Diabetic Foot Care: A Podiatrist’s Guide to Looking After Your Feet
If you have diabetes, looking after your feet is an important part of your overall health care. Diabetes can affect both the nerves and circulation in the feet, which means small problems may sometimes go unnoticed or take longer to heal.
The good news is that simple daily foot care, appropriate footwear and regular podiatrist foot checks when needed can help identify problems early.
How Does Diabetes Affect Your Feet?
Two of the main ways diabetes can affect the feet are through changes to sensation and circulation.
Peripheral neuropathy
Diabetes can damage the nerves in the feet, a condition known as peripheral neuropathy. This may cause symptoms such as:
Numbness or reduced sensation Tingling or pins and needles Burning or unusual sensations Difficulty feeling pain, pressure, heat or cold
Reduced sensation is particularly important because a blister, cut or area of pressure may develop without you noticing it.
Reduced circulation
Diabetes can also be associated with peripheral arterial disease, which reduces blood flow to the legs and feet.
Poor circulation can affect the skin and may make wounds more difficult to heal.
What Changes Should You Look Out For?
Get into the habit of looking at your feet regularly.
Pay attention to changes such as:
Cuts, blisters or sores Redness or swelling Cracked or very dry skin Corns and callouses Changes in skin colour Changes to the toenails Areas of rubbing or pressure from footwear New numbness, tingling or pain
If you have difficulty seeing underneath your feet, a long-handled foot mirror can make daily checks easier.
Daily Diabetic Foot Care
A few simple habits can make looking after your feet much easier.
Wash and dry your feet carefully
Wash your feet in warm—not excessively hot—water and dry them thoroughly afterwards.
Pay particular attention to the spaces between your toes, as leaving these areas damp can encourage skin problems.
Moisturise dry skin
Dry and cracked skin is common on the feet. Applying a suitable moisturising foot cream regularly can help keep the skin soft and supple.
Apply moisturiser to the tops, bottoms and heels of the feet, but generally avoid applying cream between the toes, where excess moisture can accumulate.
Check your feet every day
If you have reduced sensation, you may not necessarily feel a small cut, blister or area of rubbing.
A quick daily visual check can help you identify changes early.
Look after your toenails
If your nails are particularly thick, difficult to reach or you are unsure about cutting them safely, speak with a podiatrist.
Choose Shoes and Socks Carefully
Well-fitting footwear is particularly important when you have diabetes.
Shoes should provide adequate room around the toes and shouldn't create excessive pressure or rubbing.
Before putting your shoes on, it's also a good idea to check inside them for stones, rough seams or other objects that could irritate the skin.
Socks should fit comfortably without excessively tight cuffs or bulky seams.
Should You Walk Barefoot?
No, you should not walk barefoot if you have diabetes.
If you have reduced sensation in your feet, walking barefoot can increase the chance of cuts, burns and other injuries going unnoticed.
Protective footwear is particularly important to protect the feet from injury and harm.
Your podiatrist can provide footwear advice.
When Should You See a Podiatrist?
People with diabetes should have their feet assessed as part of their ongoing diabetes care. How frequently you need to see a podiatrist will depend on factors including your circulation, sensation, skin condition and previous history of foot problems.
A diabetic foot assessment may include checking:
Circulation
Sensation
Skin and nail health
Foot shape
Areas of pressure Footwear
Your podiatrist can then advise whether you require ongoing podiatry treatment and how frequently you should be reviewed.
When Should You Seek Medical Attention?
Some foot problems shouldn't be left to see whether they improve on their own.
Seek prompt professional advice if you notice:
A wound, ulcer or break in the skin Increasing redness, warmth or swelling Discharge or other signs of infection A foot that suddenly changes colour New or unexplained swelling A wound that isn't healing normally A significant change in the shape or appearance of your foot
If you have known neuropathy or poor circulation, it is particularly important to have new foot problems assessed promptly.
Common Diabetic Foot Problems
Foot ulcers
A foot ulcer is an open wound that can develop following pressure, friction or injury. Reduced sensation can mean the original injury isn't noticed.
Diabetic foot ulcers require professional assessment and shouldn't be self-treated.
Peripheral neuropathy
Peripheral neuropathy can reduce the ability to feel pain, pressure and temperature.
People with neuropathy need to be particularly careful with footwear, hot water, heaters and other potential sources of injury.
Charcot foot
Charcot foot is a serious complication associated with neuropathy in which the bones and joints of the foot become damaged.
A foot that becomes unexpectedly hot, red or swollen, particularly in someone with neuropathy, requires prompt medical assessment.
Dry and cracked skin
Dry skin can become uncomfortable and may eventually crack. Regular moisturising can help maintain the skin barrier and keep the skin supple.
Frequently Asked Questions
How often should someone with diabetes see a podiatrist?
There isn't one schedule that is right for everyone. The frequency depends on your individual foot risk. Someone with normal sensation and circulation may require less frequent podiatry care than someone with neuropathy, poor circulation or a previous foot ulcer.
What is the best foot cream for someone with diabetes?
Look for a moisturising foot cream suitable for dry or sensitive skin. Urea-containing creams can be particularly useful for dry or thickened skin, although the most appropriate strength depends on the condition of the skin.
Should I put moisturiser between my toes?
Generally, no. Moisturiser is best applied to dry areas of the feet and heels while avoiding the spaces between the toes, as excessive moisture in these areas can encourage skin problems.
What should I do if I find a cut or blister?
Keep the area clean and protected and monitor it carefully. If you have neuropathy, poor circulation, a history of ulceration, signs of infection, or the area isn't healing as expected, seek professional advice promptly.
Are diabetic socks necessary?
Not everyone with diabetes requires a specialised sock. However, comfortable socks with minimal seams, adequate room and a non-restrictive cuff can be useful, particularly if you have sensitive skin or circulation concerns.
Looking After Your Feet
Diabetic foot care doesn't need to be complicated. Checking your feet regularly, looking after your skin, wearing appropriate footwear and having your feet professionally assessed when required can help identify problems before they become more serious.
If you notice something unusual, particularly a wound, redness, swelling or a change in the appearance of your foot, don't wait for your next routine appointment—have it assessed.
To find a podiatrist in Australia, you can also use the Australian Podiatry Association's Find a Podiatrist directory.
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