Tips for Taking Care of Your Feet When You Have Diabetes

Diabetes mellitus is a common disease that affects your body's ability to regulate blood sugar. Roughly 11.3% of Americans have some form of diabetes. Diabetes causes your body to not make enough insulin, a hormone important for regulating your blood sugar. Insulin helps sugar move from your blood into muscles and other parts of the body where it can be used. Blood sugar levels can become dangerously high without insulin; over time, this can lead to nerve damage called diabetic neuropathy, which commonly affects the feet and legs.

Diabetic neuropathy can affect different nerves throughout your body, but some commonly affected nerves control sensation in your legs and feet. The loss of sensation in your feet can mean you might not always know when you have an injury or infection that needs medical attention, so what starts as a small cut or blister could turn into something much more serious.

Fortunately, there are many ways you can reduce your risk of complications due to diabetic neuropathy, including maintaining proper hygiene, wearing well-fitted shoes, and regularly checking your feet for injuries.

Why Is Foot Care Important for People with Diabetes?

Foot care is important to both prevent injuries and treat them as soon as they arise. People with diabetes are at an increased risk of getting foot wounds called diabetic foot ulcers and experiencing complications such as infection and amputation due to those wounds. It is estimated that around 15 to 25% of people with diabetes mellitus will have a diabetic foot ulcer during their lifetime.

Because of nerve damage caused by diabetic neuropathy, people with diabetes may not notice a cut or injury on the foot right away, allowing it to become infected. The neuropathy may also make it so that someone with diabetes continues to engage in behaviors that can worsen a wound. For example, someone without neuropathy would notice they were developing a blister and place a bandaid over it or change shoes whereas someone with neuropathy would not feel the blister forming and continue walking.

Diabetes also inhibits wound healing due to a few medical reasons. People with diabetes are two times more likely than the general population to have peripheral artery disease (PAD), a condition that constricts blood flow to the arms and legs. Proper blood flow is an important part of healing, so reduced blood flow can mean delayed healing.

Additionally, those with diabetes whose blood sugar is not well controlled are at particular risk for poor wound healing. High levels of sugar in the blood can have multiple negative effects, including stiffening blood vessels. This can slow circulation and impair how well white blood cells respond to wounds.

How to Care For Your Feet When You Have Diabetes

The idea of being at risk for diabetic foot ulcers can feel overwhelming, but there are many steps you can take to reduce your chances of developing one.

Check and Wash Your Feet Daily

Make sure you inspect all sides of your feet daily to look for new redness, cracks, blisters, or injuries that you may not be able to feel. If you are not able to see all angles of your feet due to mobility or other issues, you can use a mirror to help you see them or ask someone in your inner circle to help.

Washing your feet daily can also help keep your feet healthy. Be sure to check the temperature of the water with your hand or thermometer so that it is warm but not hot, especially if you have diabetic neuropathy. When washing, make sure you clean your whole foot but do not soak it. Once your foot is clean, dry it completely. Apply lotion to the top and bottom, but not in between the toes as that can increase your risk of infection.

Wear Proper Footwear

It is important to wear proper footwear at all times to prevent injury. You should never go barefoot, even inside, as you could step on something sharp and injure yourself without even knowing it.

It is also important that the shoes you wear fit well. Avoid shoes that are tight that you think you'll "wear into" or shoes that pinch your toes together. When you buy new shoes, break them in slowly by wearing them for short periods daily.

When putting on your shoes, check to make sure there are no pebbles or other objects stuck in them that could rub on your feet, and ensure the lining is smooth.

Take Care of Your Nails

People with diabetes should keep their toenails trimmed short enough that they do not snag on shoes or socks and risk being ripped. You should also trim your nails straight across to reduce the risk of cutting to the quick and causing an injury. Sharp ends of the nails may be dulled with a nail file. If you cannot see or reach your feet you should have a podiatrist (a doctor specializing in foot care) help you.

Encourage Blood Flow

You can encourage blood blow by wiggling your feet and toes for several minutes intermittently throughout the day. When you are seated, put your feet up when you can to encourage blood in your feet to flow back towards your heart.

See Your Provider Regularly

Your healthcare provider will inspect your feet to make sure they are healthy. If you have any corns or calluses, you should bring that up with your podiatrist and not try to remove them (even mild cases) at home. Your healthcare provider can also provide education on what activities are best to protect your feet and more tips for how to keep your feet healthy.

When to Contact a Healthcare Provider

When you have diabetes it is important that you see your healthcare provider regularly. However, if you have any of the following symptoms you should reach out to see your primary healthcare provider or podiatrist as soon as possible:

• You have a cut, blister, ingrown toenail, crack or bruise on your foot that does not begin healing within a few days
• Any part of your foot becomes red, hot, swollen, and tender—this could be a sign of infection
• An existing foot infection does not begin to improve with antibiotics, or it becomes black and has a foul odor—this could be a sign of gangrene (tissue death)
• You have a fungal infection like athlete's foot, especially between the toes
• Your toenails are becoming yellow and thickened
• You find a callus with dried blood inside it, which could indicate a wound forming underneath
• You notice the shape of your foot changing over time
• You notice hair loss on your legs or feet or a change in the temperature of your feet
• You lose the ability to feel the sense of touch or have a diminished sensation of touch on your feet
• You have a new loss of the ability to feel hot or cold with your feet
• You feel tingling or burning pain in your feet
• You experience cramping in your thighs, calves, or buttocks during exercise or movement

A Quick Review

Diabetes mellitus is a common disease that affects your body's ability to regulate blood sugar. Well-known complications of diabetes include risk for diabetic foot ulcers and poor wound healing, which can result in serious infection and amputation.

While it can be overwhelming to think about being at increased risk for these complications, there are many things you can do to keep your feet healthy. Habits like daily foot checks and washes, regular healthcare appointments, and proper nail care are just a few steps you can take to care for your feet.