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Why people with diabetes are more vulnerable to foot problems
Foot problems are common in people with diabetes1. Diabetes can cause two problems that can affect your feet1,2,3:
Nerve Damage or Neuropathy
- Uncontrolled diabetes can damage your nerves (legs and feet) and you might not feel heat, cold or pain. This lack of feeling is called diabetic neuropathy
- If you do not feel a cut or sore on your foot because of neuropathy, the cut could get worse and become infected
Poor Blood flow
- Diabetes also affects the flow of blood which prolongs the healing of a sore or cut
- Poor circulation (blood flow) can lead to foot infections. Diabetes causes blood vessels of the foot and leg to narrow and harden
- Poor blood flow in the arms and legs is called peripheral arterial disease
Skin Changes
- Skin dryness, cracking, and peeling can occur in the feet during diabetes
- Calluses can build up faster, and ulcers can develop on the heel or the ball of the foot or on the bottom of the big toes
Deformities
- Nerve damage from diabetes can lead to changes in the shape of your feet leading to deformities
- People with diabetes and pre-existing foot problems (such as hammer toes, overlapping toes, or bunions) are more prone to infections
Taking care of Your feet<sup>3,4</sup>
There are a few things you can do to care for your feet—here are some helpful tips:

Take care of your diabetes
Be sure to maintain your blood sugar in the range that your doctor recommends. Work with your healthcare team to manage diabetes and prevent complications

Check your feet every day
Look at your bare feet for red spots, cuts, swelling, and blisters. If you cannot see the bottoms of your feet, use a mirror or ask someone for help

Wash your feet
Wash your feet in warm water every day, using a mild soap. Do not soak your feet. Dry your feet well, especially between the toes

Keep your skin soft and smooth
Rub a thin coat of skin lotion over the tops and bottoms of your feet, but not between your toes. Gently smooth corns and calluses with an emery board or pumice stone

Trim your toenails
If you are able to see them, trim your nails straight across, or use an emery board to file them. If you are unable to do this, ask someone to help you

Wear shoes and socks at all times
Always wear closed-toed shoes or slippers. Do not wear sandals. Do not walk barefoot, even around the house

Wear shoes that fit well
Buy shoes made of canvas or leather, and break them in slowly

Protect your feet from hot and cold
Wear shoes at the beach or on hot pavement. Wear socks at night if your feet get cold.

Keep the blood flowing to your feet
Put your feet up when sitting, wiggle your toes and move your ankles several times a day, and don’t cross your legs for long periods of time

Stop smoking
Smoking can make blood flow problems worse
Ask Your doctor to check Your feet<sup>1,3<?sup>
Contact your healthcare provider if you experience any of the following problems:
A cut, blister, or bruise on your foot that does not start to heal after a few days
Changes in skin color or skin temperature
Skin on your foot that becomes red, warm, or painful—signs of a possible infection
Ingrown toenails or toenails infected with fungus
Unusual and/or persistent foot odor
A foot infection that becomes black and smelly—signs you might have gangrene
The sooner you see your healthcare provider or podiatrist to identify a problem, the better your outcome will likely be. Remember that when it comes to foot care, you are a key member of the healthcare team.
References
- Diabetes and Foot Problems | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2019 [Cited 17 April 2019]. Available from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems
- Foot Complications [Internet]. American Diabetes Association. 2019 [cited 22 April 2019]. Available from http://www.diabetes.org/living-with-diabetes/complications/foot-complications/
- Diabetes: Foot & Skin Related Complications Prevention | Cleveland Clinic [Internet]. Cleveland Clinic. 2019 [Cited 17 April 2019]. Available from https://my.clevelandclinic.org/health/diseases/9492-diabetes-foot--skin-related-complications/prevention
- Foot Care [Internet]. American Diabetes Association. 2019 [Cited 17 April 2019]. Available from http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html