Foot complications are a common and serious concern for people with diabetes. With proper education and self-care, many of these complications can be prevented or managed early. Diabetic patients who understand the importance of foot care and follow a routine are far less likely to develop conditions like ulcers, infections, or worse—amputations. In this guide, we’ll explore why daily foot care is vital for people with diabetes and how healthcare professionals can support their patients through education.
Understanding the Risks
Diabetic Neuropathy
One of the most common complications of diabetes is diabetic neuropathy, a condition where high blood sugar levels damage the nerves, particularly in the feet. Over time, this damage leads to a loss of sensation, meaning you might not feel pain or notice small injuries like cuts, blisters, or sores. While this might sound like a good thing—no pain, no problem—it’s actually a serious issue. Without pain to alert you, minor foot problems can easily be overlooked, which may turn into more significant complications like infections.
For example, if a person with diabetic neuropathy develops a blister from a poorly fitted shoe, they may not feel it. As they continue walking without knowing the blister is there, it can burst, become infected, and develop into an ulcer. This is why regular foot inspections and a focus on preventive care are so crucial.
Poor Circulation
Another issue that comes with diabetes is poor circulation. Diabetes can cause blood vessels to narrow and harden, reducing blood flow, particularly to the feet. Good blood flow is essential for healing because it carries nutrients and oxygen to damaged tissues. Without it, even a small cut or blister can take a long time to heal, leaving the wound more vulnerable to infection.
For people with diabetes, poor circulation increases the risk of gangrene (tissue death) and may even lead to amputations. This is why early intervention and proper foot care are so important—simple steps like keeping your feet clean, moisturised, and protected can prevent a cascade of more severe issues.
Common Foot Problems in Diabetics
People with diabetes are more likely to experience common foot issues, such as corns, calluses, ingrown toenails, and fungal infections. While these problems might seem minor, they can turn into bigger complications if not addressed early. Corns and calluses, for example, can create pressure points that break down skin, leading to ulcers. Fungal infections between the toes can spread and cause cracking, making the skin more susceptible to bacterial infections. Regular foot care, including proper trimming of nails and wearing the right shoes, can prevent these problems from escalating.
Daily Foot Care Routine for Diabetic Patients
Foot Hygiene
Daily foot care starts with simple hygiene practices. Washing your feet every day with lukewarm water and mild soap can help keep the skin clean and free from bacteria. But one important detail that is sometimes overlooked is the temperature of the water. People with diabetic neuropathy may not notice if the water is too hot, which can cause burns. It’s always a good idea to test the water with your hand or elbow before stepping in.
After washing, it’s equally important to dry your feet properly, especially between the toes. This area is prone to fungal infections, and excess moisture can create an environment where bacteria thrive. Pat your feet dry gently with a soft towel, making sure no moisture is left behind between the toes.
Moisturising the Skin
Dry, cracked skin can invite infections, so keeping your feet moisturised is a key part of foot care. Use a diabetic-friendly lotion or a moisturiser that’s gentle and free of harsh chemicals. The best way to apply lotion is after washing and drying your feet, when the skin can absorb moisture most effectively.
However, there’s one area you should avoid: between the toes. While it’s important to keep the skin on your feet hydrated, the space between your toes should remain dry to prevent fungal infections. If you’re not sure which moisturiser to use, a podiatrist or diabetes care specialist can recommend products that are best suited for diabetic skin.
Nail Care
Nail care may seem like a small detail, but it’s incredibly important for people with diabetes. Improper nail trimming can lead to ingrown toenails, which can cause infections if they aren’t treated early. The general advice is to trim your nails straight across and file any sharp edges to avoid them cutting into the surrounding skin.
For some, especially those with limited mobility or vision problems, trimming nails can be difficult or dangerous. In these cases, it’s best to leave the task to a professional, such as a podiatrist, to reduce the risk of injury.
Regular Foot Inspections
Daily Self-Examinations
Even with the best hygiene and nail care routine, daily foot inspections are essential for spotting potential problems before they become serious. The good news is that a foot inspection doesn’t take long—just a couple of minutes a day can make a big difference. Start by checking the tops, bottoms, and sides of your feet for any cuts, blisters, swelling, or changes in skin colour. Don’t forget to look between your toes and around your nails for any signs of redness or infection.
