People with diabetes are at risk for foot problems. This handout explains why these problems occur and what you can do to protect your feet.

Why are foot problems so common in people with diabetes?

In people with diabetes, high blood glucose can cause two complications — both of which can result in foot problems. You may have one or both of these:

  • Nerve damage (neuropathy). Nerve damage from high blood glucose usually begins in the hands and feet. It can cause painful symptoms — tingling, aching, or throbbing — but it can also reduce sensation. If you can’t really feel cold, heat, or pain in your feet, it’s easy to ignore an injury or infection. And unfortunately, in people with diabetes, even a small blister or stubbed toe can become serious.

  • Poor circulation. High blood glucose can damage your blood vessels and reduce blood flow to your feet. This means that injuries take longer to heal. Over time, poor circulation in your feet can even change the shape of your feet and toes. This can cause problems with the way you walk.

Are foot problems really that serious?

In people with diabetes, yes — foot problems can be very serious. In the worst cases, they can lead to deformed feet, wounds that won’t heal, and serious infections that require surgery. In fact, diabetes-related foot problems are a leading reason for leg and foot amputations.

Fortunately, good care can lower your chance of serious problems. You and your medical caregivers can work together to care for your feet. However, the most important things are those you do (and don’t do) on your own to protect your feet.

Work with your diabetes care team

To protect and treat your feet, take these steps with your doctor, diabetes educator, or other provider:

  • Follow your diabetes treatment plan to control your blood glucose, blood pressure, and cholesterol. This lowers the chance that neuropathy or poor circulation will cause foot problems. If you’re having trouble with any part of your treatment — medication, meal plans, or exercise — talk to your providers. Work together to make a plan that’s right for you.

  • Keep your doctor’s appointments — and be sure to get a foot exam at least once a year. Take your socks and shoes off at each visit to remind your doctor to check your feet. For a more thorough foot exam once a year, your doctor may refer you to a foot specialist. In this exam, the doctor may use special tools to check sensitivity in your feet. The doctor may also order imaging tests to see the condition of your foot bones. Foot exams help detect foot problems early on, when they are easier to treat.

Everyday DOs and DON'Ts to protect your feet

Even if you don’t have foot problems now, you still need to care for your feet. Daily foot care is the best way to prevent problems — or to catch problems early, before they become serious.

  • DO wash your feet every day. Use warm water, not hot water, and dry your feet carefully afterwards. Make sure the skin between your toes is dry.

    ... but DON’T soak or scrub your feet. People with diabetes have fragile skin, and soaking and scrubbing can cause the skin to break down.

  • DO check your feet carefully every day. If you need to, use a hand mirror to look at the bottom of your feet — or ask a family member to help check. Remember to look between your toes, too. Look for any of these problems:
    • cuts or scratches
    • blisters or irritated skin
    • cracks or very dry skin
    • calluses or corns
    • puffy, cold, or red feet

  • DO prevent and treat dry skin. Use unscented lotion or petroleum jelly (Vaseline) on your feet, though not between your toes. Diabetes can cause very dry skin, which in turn can cause cracking and other problems.

    ... but remember, DON’T put lotion or Vaseline between your toes. Extra moisture there can lead to infection.

  • DO gently care for your feet and toenails. The best time for this is after you wash your feet. Use a pumice stone to keep calluses under control. Keep your toenails trimmed straight across and use an emery board to smooth the edges.

    ... but DON’T use razors, scissors, or harsh chemicals on your feet. To get rid of corns, warts, or stubborn calluses, see a doctor or other professional.

  • DO always wear shoes or slippers with good soles that support and protect your feet. Remember, even a small foot injury can become serious for a person with diabetes. Wearing shoes is smart prevention.

    ... and DON’T go barefoot, even indoors. Headed to the bathroom in the middle of the night? Wear slippers.

  • DO choose comfortable, close-toed shoes. Make sure that new shoes are roomy enough to wiggle your toes. Avoid shoes that rub, pinch, or slip — and break in new shoes gradually. You don’t want to get blisters.

    ... and DON’T wear plastic shoes, flip-flops, high heels, or point-toed shoes.

  • DO inspect your shoes for rough, worn, or sharp internal parts. Your foot may not feel a problem with your shoe.

  • DO wear clean, thick-soled socks that fit smoothly and are made of a “breathable” material. Wearing shoes without socks can invite blisters.

    ... but DON’T wear socks with holes in them, or socks that have been mended. These may have rough areas that will irritate your skin.

When to call your doctor

  • You’re having trouble with your diabetes treatment plan or your blood glucose control.
  • You notice a sore or other injury that won’t heal or that looks infected.
  • You have signs of infection, such as swelling, redness, drainage, fever, or chills.
  • You have corns, thick calluses, or warts that need to be removed. (These can develop into sores if they’re not taken care of.) Your doctor may refer you to a foot specialist for this care.
  • It has been more than one year since you had a thorough foot exam performed by a doctor.

© 2018 Intermountain Healthcare. All rights reserved. The content presented here is for your information only. It is not a substitute for professional medical advice, and it should not be used to diagnose or treat a health problem or disease. Please consult your healthcare provider if you have any questions or concerns.