Diabetes and Feet: Tips to Ensure Foot Health

By Rebecca McKinsey

Monitoring and caring for your feet is one of the most effective ways to help avoid diabetes-related complications, or to catch problems early.

In fact, regularly checking your feet can be “limb- and life-sparing,” says David G. Armstrong, DPM, MD, PhD, professor of surgery at University of Southern California’s Keck School of Medicine and founder and co-director of the Southwestern Academic Limb Salvage Alliance (SALSA). “If you ignore your feet, they’ll go away.”

Armstrong and Dave Griffin, DPM, assistant clinical professor at Oregon Health and Science University in the Division of General Internal Medicine and Geriatrics, offer the following guidelines.

Look at your feet every day. If you can’t see your feet easily, use a mirror or have someone help check them or take photos to show you. Look for open skin cracks, sores, calluses, ingrown nails, redness, or swelling. If you see anything that is different, contact your foot provider immediately to have your feet evaluated.

Wear the right shoes. Getting measured for shoes and having them evaluated regularly by a podiatrist can ensure you have enough support and are not wearing the wrong size or shape. Shake out your shoes and put your hand inside before putting them on. You may not feel a pebble or other item in your shoe due to loss of sensation from diabetic peripheral neuropathy, and walking on it all day can cause injuries.

Wear shoes around the house. This can help protect against wounds caused by stepping on something and not realizing it due to loss of feeling. Wearing close-toed shoes rather than sandals better protects the skin on your heels from cracking open.

Check the temperature of your bathwater with your elbow. Loss of feeling in your feet can make it more likely that you’ll burn yourself with water that is too hot.

Stay on top of foot hygiene. Wash your feet regularly, dry them completely, and use a moisturizing cream on the top and bottom of your feet and the back of your heels. Avoid alcohol-based lotion. Between the toes, dry well but avoid using cream, as too much moisture there can cause problems.

Get help with nail care. If you have loss of sensation, difficulty reaching or seeing your feet, or difficulty cutting your toenails because they are thick or ingrown, have someone help you. Visit a podiatrist, foot care nurse, or other provider regularly. If you see a pedicurist for nail care, tell them about your diabetes and confirm they have experience working with individuals with diabetes and loss of sensation.

It’s best not to roll the dice if you’re unsure about handling your foot care yourself, Griffin urges. “If it’s a difficult nail to trim, go see the podiatrist to help,” he says. “What you don’t feel can hurt you or even cause amputation of your leg.”