Diabetes: Foot Care

What is diabetes?

Diabetes is a disease that occurs when a person’s body doesn’t make enough of the hormone insulin or can’t use insulin properly. There are 2 types of diabetes. Type 1 diabetes occurs when your body’s pancreas doesn’t produce any insulin. Type 2 diabetes occurs when the pancreas either doesn’t produce enough insulin or your body’s cells ignore the insulin. Between 90% and 95% of people who are diagnosed with diabetes have type 2 diabetes.

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How does diabetes affect my body?

When you digest food, your body changes most of the food you eat into glucose (a form of sugar). Insulin allows this glucose to enter all the cells of your body and be used as energy. When you have diabetes, your body doesn’t make enough insulin or can’t use it properly, so the glucose builds up in your blood instead of moving into the cells. Over time, too much glucose in the blood can damage the blood vessels and nerves in your body.

Damage to your nerves means that you may have burning pain or lose feeling in a part of your body (this is called diabetic neuropathy). Damage to the blood vessels that some areas of your body (usually the feet) may not be getting a good supply of blood.

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Why do I have to worry more about my feet?

People who have diabetes often have trouble with their feet. The loss of feeling in your feet can make it hard for you to tell if you have a blister or sore. If little sores aren't taken care of, they can get worse and turn into ulcers (serious, deep sores). If these ulcers become infected, you may have to go to the hospital or, in very serious cases, have a foot amputated (removed). This handout will give you some tips on how to care for your feet.

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How can I avoid problems with my feet?

Keep your blood sugar level as close to normal as possible. Also, follow your doctor's advice on diet and exercise. Take your insulin or medicine exactly as prescribed. Here are some other ways to protect your feet:

• Wash your feet every day with lukewarm (not hot) water and mild soap.
• Dry your feet well, especially between the toes. Use a soft towel and pat gently; don't rub.
• Keep the skin of your feet smooth by applying a cream or lanolin lotion, especially on the heels. If the skin is cracked, talk to your doctor about how to treat it.
• Keep your feet dry by dusting them with nonmedicated powder before putting on shoes, socks or stockings.
• Check your feet every day. You may need a mirror to look at the bottoms of your feet. Call your doctor if you have redness, swelling, pain that doesn't go away, numbness or tingling in any part of your foot.
• Don't treat calluses, corns or bunions without talking to your doctor first.
• Cut toenails straight across to avoid ingrown toenails. It might help to soak your toenails in warm water to soften them before you cut them. File the edges of your toenails carefully.
• Don't let your feet get too hot or too cold.
• Don't go barefoot.

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What should I look for when choosing shoes and socks?

• Don't wear shoes without socks.
• Don't wear sandals or other open-toed shoes.
• Avoid high-heeled shoes and shoes with pointed toes.
• Wear well-padded socks or stockings that are 1/2 inch longer than your longest toe. Don't wear stretch socks, nylon socks, socks with an elastic band or garter at the top, or socks with inside seams.
• Don't wear uncomfortable or tight shoes that rub or cut into your feet. If you've had problems before because of shoes that didn't fit, you may want to be fitted for a custom-molded shoe.
• Talk to your doctor before you buy special shoes or inserts.
• Shop for new shoes at the end of the day when your feet are a little swollen. If shoes are comfortable when your feet are swollen, they'll probably be comfortable all day.
• Break in new shoes slowly by wearing them for no more than an hour a day for several days.
• Change socks and shoes every day. Have at least 2 pairs of shoes so you can switch pairs every other day.
• Look inside your shoes every day for things like gravel or torn linings. These things could rub against your feet and cause blisters or sores.

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How often will my doctor check my feet?

Your doctor or nurse should check your feet periodically when you go in for a visit. If you are having any problems, such as numbness, sores or ingrown toenails, tell your doctor right away.

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