Safeguarding Diabetic Feet

Even a small foot problem can become serious if you have diabetes. High blood sugar over time can damage the nerves and blood vessels in your feet, making it harder to feel injuries or heal from. This means a tiny cut or blister might go unnoticed until it gets infected. It’s no surprise, then, that people with diabetes are at higher risk for foot ulcers and even amputations than those without diabetes. In fact, about 12% of people with diabetes will develop a foot ulcer during their lifetime. The good news is that most diabetes-related foot complications are preventable with proper care and early intervention. In this article, we’ll explore how to safeguard your feet through proactive daily care, smart lifestyle choices, and regular medical check-ups.

Why Foot Health Matters in Diabetes

Diabetes can silently wreak havoc on your feet. Elevated blood sugar can cause diabetic neuropathy, a nerve damage that leads to tingling, burning pain, or more often a loss of feeling in the feet. You could injure your foot – for example, get a cut or blister from a shoe – and not even feel it due to reduced sensation. Diabetes also impairs circulation by narrowing blood vessels in the legs, leading to peripheral artery disease (PAD). This poor blood flow means any cut or sore heals more slowly and struggles to fight off infection. Neuropathy can even alter the shape of your feet or toes, making normal shoes rub your skin, while PAD deprives the feet of oxygen-rich blood.

Together, nerve damage and poor circulation create a perfect storm for foot problems. A small foot injury can quickly turn into a deep ulcer because you didn’t feel it and it didn’t heal well. These ulcers are the leading cause of infections that can spread to bone. Alarmingly, a foot ulcer is the first step in about 85% of diabetes-related amputations. This is why foot health is absolutely crucial for people with diabetes – preventing problems before they start (and treating them early) can literally save your limb. By staying vigilant and caring for your feet daily, you can greatly reduce the risk of wounds and keep your feet healthy.

Daily Foot Care Routine

One of the best defences against serious foot issues is a consistent daily foot care routine. Make these habits part of your everyday schedule:

• Inspect your feet every day: Check the tops, soles, sides, and between your toes for any cuts, blisters, redness, swelling, or nail problems. Use a mirror to see the bottoms of your feet or ask for help if needed. Catching a small sore or crack early can prevent it from turning into an ulcer.
• Wash your feet in lukewarm water: Clean your feet daily with warm (not hot) water and mild soap. Do not soak your feet for long, as this can dry out your skin. Always check the water temperature with your elbow or a thermometer – not with your foot – to avoid burns. Due to neuropathy, your feet might not sense heat correctly.
• Dry thoroughly, especially between toes: After washing, dry your feet carefully. Pat them dry and make sure to dry between your toes. Moisture between toes can lead to fungal infections like athlete’s foot. If you tend to sweat, you might even use talc or foot powder (sparingly) to keep those spaces dry.
• Moisturize dry skin (but not between toes): Apply a moisturizing lotion or cream to the tops and bottoms of your feet to prevent dryness and cracking. Dry, cracked skin (for example, on your heels) can let bacteria in. Avoid putting lotion between toes, which should stay dry. Keep your skin supple but not soggy.
• Trim nails carefully: Keep your toenails trimmed to prevent problems. Cut nails straight across with a nail clipper – don’t cut into the corners, as that can cause ingrown toenails. It’s okay to use an emery board or file to smooth the edges. If you have thick or ingrown nails or can’t see/reach your feet well, have a podiatrist or nurse trim them.
• Never perform “DIY surgery” on your feet: Don’t try to cut off corns, calluses, or warts yourself, and avoid harsh over-the-counter corn removers. Cutting your own calluses or using strong chemicals can easily create a wound. Instead, see a healthcare professional if you have corns or calluses so they can be treated safely.
• Wear shoes at all times: Always protect your feet with shoes or hard-soled slippers, even indoors. Going barefoot (or just in socks) puts you at risk of cuts or stepping on something sharp. Also, avoid thin-soled or flimsy footwear that doesn’t shield your feet. A minor injury you don’t feel could become infected, so it's best to always have some foot protection.
• Protect from extreme temperatures: Because of reduced sensation, your feet can be prone to burns or frostbite. Test bath water with your elbow to ensure it’s not too hot. Don’t use heating pads, electric blankets, or hot water bottles on your feet – you could burn yourself without realizing it. If your feet are cold at night, wear socks instead of applying direct heat. Likewise, wear shoes if walking on hot pavement or sand to prevent burns.

By following these daily steps, you’ll keep your feet clean, conditioned, and guarded against injury. It may help to think of foot care as an essential part of your diabetes management routine, just like checking your blood sugar.

