Open a PDF version to print this topic

HealthInfo Canterbury

Diabetes & high-risk feet

If you have been told by your diabetes health professional that you are at high risk of diabetic foot damage, this information will help you to avoid any further complications with your feet. If you have diabetes and don't know whether you have high-, medium-, or low-risk feet, ask your health professional.

Some of the foot problems that can come with diabetes happen because the nerves and blood vessels supplying your feet are damaged. This can affect the feeling in your feet (peripheral neuropathy) and the circulation in your feet (peripheral arterial disease or ischaemia).

These changes can be very gradual and you may not notice them. This is why it's important to have your feet screened (checked) by a podiatrist every year. You can then agree on a treatment plan that suits your needs.

In some circumstances you may qualify for publicly funded care from a podiatrist (you won't have to pay). Your GP or diabetes nurse can assess whether you qualify.

There are many risk factors for developing foot ulcers. Your podiatrist will let you know which of the following risk factors you have.

Diabetes affects your feet because higher blood sugar damages your nerves and blood vessels.

Longer nerves are more likely to be damaged by high glucose levels, and the nerves to your feet have the longest way to travel from your spine. The arteries in your legs are also prone to become narrow, which restricts blood flow to your feet.

The first sign your nerves and blood vessels are being damaged is usually pins and needles, burning, or numbness in your toes. This is why it's important to have good control of your blood sugar level. Controlling your cholesterol and blood pressure is also important for your feet.

If you smoke, it's really important to stop. Smoking affects your circulation and can lead to amputation.

As your feet are at high risk, you will need to take extra care of them. You will need regular treatment by a podiatrist.

If you follow the advice and information on this page it will help you to take care of your feet between visits to your podiatrist. Hopefully this will help to reduce problems in the future.

Advice on keeping your feet healthy

Check your feet every day

You should check your feet every day for any blisters, breaks in the skin, pain or any signs of infection such as swelling, heat or redness. If you can't do this yourself, ask your partner or carer to help you.

Wash your feet every day

You should wash your feet every day in warm water and with a mild soap. Rinse your feet thoroughly and dry them carefully, especially between the toes. Don't soak your feet as this may damage your skin. Because of your diabetes, you may not be able to feel hot or cold very well. You should test the temperature of the water with your elbow, or ask someone else to test the temperature for you.

Moisturise your feet every day

If your skin is dry, apply a moisturising cream every day, avoiding the areas between your toes.

Toenails

Don't cut your toenails unless your podiatrist advises you to.

Socks, stocking and tights

You should change your socks, stockings or tights every day. They should not have bulky seams and the tops should not be elasticised.

Avoid walking barefoot

If you walk barefoot you risk injuring your feet by stubbing your toes and standing on sharp objects that can damage your skin.

Check your shoes

Check the bottom of your shoes before you put them on to make sure that nothing sharp such as a pin, nail or glass has pierced the outer sole. Also run your hand inside each shoe to check that no small objects such as small stones have fallen in.

Badly fitting shoes

Badly fitting shoes are a common cause of irritation or damage to feet. The podiatrist who assessed your feet may give you advice about the shoes you already own or about buying new shoes. They may suggest that you are measured for special shoes to get on prescription from the orthotic service.

Prescription shoes

If you have been supplied with shoes, they will have been made to a prescription. You should follow the instructions your podiatrist or orthotist (the person who makes the shoes) gives you. These should be the only shoes you wear. Shoes will normally be prescribed with insoles. These are an important part of your shoes and you should only remove them if your orthotist or podiatrist advises you to. Whoever provided your shoes will carry out all repairs or alterations to make sure that they will match your prescription.

Minor cuts and blisters

If you check your feet and discover any breaks in the skin, minor cuts or blisters, cover the area with a sterile dressing. Do not burst blisters. Contact your podiatry service or GP immediately. If these people aren't available and there is no sign of healing after one day, go to your local after-hours GP clinic.

Hard skin and corns

Don't try to remove hard skin or corns yourself. Your podiatrist will provide treatment and advice where necessary.

Over-the-counter corn remedies

Don't use over-the-counter corn remedies. They are not recommended for anyone with diabetes as they can damage your skin and cause ulcers.

Avoid high or low temperatures

If your feet are cold, wear socks. Never sit with your feet in front of the fire or heater to warm them up. Always remove hot water bottles or heating pads from your bed before getting in.

A history of ulcers

If you have had an ulcer before, or an amputation, you are at high risk of developing more ulcers. If you look after your feet carefully, with the help of a podiatrist, you will reduce the risk of more problems.

Important!

If you discover any problems with your feet, contact your podiatry service or GP immediately. If they are not available, go to your nearest after-hours GP clinic. Remember, any delay in getting advice or treatment when you have a problem can lead to serious problems.

Written by Podiatrist Special Interest Group.Endorsed by HealthInfo clinical advisers. Updated November 2016.

Source

See also:

Diabetes and holiday feet

Diabetic neuropathy

More information on diabetes and feet

Images courtesy of FreeDigitalPhotos.net. Men's shoes and socks by Suat Eman; young woman by stockimages

Page reference: 84657

Review key: HIDIF-84656