Diabetic Foot Care Guidelines
Do you want to avoid serious foot problems that can lead to a toe, foot or leg amputation? Keeping your blood glucose (sugar) in good control and taking care of your feet every day can help you avoid serious foot problems.
Foot care is very important for each person with diabetes, but especially if you have:
• Loss of feeling in your feet (Diabetic Peripheral Neuropathy)
• Changes in the shape of your feet
• Foot ulcers or sores that do not heal
Nerve damage can cause you to lose feeling in your feet. You may not feel a pebble inside your sock that is causing a sore. You may not feel a blister caused by poorly fitting shoes. Foot injuries such as these can cause ulcers, which may lead to amputation.
There is a lot you can do to prevent serious problems with your feet. Here’s how:
Take Care of Your Diabetes
• Make healthy lifestyle choices to help keep your blood glucose (sugar), blood pressure and cholesterol close to normal. Doing so may help prevent or delay diabetes-related foot problems as well as eye and kidney disease.
• Work with your health care team to make a diabetes plan that fits your lifestyle. The team may include your doctor, a diabetes educator, a nurse, a dietitian, a foot care doctor called a podiatrist and other specialists. This team will help you to:
• Know when to get checks of your A1C*, blood pressure and cholesterol
• Know how and when to test your blood glucose
• Take your medicines as prescribed
• Eat regular meals that contain a variety of healthy, low-fat, high-fiber foods including fruits and vegetables each day
• Get physical activity each day
• Stop smoking
• Follow your foot care plan
• Keep your doctor’s visits and have your feet, eye and kidneys checked at least once a year
• Visit your dentist twice a year
*A1C is a measure of your blood glucose over a three-month period.
Check Your Feet every Day
• You may have serious foot problems, but feel no pain. Check your feet for cuts, sores, red spots, swelling and infected toenails. Find a time (evening is best) to check your feet each day. Make checking your feet part of your every day routine.
If you have trouble bending over to see your feet, use a plastic mirror to help. You also can ask a family member or caregiver to help you.
Make sure to call your doctor right away if a cut, sore, blister or bruise on your foot does not begin to heal after one day.
Wash Your Feet Every day
• Wash your feet in warm, not hot, water. Do not soak your feet, because your skin will get dry. Before bathing or showering, test the water with your fingers to make sure it is not too hot. You can also use a thermometer (90° to 95° F is safe) or your elbow.
• Dry your feet well. Be sure to dry between your toes. Use talcum powder or cornstarch to keep the skin between your toes dry.
keep the Skin Soft and Smooth
• Rub a thin coat of skin lotion, cream or petroleum jelly on the tops and bottoms of your feet.
• Do not put lotion or cream between your toes, because this might cause an infection.
Smooth Corns and Calluses Gently
• If you have corns and calluses, check with your doctor or foot care specialist about the best way to care for them.
• If your doctor tells you to, use a pumice stone to smooth corns and calluses after bathing or showering. A pumice stone is a type of rock used to smooth the skin. Rub gently, only in one direction, to avoid tearing the skin.
• Do not cut corns and calluses. Don’t use razor blades, corn plasters, or liquid corn and callus removers — they can damage / burn your skin, leading to infection.
Trim Your Toenails Each Week or When Needed
• Trim your toenails with clippers after you wash and dry your feet.
• Trim toenails straight across and smooth them with an emery board or nail file.
• Don’t cut into the corners of the toenail.
If you can’t see well, if your toenails are thick or yellowed, or if your nails curve and grow into the skin, have a foot care doctor trim them.
Wear Shoes and Socks at all Times
• Wear shoes and socks at all times. Do not walk barefoot — not even indoors — because it is easy to step on something and hurt your feet.
• Always wear socks, stockings or nylons with your shoes to help avoid blisters and sores.
• Choose clean, white color, lightly padded socks that fit well. Socks that have no seams are best.
• Check the insides of your shoes before you put them on to be sure the lining is smooth and that there are no objects in them.
• Wear shoes that fit well and protect your feet. Avoid wearing open toe shoes.
Protect Your Feet From Hot and Cold
• Wear shoes at the beach or on hot pavement.
• Put sunscreen on the top of your feet to prevent sunburn.
• Keep your feet away from radiators and open fires.
• Do not put hot water bottles or heating pads on your feet.
• Wear socks at night if your feet get cold. Lined boots are good in winter to keep your feet warm.
Check your feet often in cold weather to avoid frostbite.
keep the Blood Flowing to Your Feet
• Wiggle your toes for five minutes, two or three times a day. Move your ankles up and down and in and out to improve blood flow in your feet and legs.
• Don’t cross your legs for long periods of time.
• Don’t wear tight socks, elastic or rubber bands, or garters around your legs.
• Don’t smoke. Smoking reduces blood flow to your feet. Ask for help to stop smoking.
Work with your health care team to control your A1C (blood glucose), blood pressure and cholesterol.
Be More Active
• Ask your doctor to help you plan a daily activity program that is right for you.
• Walking, dancing, swimming, and bicycling are good forms of exercise that are easy on the feet.
• Avoid activities that are hard on the feet, such as running and jumping.
• Always include a short warm-up and cool-down period.
Be Sure to Ask Your Doctor To:
• Check the sense of feeling and pulses in your feet at least once a year.
• Tell you if you are likely to have serious foot problems. If you have serious foot problems, your feet should be checked at every visit to your doctor.
• Show you how to care for your feet.
• Refer you to a foot care doctor if needed.
• Decide if special shoes would help your feet stay healthy.
Tips for Proper Footwear
Proper footwear is very important for preventing serious foot problems.
• Athletic or walking shoes are good for daily wear. They support your feet and allow them to “breathe.”
• Never wear vinyl or plastic shoes, because they don’t stretch or “breathe.”
• When buying shoes, make sure they are comfortable from the start and have enough room for your toes.
• Don’t buy shoes with pointed toes or high heels. They put too much pressure on your toes.
Ask your doctor about Medicare or other insurance coverage for special footwear.
You may need special shoes or shoe inserts to prevent serious foot problems. If you have Medicare, you may be able to get some of the cost of special shoes or inserts paid for. Ask your doctor whether you qualify for:
• 1 pair of depth shoes* and 3 pairs of inserts, or
• 1 pair of custom molded shoes (including inserts) and 2 additional pairs of inserts
If you qualify for Medicare or other insurance coverage, your doctor or podiatrist will tell you how to get your special shoes.
* Depth shoes look like athletic or walking shoes, but have more room in them. The extra room allows for different shaped feet and toes, or for special inserts made to fit your feet.
American Association of Diabetes Educators
American Diabetes Association
American Podiatric Medical Association
National Diabetes Education Program
National Institute of Diabetes and Digestive and Kidney Diseases
National Diabetes Information Clearinghouse (NDIC)
Source: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health