If it’s hard to get a good look at your feet, try using a mirror or ask a family member or carer for help. Catching a small issue early, like a tiny blister or a red spot, can prevent it from becoming a much bigger problem down the line.
Signs of Infection or Problems
When inspecting your feet, there are certain warning signs you should never ignore. If you notice any redness, swelling, warmth, or discharge, it could be a sign of infection. Similarly, skin that feels unusually warm to the touch, or any area where the skin is broken, should be taken seriously.
If you spot anything unusual, it’s important to seek professional care right away. A small infection that’s left untreated can quickly escalate into something more severe, especially in someone with diabetes. Timely intervention can often prevent more drastic measures like surgery or amputation.
Selecting Proper Footwear
Choosing Diabetic-Friendly Shoes
One of the easiest ways to prevent foot problems is by wearing the right shoes. Diabetic-friendly shoes are designed to minimise pressure on the feet, offer plenty of space for the toes, and reduce the risk of rubbing or blisters. The shoes should fit well—not too tight, not too loose—and provide good support, particularly around the arch of the foot.
It’s tempting to stick with shoes you’re used to, but shoes that are too tight, have high heels, or are pointed at the toes can create pressure points that lead to blisters or sores. Comfortable, well-fitting shoes are a great way to protect your feet, especially if you’re walking or standing for long periods.
The Role of Orthotics
For some people, custom orthotics may be necessary to further protect the feet. Orthotics are specially designed shoe inserts that can help distribute pressure more evenly across the foot, reducing the risk of ulcers and other complications. A podiatrist can help determine if orthotics are the right choice for you, and they can make sure your orthotics are fitted properly.
Socks and Footwear Hygiene
Wearing moisture-wicking socks is another key part of diabetic foot care. Socks made from materials that pull moisture away from the skin can help prevent fungal infections and keep your feet dry throughout the day. It’s a good idea to change your socks daily, or more often if your feet sweat frequently.
Before putting on your shoes, always check the inside to make sure there are no foreign objects, such as small stones, that could rub against your skin and cause an injury. Shoes should also be kept clean and dry, as wet or dirty shoes can create the perfect environment for bacteria to grow.
When to Seek Professional Care
Podiatric Visits
Even if you follow a consistent foot care routine at home, it’s still essential to visit a podiatrist regularly. We talked with the people at AppliedMotion Podiatry Wembley, and they mentioned that regular check-ups allow for early detection of issues that may not be visible or noticeable to patients, which can be key in preventing serious complications.A podiatrist is a specialist in foot health, and they can spot potential issues that might go unnoticed in your daily inspections. Depending on the severity of your diabetes, you may need to see a podiatrist every few months or more frequently if you have high-risk feet, such as those with poor circulation, neuropathy, or a history of ulcers.
During these visits, your podiatrist will check for any signs of developing complications, trim your toenails if necessary, and provide advice on keeping your feet healthy. They might also recommend additional treatments, like custom orthotics, or suggest lifestyle adjustments to prevent future problems.
Early Intervention for Minor Issues
One of the most important parts of diabetic foot care is understanding when to seek professional help for minor issues. It’s easy to brush off a small cut or blister as nothing serious, but for people with diabetes, even minor wounds can lead to big problems if left untreated.
If you notice any issues like corns, calluses, or ingrown toenails that aren’t healing or are getting worse, it’s time to see a healthcare professional. Catching these issues early can prevent infections and other complications down the line. Your podiatrist can offer treatments that will help the problem heal faster and reduce the risk of it developing into something more serious.
Emergencies
There are times when foot problems require urgent medical attention. If you notice any of the following symptoms, you should contact a healthcare provider immediately:
- A wound that isn’t healing after a few days.
- Any signs of infection, like redness, swelling, or warmth around the area.
- Discharge or pus from a sore or cut.
- Sudden pain or changes in the shape or colour of your foot.
In some cases, an untreated infection can lead to more severe complications like gangrene, where the tissue dies due to a lack of blood flow. In these situations, quick medical intervention is critical to prevent the need for amputation. Always err on the side of caution—when in doubt, it’s better to seek help sooner rather than later.
