of sensation or blood circulation in the feet.
Diabetes is the highest cause of amputations in the UK which is why it is important to check your feet daily and notify your health team of any signs of damage. When speaking to your health team, ensure that they know you have diabetes. If you cannot check your feet, ask someone to check your feet for you.
Check your feet for any signs of damage including:
If you have signs of foot damage, Diabetes UK advise seeking immediate advice from your health team. If your foot damage is treated in the wrong way, or left untreated, it could lead to more serious damage occurring.
Check your feet for ingrown toenails, corns, and calluses. These can lead to infections setting in and so it’s important that these are treated correctly. Contact your health team for advice on how these conditions should be treated.
Nerve damage is a relatively common complication of diabetes which is important to diagnose as it can lead to foot problems developing. Signs of nerve damage include:
- A tingling or pins and needles feeling in the feet or legs
- A burning or hot sensation in the feet
- Feet sweating less than usual
Contact you doctor if you experience any of these symptoms.
As with nerve damage, poor blood circulation can also lead to a higher chance of developing foot problems.
Signs of loss of blood circulation include:
- Cold or pale feet
- Thickened toe nails
- Loss of hair on your feet or legs
- Experiencing cramp in your calves
If you notice these signs, notify your doctor.
Seek advice before commencing home treatment
Whilst some treatments, such as protecting wounds with plasters or bandages, is advised, there are a number of home treatments for other foot problems, such as verrucas, which are available from pharmacies but should not be used by people with diabetes unless recommended by your health team.
The reason for this is that some of these treatments can cause damage to the skin and therefore pose a health risk for those of us with diabetes.
Keeping feet moisturised
Normal skin lubrication may become impaired by diabetes, particularly if you have neuropathy, causing the feet to become dry and this could then lead to cracked skin. If skin on the feet starts to crack, this ups the chance of developing a foot ulcer or wound infection which can often be serious.
Regularly moisturising your skin with an emollient cream will help protect your skin from becoming too dry and can therefore reduce the chances of developing diabetic foot ulcers.
Note that it’s generally advisable not to use moisturising cream between the toes as this could raise the risk of developing a fungal infection such as athlete’s foot.
Manage your diabetes
If you can work towards controlling your diabetes, you are less likely to suffer from foot complications, such as foot ulcers.
Maintaining a healthy diet, taking regular exercise and, particularly for people with type 1 diabetes, being able to count carbohydrate values and adjust insulin doses.
Exercise and foot care
Research indicates that exercise is beneficial for increasing blood circulation and may help to reduce symptoms of peripheral arterial disease, a condition which leads top restricted blood flow to the legs and feet.
Helping to improve blood circulation in this way can therefore be helpful as a preventative measure against slow healing of wounds and the other foot complications that can be a consequence of poor circulation.