Choosing Proper Footwear and Socks

Wearing the right footwear is vital for preventing foot injuries and ulcers. Ill-fitting shoes are a common source of blisters and sores for people with diabetes. Here’s how to choose and use footwear wisely:

• Always wear shoes and socks: A good rule is no barefoot and no stocking-feet. Even at home, wear shoes or supportive slippers to protect your feet. Outdoors, stick to closed-toe shoes. In warm weather, avoid flimsy sandals or flip-flops that expose your feet. Socks are important too – they add cushioning and reduce friction. Never wear shoes without socks, which can lead to rubbing and fungal infections.
• Ensure shoes fit well: Have your feet measured when buying shoes and try them on towards the end of the day (when your feet might be slightly swollen). There should be a little space (about a thumb’s width) between your longest toe and the end of the shoe. Shoes should be snug enough to not slip off, but with enough width and depth so they don’t press or rub any part of your foot. A roomy, comfortable fit is key. If you have one foot larger than the other, fit the shoe to the larger foot.
• Choose protective, comfortable styles: Opt for shoes with closed toes and good support. Look for styles with a firm outsole (to prevent injury from stepping on objects) and a soft, cushioned insole to reduce pressure. The interior should be smooth, with no protruding seams or rough areas that could irritate your skin. Athletic sneakers or walking shoes are often a great choice. If dress shoes are needed, find those with soft leather uppers and avoid high heels or narrow, pointed toes that squeeze the foot.
• Break in new shoes gradually: Don’t wear a brand-new pair of shoes for a full day right away. Start with an hour or two and gradually increase the time. This helps prevent blisters. Also, consider rotating between at least two pairs of shoes so you’re not putting pressure on the same spots every day.
• Check your shoes before wearing: Get in the habit of shaking out and inspecting your shoes before you put them on. Tiny objects like gravel, or uneven insoles, can cause injuries or blisters if trapped in your shoe. Make sure the lining is intact and there are no sharp edges.
• Wear appropriate socks: Socks can help keep your feet dry and cushioned. Choose soft, moisture-wicking socks (for example, those made with acrylic blends or wool, not 100% cotton) that pull sweat away from your skin. Socks should fit well without bunching up. Importantly, avoid tight elastic bands at the top of socks and avoid socks with seams that could rub. Many diabetic socks are designed to be non-constricting and seamless for these reasons. If your feet get cold at night, wearing clean socks to bed is safer than using a heating device.
• Consider special footwear if needed: If you have foot deformities (like bunions, hammertoes) or a history of ulcers, talk to your doctor about therapeutic shoes or orthotic inserts. These are specialty shoes/insoles that provide extra protection (often covered by insurance for diabetics). They can offload pressure from high-risk areas of your feet.

Wearing proper shoes and socks every day will significantly reduce the risk of cuts, blisters, and sores. It’s an investment in your foot health. Remember to replace worn-out shoes promptly – if the soles are worn thin or the inside is torn, they can no longer safeguard your feet.

Healthy Habits for Better Foot Health

Beyond daily foot care and footwear, your overall lifestyle plays a huge role in keeping your feet healthy with diabetes. Good diabetes management and general health habits will directly benefit your feet. Keep these tips in mind:

• Control your blood sugar: Keeping your blood glucose levels in target range helps prevent ongoing nerve damage and supports your body’s healing ability. Elevated blood sugar over time is what causes neuropathy and poor circulation, so managing your diabetes carefully (with diet, medication, and monitoring) is fundamental to foot health.
• Don’t smoke: If you do smoke, plan to quit. Smoking causes blood vessels to constrict and harden, worsening circulation to the legs and feet. In fact, smokers with diabetes have significantly higher rates of foot complications. Quitting smoking is one of the best things you can do for your feet (and the rest of you).
• Stay active to boost circulation: Regular exercise improves blood flow to the feet and can even help with blood sugar control. Activities like walking, cycling, or swimming a few times a week are excellent. Even simple foot exercises – wiggling your toes, rotating your ankles, or calf stretches – can keep blood moving if you have to sit for long periods. (Always wear appropriate footwear when exercising and avoid walking on any foot that has an open sore until it heals.)
• Manage blood pressure and cholesterol: High blood pressure and high cholesterol can damage blood vessels and further impair circulation. Work with your healthcare provider to keep your blood pressure and cholesterol in a healthy range. Eating a balanced diet, taking prescribed medications, and staying active all contribute to better circulation. This means more oxygen and nutrients reach your feet.
• Avoid foot neglect during illness: If you’re ill or your blood sugars have been running high, be extra attentive to your feet. Periods of uncontrolled diabetes can accelerate nerve damage and infections. During these times, be vigilant with foot checks and try to keep blood sugar as stable as possible.
• Keep the blood flowing: Try not to sit or stand in one position for too long. If you’re sitting, don’t cross your legs (which can pinch blood vessels). Stand up and move around every hour to encourage circulation. When you relax, consider propping your feet up on a footrest or pillow to aid blood flow (at or above heart level if swelling is an issue).

These healthy habits support your feet from the inside out. Remember that taking care of your overall health – managing diabetes and cardiovascular risk factors – will pay off in the form of healthier feet and a lower chance of serious foot problems.

