Foot Care for Diabetics

General Foot Care Guidelines

People with diabetes or those who lack sensation in their feet can develop foot problems that are very serious in a hurry. People over 60 years of age, those who have had a foot ulcer in the past, or diabetics who have had to undergo laser eye surgery, or have kidney disease are more likely to develop foot ulcers.

If your foot structure has changed over time, you may have developed claw, or hammer toes or other bony deformities that result in pressure areas if your shoes don't fit properly. If you have poor circulation to your feet, or nerve damage to your feet or legs or are diabetic, you need to take especially good care of your feet. However, good foot care is important for anyone.

1. Never go barefoot either indoors or out.

2. Inspect your feet daily. Use a mirror and pay particular attention to your soles and between your toes. (If you have difficulty doing this, ask a family member or friend for help.)

3. Wash your feet daily. Test the water first with your hand or elbow to be sure it's not too hot

4. If your feet become excessively dry, lubricate them. Spread a thin film of moisturizing cream or plain petroleum jelly on the soles of your feet while still damp after bathing. Take care not to get the cream between your toes.

5. Don't use garters or elastics to hold up your stockings.

6. Don't use panty girdles that are tight around your legs.

7. Avoid exposing your feet to extremes:

  • Don't walk on hot sand or pavement in summer
  • Protect your feet against sunburn with a sunscreen.
  • Check temperature of bath water before stepping in
  • Never use hot water bottles or heating pads to warm cold feet. Wear socks at night in bed if your feet are cold
  • Beware of car heaters on long trips
  • Keep nails trim and cut straight across; don't round corners.
  • Never cut corns or calluses yourself. However, with careful instruction from your physician, you can be taught how to smooth calluses using a pumice stone or emery board if they are not too thick.
  • Never use commercial corn or callous removers, foot pads, or arch supports.
  • Don't use adhesive tape on your feet.
  • Don't "ice down" your feet if they feel hot.
  • Don't use hot or cold soaks for your feet.
  • Keep toes clean and free of debris between them.

8. Be sure to see your doctor or podiatrist for a foot inspection at least twice a year. Be sure they know if you are a diabetic.

9. Notify your doctor or podiatrist promptly if you develop a blister, puncture, or sore on your foot.

10. If your doctor suggests that you need a cane or walker, use it safely.

11. Don't stand in one place for more than 15-20 minutes at a time without walking or flexing your calf muscles.

12. Don't place pillows under your knees in bed. If you want to elevate your legs, put the pillow under your entire lower leg.

13. Don't smoke. It constricts your blood vessels and limits the circulation to your feet.

14. Follow your doctor's advice to control cholesterol and high blood pressure if you have these problems. They can also affect your circulation.

15. Get some exercise every day. Walking will increase circulation to your legs and feet and help develop new, although smaller, blood vessels. If you have pain in your calf when walking fast, up an incline, or on a hard surface, stopping to rest should help. Be sure to tell your doctor if you have this problem.

If you develop a foot ulcer, or you already have an ulcer that is not getting better, call The Wound Care Center at Harrington (508-248-6780) for assistance.

Resources:
Diabetes Day-by-Day Foot Care. American Diabetes Association
Nancy N. Bell. Feet First. Diabetes Forecast. June, 1997. pp 27-30.
Marvin E. Levin, M.D. On Your Feet - Don't let foot problems be your Achilles heel.