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Diabetic Foot Care

What is diabetic foot care?

Diabetic foot care is a routine you do each day to protect your feet. Diabetes increases your risk of foot ulcers (wounds). Long-term high blood sugar levels can damage the blood vessels and nerves in your legs and feet. Foot care is needed to prevent serious problems, such as an infection or amputation.

Why is diabetic foot care important?

Diabetes may cause your toes to become crooked or curved under. These changes may affect the way you walk and can lead to increased pressure on your foot. The pressure can decrease blood flow to your feet. Lack of blood flow increases your risk for a foot ulcer. Do not ignore small problems, such as dry skin or small wounds. These can become life-threatening over time without proper care.

  • Neuropathy: You may have nerve damage in your feet that makes it difficult to feel touch, pressure, pain, and temperature. You may not be able to feel when your footwear is too tight. You may also not be able to feel a cut or sore on your foot. Even a small cut or scratch can become an ulcer. Diabetic foot ulcers do not heal well and are hard to treat.

  • Peripheral vascular disease (PVD): PVD decreases blood flow to your feet and slows healing. You may have an increased risk of infection if you have PVD.

  • Retinopathy: Problems with your vision may make it hard for you to see problems with your feet.

How do I care for my feet?

  • Check your feet: Look at your whole foot, including the bottom, and between and under your toes. Check each day for wounds, corns, and calluses. The skin on your feet may be shiny, tight, or darker than normal. Your feet may also be cold and pale. Feel your feet by running your hands along the tops, bottoms, sides, and between your toes. Redness, swelling, and warmth are signs of blood flow problems that can lead to a foot ulcer. Do not try to remove corns or calluses yourself.

  • Wash and dry your feet carefully: Wash your feet each day with soap and warm water. Do not use hot water, because this can injure your foot. Dry your feet gently with a towel after you wash them. Dry between and under your toes.

  • Moisturize your feet: Use lotion or a moisturizer after you wash and dry your feet. Do not put lotion or moisturizer between your toes. Ask your healthcare provider what to use.

  • Cut your toenails correctly: File or cut your toenails straight across. Use a soft brush to clean around your toenails. If your toenails are very thick, you may need to have a healthcare provider or specialist cut them.

  • Protect your feet: Do not walk barefoot or wear your shoes without socks. Check your shoes for rocks or other objects that can hurt your feet. Wear cotton socks to help keep your feet dry. Wear socks without toe seams, or wear them with the seams inside out. Change your socks each day. Do not wear socks that are dirty or damp.

How are diabetic foot problems diagnosed?

  • Foot exam: Your healthcare provider will check your feet for wounds and for any changes in how they look or move. He will look at your shoes to see if they fit you well.

  • Monofilament test: Your healthcare provider will press a small wire against the bottoms of your feet until the wire bends. If you cannot feel the wire, you may have nerve damage.

  • Ankle brachial index: This test checks blood pressure in your ankle. It can help to test how well your blood is flowing to your feet.

How are diabetic foot problems treated?

  • Cast: A cast protects your foot from injury.

  • Foam bandages: Your healthcare provider may wrap one or both of your feet in a cushioned bandage.

  • Insoles: Insoles are pads or cushions that are put inside your shoes to help protect your feet.

  • Orthotics: Orthotics are foot braces that help decrease pressure.

  • Diabetic footwear: Your healthcare provider may have shoes made for you if you have foot deformities.

  • Walking aids: These include canes, crutches, walkers, and wheelchairs.

  • Surgery: Surgery may be done to fix foot deformities, and to increase the blood flow to your feet.

What can I do to help prevent diabetic foot problems?

  • Check your blood sugar level: Keep your blood sugar steady to decrease your risk for foot ulcers. Your healthcare provider will tell you what your blood sugar level should be and how often to check it. You may need to check at least 3 times each day. Keep a record of your blood sugar levels with the date and time that you checked them. Your healthcare provider may want to review your record during follow-up visits.

  • Take your medicine as directed: Your healthcare provider may give you medicine to keep your blood sugar level steady. You may also have medicine to help treat your nerve damage, or other health problems. Keep a list of the medicines you take. Do not stop taking your medicines unless you ask your healthcare provider.

  • Create a meal plan: Your dietitian will help you create a meal plan. Your plan will have the right amount of calories and nutrition for you. Good nutrition will help control your blood sugar levels and help prevent foot problems.

  • Quit smoking: If you smoke, it is never too late to quit. Smoking increases your risk for diabetic foot problems. Smoking can also slow healing if you get a foot ulcer. Ask your healthcare provider for information if you are having trouble quitting.

  • Exercise: Your healthcare provider may suggest an exercise plan for you to help prevent any serious conditions caused by your diabetes. You will need to do activities that do not make a foot ulcer worse.

  • Wear shoes that fit well: Wear shoes that do not rub against any area of your feet. Your shoes should be ½ to ¾ inch (1 to 2 centimeters) longer than your feet. Your shoes should also have extra space around the widest part of your feet. Walking or athletic shoes with laces or straps that adjust are best. Ask your healthcare provider for help in choosing shoes that fit you best.

When should I contact my healthcare provider?

  • Your blood sugar level is higher or lower than healthcare providers have told you it should be.

  • You see blisters, cuts, scratches, calluses, or sores on your foot.

  • You have a wound on your foot that gets bigger, deeper, or does not heal.

  • Your toenails become thick, curled, or yellow.

  • You find it hard to check your feet because your vision is poor.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • Your feet become numb, weak, or hard to move.

  • You have pus draining from a sore on your foot.

  • Your feet become red, warm, and swollen.

  • You have a fever.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.