Diabetes can lead to foot complications by damaging nerves, the immune system and restricting blood supply to the feet. It is essential to examine your feet daily for broken skin, blisters and inflammation. Using a mirror will help. Ask a carer or family member to check your feet if you have difficulty seeing or reaching. Breaks in the skin should be washed and covered with a dry, sterile dressing. Seek treatment and advice immediately from your GP surgery or Podiatrist if you notice signs of infection eg, pain, swelling, bleeding, discolouration or a sudden increase in temperature. If these services are not available and the broken skin shows no sign of healing after one day, attend your local accident and emergency department. Any delay in getting treatment and advice could lead to further complications.
You have Diabetes and following your review the evidence suggests you have:
- Sensory loss in part of your foot or feet
- Impaired circulation
- A foot deformity
Any one of these risk factors may lead to further physical deterioration in foot health eg ulceration.
To avoid foot problems in the future
- Maintain good control of your blood glucose levels, as the risk of nerve damage is increased with poor Diabetes control.
- Keep to a healthy eating plan recommended by your dietitian.
- Take regular exercise and do not smoke.
Nail care
- Do not cut your toenails unless your Podiatrist advises you to.
Footwear
- Do not walk barefoot at all. This can lead to skin damage that you might not feel.
- If your Doctor has prescribed orthopaedic footwear, please ensure you wear them. These should be the only shoes you wear. They will normally have insoles which protect your feet. Do not remove the insoles, unless advised to by the Podiatrist or Orthotist (the person who made the shoes).
- The Podiatrist who assessed your feet can advise you about footwear.
- Trainers are recommended as they are light and cushioning.
- Slip-on shoes should be avoided.
- Change socks, stockings and tights daily.
- Avoid socks with thick seams that might rub the toes.
- Avoid socks with elasticated tops as they can affect the circulation.
- Check inside the shoes for any foreign objects eg, a stone that may cause a break in the skin.
Skin care
- Wash your feet daily. Do not soak your feet as this can damage your skin.
- Dry feet and toes thoroughly.
- Apply a moisturiser each day except between the toes.
- Never use sharp instruments, corn plasters or corn cures on your feet as they can damage your skin. Contact your Podiatrist for regular treatment.
- Avoid direct heat on the skin from open fires and hot water bottles as loss of sensation to pain can make these dangerous.
- Use of a foot spa is not recommended for patients with Diabetes.
- Test the temperature of the bath water before you put your foot in the bath; it should not exceed 37°C (body temperature).
On holiday or in hot weather
- Do not wear new shoes on holiday. In hot weather your feet will swell in the
heat and new shoes may not accommodate the swelling. - Do not walk barefoot.
- Continue to check feet daily.
- Apply sunscreen to your feet
Useful contacts
Wirral Community Health and Care NHS Foundation Trust: To manage your appointment with the Podiatry Service call the Centralised Booking Service on 0151 514 2222.
ABL Health Wirral (Smoking cessation support)
Diabetes UK
Royal College of Podiatry
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