Role of Healthcare Providers in Foot Care Education
Multidisciplinary Approach
Diabetic foot care doesn’t fall solely on one healthcare provider—it’s often best managed through a multidisciplinary team that includes podiatrists, diabetes educators, nurses, and endocrinologists. Each of these professionals plays a unique role in helping patients maintain good foot health.
For example, while your podiatrist focuses on the physical health of your feet, your diabetes educator may provide guidance on how to manage your blood sugar to prevent foot complications. Working together, they can develop a comprehensive care plan tailored to your needs, addressing both prevention and treatment.
This team approach not only ensures that all aspects of diabetic foot care are covered but also helps patients feel supported by a network of professionals who are focused on their well-being.
Teaching Tools and Resources
Education is one of the most powerful tools in preventing diabetic foot complications. Healthcare providers can use various teaching tools and resources to make learning about foot care more engaging and effective. Visual aids, such as charts or diagrams, can help patients understand how to inspect their feet properly and identify signs of trouble.
Many clinics also offer instructional videos or demonstrations that show the proper way to wash and dry your feet, trim your nails, and choose the right footwear. These resources are especially helpful for patients who may be new to diabetic foot care or those who learn better through hands-on examples.
In addition to in-person education, there are also plenty of online resources, such as websites, apps, and support groups, where patients can learn more about managing their diabetes and foot care. Providing patients with access to these resources ensures they have the information they need at their fingertips.
Monitoring and Reinforcement
Education alone isn’t enough—it’s important to regularly monitor patients’ progress and reinforce the importance of foot care at every visit. Healthcare providers should ask patients about their daily foot care routine, check their feet for any issues, and provide encouragement to continue their efforts.
Sometimes, patients might struggle with sticking to their foot care routine, so offering feedback, praise, or adjustments to their care plan can help them stay on track. Reinforcing these practices consistently helps ensure that patients remain vigilant about their foot health, reducing their risk of serious complications.
Overcoming Barriers to Foot Care Education
Addressing Cultural and Language Differences
One of the challenges healthcare providers face is addressing cultural and language differences that may affect how patients understand and practice foot care. Some patients may have traditional beliefs or cultural practices around health and wellness that differ from standard medical advice, making it important for healthcare providers to approach education with cultural sensitivity.
Offering educational materials in the patient’s preferred language and respecting their cultural background can make the information more relatable and easier to follow. It’s also helpful to work with interpreters or community health workers when language barriers exist, ensuring that patients fully understand the importance of foot care.
Dealing with Financial Constraints
For some patients, the cost of care can be a significant barrier to following through with recommended foot care practices. Orthotics, diabetic shoes, and regular visits to a podiatrist may not be affordable for everyone, especially those without adequate insurance coverage. Financial constraints may also lead patients to delay care, risking complications.
To overcome this barrier, healthcare providers can help patients access financial assistance programmes or community resources that provide low-cost or free care. There may also be charitable organisations or local clinics that offer free foot exams or provide diabetic shoes at a reduced cost. Educating patients about these options ensures that cost doesn’t prevent them from receiving the care they need.
Patient Motivation and Compliance
Even with the best education and support, some patients may struggle with motivation when it comes to sticking to a foot care routine. Busy schedules, forgetfulness, or simply not understanding the full risk of neglecting foot care can lead to poor compliance.
Healthcare providers can help by setting realistic goals with patients and offering regular reminders or follow-up appointments. Positive reinforcement, such as praising patients for their efforts and celebrating small successes, can boost motivation and help them stay engaged with their care. Understanding each patient’s individual challenges and working with them to create a manageable foot care routine can make a huge difference in long-term compliance.
Conclusion
Taking care of your feet is a vital part of managing diabetes. By following a daily foot care routine—washing, inspecting, wearing proper footwear, and seeking professional help when needed—diabetic patients can prevent many of the serious complications that threaten their health. With the support of healthcare providers and education tailored to their individual needs, patients can take an active role in keeping their feet healthy and improving their overall quality of life.
By making foot care a priority, diabetic patients can significantly reduce their risk of complications like ulcers, infections, and amputations, ensuring they stay on their feet for years to come.