Proper care and early detection of foot problems are the utmost importance to diabetics. Since diabetes often reduces the blood supply to the feet, diabetics are more likely to develop foot disorders, which in turn may heal very slowly. With their increase in blood sugar levels a much greater risk of infections exists. Diabetics may also experience a decreased sensation to pain and to temperature changes in their feet. This can result in diabetics either burning their feet with hot water bottle, or stepping on a nail and having either injury go unnoticed.
This pamphlet was prepared by the Canadian Podiatric Medical Association to help diabetics and their families understand the best ways to care for their feet.
Corns and calluses are growths of hard skin at points of pressure. Foot imbalances, bone deformities, and/or improper shoes may cause them. Never cut them with a razor, knife or any other instrument! Do not use commercial corn removers or medicated pads! These contain acids, which often burn the skin and result in serious infection. It is very important that all diabetics obtain professional care from a podiatrist.
A very serious situation could arise if corns and calluses are present in a diabetic with decreased sensation in their feet. If no pain is present, the individual may simply ignore this condition. As the skin continues to thicken, an open sore (ulcer) frequently develops undetected beneath this area. This all-to-common yet potentially very serious complication of diabetes can often be prevented with professional care. REMEMBER: Corns and calluses in the presence of reduced sensation demand attention by your podiatrists.
Cut toenails after bathing when they are soft. They should be cut straight across, and never too close to the skin. Do not cut into the corners and do not cut a ‘V” in the front of the nail. Those with poor vision or unsteady hands should consult a podiatrist for assistance. A podiatrist should also be seen if your nails are ingrown, thick, or deformed. Never use “over-the-counter” medicines for ingrown nails.
Bathe your feet in lukewarm (never hot) water, using mild soap. Check the temperature of the water with your wrist or elbow. After bathing, gently pat your feet dry. Do not forget to dry the skin between toes. For dry skin, use moisturizing lotion or cream sparingly. For moist skin, dust lightly with cornstarch.
After bathing, it is a good time to check all over the feet for cuts, cracks, swelling, bruises, blisters and redness. Consult your podiatrist if you notice any of these, even if you have no pain. Also, check the inside of shoes for foreign objects; nail points or torn linings before putting shoes on. If foot inspection is difficult for you, have a friend or family member help.
A good quality shoe with firm sole and soft upper is best for daily wear. New shoes should not be worn for more than two hours at a time, until they are “broken in” and your feet are comfortable in them. Casual or sport shoes should only be worn for short intervals. All shoe correction should be done on the advice of your physician or podiatrist. Walking barefoot should be avoided.
Cotton or wool socks (or stockings) are recommended. Be sure that they fit well and are free from holes and darns. To ensure cleanliness, it is important to change them everyday. Loose woollen socks may be worn at night for warmth. Never apply a hot water bottle or heating pad to your feet for warmth or any other purpose. Do not wear constricting circular socks or garters with tight elastic tops as these impair the circulation to your feet and legs.
Physical activity is important for everyone, including the diabetic. Walking is the best exercise for your feet. Your doctor may advise special exercises. You can help protect your feet by avoiding exposure to rain, cold and excessive sunlight. Do not smoke, as this seriously reduces blood flow to your feet.
Diabetes is a serious problem and the feet of the diabetic deserve the best of care. With proper professional management and personal care, this disease need not limit activity. You, your medical doctor, and your podiatrist must work together to give you the best possible foot health.