Foot Care

Diabetes and your feet

Diabetes is a disorder that results in increased blood glucose levels. As this progresses it affects your body in a number of different ways. Some of these effects have the possibility of causing harm to your feet and legs.

Nerve disease of the lower limbs (peripheral neuropathy) is one of the most debilitating of the diabetes complications. Problems such as high blood glucose levels over a period of time, can cause nerve damage.

Nerve damage can cause numbness, pins and needles sensations in the feet, and burning pains in the feet and legs especially at night. Special care is required for people with painful nerve problems, or numbness of their feet to prevent injury.

Vascular(blood vessel) damage is another major problem that may affect the lower limbs. Smoking will make this worse. This problem combined with the nerve problem may lead to leg or foot ulcers, unrecognised infections and serious foot problems from which limb amputation may result.

To avoid injury to diabetic feet there are a number of precautions you can take:

Check your feet every day. If needed use a mirror or get someone to check for you. Check for cuts, abrasions, corns, callouses, nail infections skin cracks and blisters. Report any injury especially injury, colour changes, or discharge to your doctor or Podiatrist.

Wash feet each day with mild soap and dry carefully.

Toenails should be cut approximately straight across and gently filed. It is better to cut a little bit more often than to take off big chunks of nail.

Use plain moisturising cream on dry skin areas only � don�t put cream in toe webbingie areas in between toes.

If you have moist areas between toes or tinea only use tinea powders or sprays. Using ordinary talc between toes creates an environment in which bacteria thrive.

Avoid going barefooted to reduce the chance of injury � well constructed shoes, ventilated shoes, or well constructed sandals are suitable for our climate. For ladies, these should also be without heel height greater than 2cm.

Shoes should be fitted properly prior to wear. Ask the shoe fitter to measure your feet standing if this has not been done in the last 12 months. Never �break in� shoes � this is a sure way to injure your feet.

Check shoes for gravel, worn soles, worn lining before putting them on.

If wearing new shoes start by wearing them at home for a while and check your feet for rubbing, blisters etc before you wear them for long periods.

Try to wear cotton / wool based socks. Also do not wear anything with a tight or garter type band. Circulation socks are available at pharmacies.

Avoid extreme temperatures eg direct heat from heaters or hot water bottles, or placing feet in hot water.

You should seek advice early from your GP or Podiatrist if you have open wounds, any red weeping wounds, infections, red swollen joints, discoloured feet, or anything you are concerned about .

Please remember

Everybody with diabetes should have their circulation and sensation assessed as early after diagnosis as possible by your GP, Diabetes Educator or Podiatrist.

Once this is done you will need to be reassessed every 12 months.

Some people may need more frequent assessment or follow up specialized assessment.

Any specialized care or advice for caring for special footcare needs can be given as a result of these assessments.

Extra tips� good control of your blood glucose, gentle exercise, and stopping smoking helps to prevent foot and leg problems associated with diabetes.

Developed by Helen Mc Gregor, NCAHS.