Nerve damage (neuropathy)
The nerves of the feet are the longest in the body. People with diabetes often have poor circulation and nerve damage in hands and feet. If the nerves are damaged there may be less than normal or no feeling in the feet. This means that you don’t feel pain so you don’t notice when you have hurt your foot., this can lead to ulcers – sores that do not easily heal.
Vascular (blood vessel) damage – in the legs and feet is referred to as peripheral vascular damage. Peripheral vascular disease is a circulation disorder that affects blood vessels away from the heart such as at arms, legs and feet. Poor blood flow can mean it takes longer for a sore or cut to heal.
For both conditions, a daily foot care routine is important as well as controlling blood glucose levels.
Getting feet checked and professional care by a podiatrist
For professional foot care always see a healthcare professional (podiatrist) to remove corns, calluses or warts and for fungal infections, and even nail cutting if you are unable to do this. Ask your healthcare professional to check your feet each time you visit the doctor’s office.
What can I do?
It is important to check feet every day. Look at the top and bottom (sole) and in between toes. Use a mirror if needed or ask someone else to help. Look for breaks in the skin, cuts, corns, calluses, blisters – objects such as small stones, twigs, pins, or note any red areas where your shoes may be putting pressure or rubbing a part of your foot or toes. If you see any cuts or breaks, clean and cover the area with a suitable ‘dressing’ and let your doctor, nurse or podiatrist know of any problems as soon as possible.
|Happy feet||Keeping feet happy|
|Check feet and toes daily for any cuts, sores, bruises, bumps, or infections--use a mirror if necessary. Any foot damage needs to be treated and monitored to help reduce the possibility of them becoming serious.||Examine inside shoes before putting them on to make sure they have no tears, sharp edges or stones or other sharp objects in them that might injure feet.|
|Wash feet daily using warm (not hot) water and a mild soap to help to protect against any bacteria. If you have neuropathy (nerve damage), test the water temperature with your wrist before putting your feet in the water. Do not soak feet for long periods. Dry feet carefully with a soft towel, especially between the toes.||Use an emery board to file away dead skin, but do not remove calluses, which act as protective padding. Do not try to cut off any growths yourself, and avoid using harsh chemicals such as wart remover or corn caps on your feet. See a podiatrist for professional treatment.|
|Moisturise feet daily except the skin between the toes, otherwise it could lock in moisture and cause a fungal infection such as athlete’s foot. Use some petroleum jelly, a lotion containing lanolin, or cold cream and let it absorb into the skin before putting on shoes and socks. For people with diabetes, the feet tend to sweat less than normal, so using a moisturizer helps prevent dry, cracked skin.||Wear shoes that fit well and allow toes to move. Break in new shoes gradually, wearing them for only an hour at a time at first. After years of neuropathy, as reflexes are lost, the feet are likely to become wider and flatter. If you have difficulty finding shoes that fit, ask your doctor or nurse to refer you to a podiatrist, who can help with choosing corrective shoes or shoe inserts. Buy new shoes late in the day, most people have more swollen feet by then.|
|Cut toenails straight across, but be careful not to leave any sharp corners that could cut the next toe. Keeping your toenails properly trimmed is the best way to prevent ingrown toenails. If you have a persistent problem or if you have a nail infection, you may need a healthcare provider’s advice and care.||Sitting stay active to help reduce the flow of blood to the feet. Without good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called peripheral vascular disease.|
|Wear socks if your feet become cold at night. Avoid using heating pads or hot water bottles because too hot temperatures may not be obvious and can cause burns.||Going barefoot is tempting but a habit of wearing shoes can help to protect feet especially on the beach, hot sand, or rocks. Walking on a hot pavement can burn feet. Even at home wear suitable footwear, it’s easy to knock toes on the edge of a bed or sofa or stand on something sharp causing injury.|
|Heaters and hotties - wear soft socks and avoid wearing slippery pantyhose or socks with seams (that may increase pressure) or holes that may restrict blood flow – particularly if toes get caught up. Avoid ‘knee-high’ stockings that can hinder blood flow below the knee.||Ask your doctor and healthcare professional to check your feet at every visit, and call your doctor if you notice that a sore is not healing well. Foot ulcers can result from minor scrapes, cuts that heal slowly or from the rubbing of shoes that do not fit well. Early treatment is important to stop complications. Keep wounds covered with clean dressings and check them daily.|