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Wound Care
Protecting Your Feet When You Have Diabetes
Diabetes affects feet in ways that can lead to serious complications, including ulcers, infections, and in severe cases, amputation. The combination of nerve damage, poor circulation, and impaired healing creates conditions where minor foot problems can quickly become major medical issues.
The good news is that most diabetes-related foot complications are preventable with proper care and attention. By following consistent foot care practices, you can protect your feet and maintain mobility for years to come.
These essential tips will help you manage diabetes in ways that specifically protect your feet from the complications that threaten so many people with this condition.
Control Your Blood Sugar
Blood sugar management is the foundation of preventing all diabetes complications, including those affecting your feet.
Why Blood Sugar Matters for Feet
Elevated blood glucose over time damages nerves and blood vessels throughout the body, with feet particularly vulnerable. High blood sugar impairs nerve function causing neuropathy, damages blood vessels reducing circulation, compromises immune function increasing infection risk, and slows wound healing when injuries occur.
Target Levels
Work with your healthcare team to establish appropriate blood sugar targets. For most people with diabetes, this means fasting blood glucose between 80 and 130 mg/dL, post-meal blood glucose below 180 mg/dL, and hemoglobin A1C below 7 percent.
Individual targets may vary based on age, other health conditions, and personal circumstances. Follow your healthcare provider recommendations.
Consistent Management
Consistent blood sugar control, not occasional good readings, protects against complications. Take medications as prescribed, follow dietary recommendations, exercise regularly, and monitor blood sugar as directed.
Inspect Your Feet Daily
Daily foot inspection catches problems early when they are easiest to treat. When neuropathy reduces sensation, your eyes must do what your nerves cannot.
How to Inspect
Examine your entire foot, including tops, bottoms, sides, heels, and between all toes. Use a mirror to see the bottom of your feet, or ask a family member to help if you cannot see well.
What to Look For
During inspection, look for cuts, scrapes, blisters, or open areas, redness, warmth, or swelling, calluses or corns, ingrown toenails, changes in skin color, cracks or dry skin especially around heels, and any changes from previous inspections.
When to Seek Help
Any break in the skin, signs of infection, or changes you cannot explain warrant prompt medical attention. Do not wait to see if problems resolve on their own. Early treatment prevents complications.
Practice Proper Foot Hygiene
Daily foot care maintains skin health and prevents problems before they start.
Daily Washing
Wash feet daily with mild soap and warm water. Test water temperature with your elbow or a thermometer rather than your feet, as neuropathy may prevent you from sensing dangerously hot water. Keep water below 90 degrees Fahrenheit.
Wash gently and thoroughly, including between toes. Do not soak feet, as prolonged soaking softens skin excessively.
Drying Carefully
Dry feet thoroughly after washing, paying special attention to areas between toes where moisture promotes fungal growth and skin breakdown.
Moisturizing
Apply moisturizer to prevent dry, cracking skin, but avoid applying between toes where moisture should not accumulate. Use lotion without alcohol or fragrance that could irritate skin.
Nail Care
Trim toenails straight across and file edges smooth. Do not cut into corners, which can cause ingrown nails. If you cannot see well, reach easily, or have thickened nails, have a podiatrist trim your nails.
Wear Proper Footwear
Appropriate shoes protect feet from injury and pressure that can cause problems.
Choosing Shoes
Select shoes that fit well and protect your feet.
- Buy shoes in the afternoon when feet are largest
- Choose shoes with adequate room in the toe box
- Avoid pointed toes, high heels, and shoes that pinch
- Select breathable materials that do not trap moisture
- Consider diabetic shoes designed for foot protection
- Break in new shoes gradually to avoid blisters
Checking Shoes
Before putting on shoes, check inside for objects, rough areas, or anything that could cause injury. Run your hand inside the shoe to feel for problems your eyes might miss.
Never Go Barefoot
Always wear shoes or slippers, even indoors. Bare feet are vulnerable to injuries you might not feel due to neuropathy. Stepping on a small object or stubbing a toe can cause injuries that lead to serious complications.
Socks Matter
Wear clean, dry socks daily. Choose seamless socks or socks with seams on the outside to prevent rubbing. Avoid socks with tight elastic that restricts circulation.
Protect Feet from Injury
Since you may not feel injuries when they occur, preventing them is essential.
Temperature Protection
Protect feet from temperature extremes. Do not use heating pads or hot water bottles on feet. Test bath water temperature before entering. Wear shoes on hot pavement or sand. Protect feet from cold in winter with warm, dry footwear.
Avoiding Trauma
Take precautions to prevent foot injuries. Keep walkways clear of objects. Use a flashlight in dark areas. Be careful around pets that might scratch or step on feet. Avoid going barefoot anywhere.
Do Not Treat Problems Yourself
Avoid self-treatment that can cause harm. Do not use corn removers, callus shavers, or wart treatments. Do not cut calluses yourself. Do not try to remove ingrown toenails. Seek professional care for any foot problems.
See Healthcare Providers Regularly
Professional monitoring catches problems you might miss and provides expert treatment when needed.
Regular Foot Exams
See your healthcare provider for comprehensive foot exams at least annually, or more often if you have existing foot problems or high risk factors. These exams assess circulation, sensation, skin condition, and foot structure.
Podiatric Care
A podiatrist specializes in foot care and can provide regular maintenance including nail trimming and callus care, treatment for foot problems, custom orthotics if needed, and guidance on appropriate footwear.
Report Problems Promptly
Do not wait for scheduled appointments if problems develop. Contact healthcare providers immediately for any wound or sore, signs of infection, pain or changes in sensation, and unexplained changes in your feet.
When Wounds Develop
Despite best prevention efforts, wounds sometimes occur. Proper response is critical.
Immediate Steps
If you discover a foot wound, clean gently with mild soap and water, apply a sterile bandage, stay off the foot to reduce pressure, and contact your healthcare provider promptly.
Professional Wound Care
Diabetic foot wounds require professional management. Wound care from skilled clinicians provides appropriate treatment that promotes healing and prevents complications.
Home health skilled nursing can deliver professional diabetic wound care at home, monitoring healing progress and ensuring wounds receive appropriate treatment.
Do Not Ignore Wounds
No wound is too small to warrant attention in a diabetic foot. What appears minor can progress rapidly to serious infection without proper care. Always seek professional evaluation for any foot wound.
Manage Other Risk Factors
Foot health connects to overall health. Managing other conditions protects your feet.
Blood Pressure
High blood pressure damages blood vessels and worsens circulation. Follow treatment recommendations to keep blood pressure controlled.
Cholesterol
Elevated cholesterol contributes to vascular disease affecting foot circulation. Maintain healthy cholesterol through diet, exercise, and medication if prescribed.
Smoking
Smoking dramatically worsens circulation and impairs healing. If you smoke, quitting is one of the most important things you can do for your feet and overall health.
Physical Activity
Regular physical activity improves circulation and helps with blood sugar control. Choose foot-friendly activities and wear appropriate footwear during exercise.
Protecting Your Mobility
Your feet carry you through life. Protecting them protects your independence, mobility, and quality of life. The daily attention diabetes requires may seem burdensome, but the consequences of foot complications are far more burdensome.
Make foot care a non-negotiable part of your diabetes management routine. The few minutes daily you invest in inspection, hygiene, and protection can save you from the serious complications that threaten so many people with diabetes.
If you have concerns about your feet or need support managing diabetes-related foot issues, consult your healthcare providers. Professional guidance helps you protect the feet you depend on.
