Caring for your feet
Foot care is extremely important for people with diabetes.
In fact, foot complications are a major cause of diabetes-related hospitalisations. In particular, if you suffer from a loss of sensation in your feet (numbness), the need for vigilance is increased as foot ‘insensitivity’ is associated with an increased risk of developing a foot ulcer.
Fortunately, many foot problems are actually preventable and with the correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent foot ulcers and their more serious complications, such as amputation.
Below we outline some simple steps that you can take daily to significantly reduce your risk of foot problems.
Ideally, if you are a person with diabetes, you should aim to give yourself a quick foot examination once a day. Aim to incorporate the foot care and foot examination steps below into your daily routine. This page can be printed (printable version link below) and kept handy for daily reference.
Please note: if you are currently experiencing foot pain, a lack of sensation, have noticed changes in the appearance of your feet, or a cut, bruise or sore that does not heal; please make an appointment to see your GP or other health care professional as soon as possible for an examination.
Print out the DFA Passport to foot disease prevention here or read below.
[ ] CHECK your feet daily – a convenient time to do this is before bed each evening, before your daily shower, or when dressing each morning.
- Look for ulcers, cuts, bruises, new calluses and other signs of injury or damage, including between toes and on lower legs.
- Take note of changes in sensitivity (or loss thereof).
- Be aware of the temperature of your feet, and monitor for noticeable changes (hot or cold).
- Be aware that you may not feel pain from visible injuries due to loss of sensation in your feet. These injuries still need attention even if they are not currently causing you pain.
- If you have vision or mobility impairment, please seek support from your Carer or health care professional. A mirror may be helpful for examining the bottom of your feet.
- If you notice any areas of concern, make an appointment with your GP or other health care professional (HCP) as soon as possible to ensure early treatment for the best-possible outcome.
[ ] WASH feet daily – keeping your feet clean will help reduce the risk of infection-causing bacteria.
- Clean daily using soap/body wash and warm (not hot) water, including between toes and around toenails.
- Dry feet well, including between toes.
- If you have difficulty reaching your feet, please discuss options with your carer or health care professional.
[ ] CARE – care for your feet and your general health & wellbeing.
- Moisturise – keep skin soft and supple by applying moisturiser to the tops and bottoms of your feet and lower limbs daily. Avoid between the toes as this may lead to infection, and do not moisturise close to broken skin or wounds.
- Toenail maintenance – long or ingrown toenails can cut into the skin of your feet, potentially causing infection and ulcers. Toenails should be cut straight across. If required, seek assistance from a carer or podiatrist.
- Corns & Calluses – these can be a sign of pressure being applied to these areas of the feet, and are worth mentioning to your GP or podiatrist. There are many do-it-yourself removal methods that can cause wounds, so if treatment is necessary, please consult with your GP, podiatrist or other diabetes advisor, and avoid over-the-counter remedies.
- Footwear – protect your feet with well-fitting footwear, both indoors and outdoors.
- This is important as you can easily injure yourself without realising (due to loss of sensation in the feet) by stepping on something hard or sharp.
- Wear clean socks to protect skin from chafing. Avoid sock seams where possible.
- shoes should fit well and not be too tight, as chafing and blisters may result. Avoid thin-soled slippers.
- Speak to a podiatrist to see if you require specialised insoles or custom-fitted footwear.
- Check your feet for signs of blisters when removing footwear. With lack of sensation a blister may not be noticed without a visual check.
- Never store things in your shoes, as injuries can result. Check inside shoes before putting them on, checking for small pebbles, or rough stitching.
- Avoid exposure to heat/cold – remember that the nerves in your feet may be less efficient at communicating temperature and pain messages than before, so take preventative measures:
- Avoid exposure to hot pavements, sunburn, heaters, hot or very cold water, or exposure to the cold (wear warm socks and shoes in cooler months, and non-constrictive socks to bed if needed).
- Blood Flow – keeping the blood flowing to your extremities can help reduce foot ulcers and improve healing. Avoid tight socks or stockings, and avoid sitting in the same position (especially with legs crossed) for extended periods. Maintaining activity levels are also important, so talk to your health care professional about a gentle exercise program suitable for you.
- Manage your diabetes – monitor your blood sugar levels, take any prescribed medications and eat a healthy diabetes-friendly diet.
[ ] SHARE – talk to your health care professional about your foot care management plan and ask for their support.
In particular, ask them to incorporate a foot check into your regular appointments and ensure a GP, podiatrist or other diabetes-advisor professional inspects your feet at least once every 12 months, or more regularly if you have current (or a history of) foot problems. Report any signs and symptoms to your GP/HCP as soon as possible for examination. If you have a Carer, please discuss the health of your feet with them also. Keep up your own daily checks!
Other Tips & Hints:
- Print off this checklist and keep by your bed as a daily reminder.
- Establish a regular daily time for checking your feet, such as every evening.
- For convenience, keep everything you need for your daily check in a footcare ‘kit’ (such as moisturiser and nail clippers).
- ‘Prevention and management of foot problems in diabetes: a Summary Guidance for daily practice 2015 based on IWGDF Guidance Documents”, 2015 International Working Group on the Diabetic Foot.
- National Institute of Diabetes and Digestive and Kidney Disease USA, http://www.niddk.nih.gov/health-information/health-topics/Diabetes/take-care-feet/Pages/publicationdetail.aspx, 2016.