Regular Check-Ups and When to Seek Help

Professional check-ups are another critical piece of protecting your feet. Doctors and podiatrists (foot specialists) can catch issues you might miss and provide treatments to prevent small problems from escalating. Here’s what to do:

• Get a foot exam at least once a year: All people with diabetes should have a comprehensive foot exam by their doctor or podiatrist at least annually. During these exams, the provider will check your foot circulation, sensation, and skin condition – for example, checking pulses, testing feeling with a small filament, examining for calluses or deformities, and trimming nails if needed. Regular exams help catch problems like neuropathy or poor blood flow early. If you already have neuropathy or a history of foot ulcers, your doctor may recommend foot exams every 3-6 months instead of yearly.
• Ask for foot checks at routine visits: Even between annual exams, it’s wise to have your primary care doctor take a quick look at your feet during regular appointments. Take off your shoes and socks when you’re in the exam room to remind them. A brief check for skin changes or wounds at every visit can spot issues early. Don’t be shy about requesting a foot check – your healthcare team understands how important this is for diabetics.
• Know when to call the doctor: Never ignore foot problems. If you notice any concerning signs, contact your doctor or podiatrist right away – waiting can be dangerous. Watch for things like:
• A cut, blister, or sore that does not begin to heal within a day or two, or any wound that is getting bigger or draining fluid.
• Redness, warmth, swelling, or pain in your foot, which could signal infection. (For instance, an area between your toes that is red, and tender might be a fungal infection, or a red, swollen foot could indicate a serious deep infection or even Charcot foot.)
• Pus or odour coming from a wound – these are clear signs of infection that need prompt treatment.
• Black or blue discoloration of the skin on your foot, which could mean a loss of blood flow or dead tissue – this is an emergency.
• New or worsening numbness, tingling, or burning pain in your feet. Increasing numbness means your neuropathy may be getting worse, and burning pain could mean a nerve issue or infection.
• Ingrown toenail that looks infected (red, swollen, with pus), or athlete’s foot (fungal infection causing cracked skin between toes) that isn’t improving with over-the-counter treatment. In short, any noticeable change in your foot’s skin colour, temperature, or shape – or any injury – should be evaluated. It’s always better to have a doctor check it than to wait. Small foot issues can deteriorate quickly in diabetes, so early professional care is crucial. Don’t try to “tough it out” or self-treat serious wounds – get medical help.
• Work with a podiatrist: A podiatrist is a doctor specializing in foot care. They are an important part of the diabetes care team. If possible, see a podiatrist at least once a year (more often if you have neuropathy). They can expertly trim nails, remove calluses, treat foot deformities, and recommend proper footwear. Podiatrists can also educate you on foot exercises and custom orthotics. If you develop a foot ulcer or infection, a podiatrist will be central in your treatment and recovery. Don’t hesitate to ask your primary doctor for a podiatry referral – it can make a big difference in keeping your feet intact.

Staying in close touch with healthcare professionals about your foot health is key. Think of it as a partnership: you do your part with daily care, and your providers will do theirs with exams and treatments. Together, you can prevent most serious problems.

Conclusion

Caring for your feet is a warm act of self-care that can save you from severe complications down the road. When you have diabetes, healthy feet don’t happen by accident – they result from diligence and mindful habits. The effort you put into inspecting your feet daily, keeping them clean and protected, wearing proper shoes, and controlling your diabetes will pay off in the form of feet that remain free of ulcers and infections. Most diabetes-related foot problems, including amputations, are preventable with the right precautions. By safeguarding your diabetic feet each day and getting prompt medical attention when something isn’t right, you are taking crucial steps to preserve your mobility, independence, and quality of life. 

Remember, you’re not alone in this effort. Don’t hesitate to consult your healthcare professionals – whether it’s your doctor, a diabetes educator, or a podiatrist – for guidance on foot care or to examine any issue, no matter how minor it seems. They are there to help you keep your feet healthy. With a proactive mindset and proper care, you can confidently step forward knowing you’ve got your diabetic foot health well in hand.

Sources:

• American Diabetes Association – Diabetes Foot Care Tips (Diabetes Foot Care: Tips for Healthy Feet & Preventing Complications) (Diabetes Foot Care: Tips for Healthy Feet & Preventing Complications) (Diabetes Foot Care: Tips for Healthy Feet & Preventing Complications)
• American Diabetes Association – Amputation Prevention Alliance: Diabetes and Your Feet (Amputation Prevention Alliance | ADA) (Amputation Prevention Alliance | ADA)
• Centers for Disease Control and Prevention – Promoting Foot Health for People with Diabetes (Promoting Foot Health | Diabetes | CDC) (Promoting Foot Health | Diabetes | CDC)
• American Diabetes Association – 8 Tips to Protect Your Feet with Diabetes (8 Tips to Protect Your Feet with Diabetes | American Diabetes Association) (8 Tips to Protect Your Feet with Diabetes | American Diabetes Association)
• Better Health Channel (Victoria, AU) – Diabetes – Foot Care (Diabetes - foot care | Better Health Channel) (Diabetes - foot care | Better Health Channel)
• WebMD – Diabetes Foot Care: Tips for Healthy Feet (Diabetes Foot Care: Tips for Healthy Feet ) (Diabetes Foot Care: Tips for Healthy Feet )
• Azura Vascular Care – Statistics About Amputation Due to Diabetes