Diabetes

Foot care for the low risk foot

Taking care of your feet is an important part of staying healthy when you have diabetes. Knowing your risk level for foot problems helps you know how to keep your feet healthy.

Your foot exam shows you are at low risk for foot problems.

At this time, you have no concerns with your nails or skin. Your foot exam shows that you have no open sores and no numbness, tingling, burning, or throbbing in your feet. Your healthcare provider finds you have no loss of sensation (feeling) in your feet. You also don’t have any changes to the shape of your foot.

Even though you’re low risk, you can still develop foot problems. These may include problems with:

• your skin or nails (redness over a toe or other area, ingrown toenail)
• corns or calluses (areas of thick, hard, skin on your feet)
• sensation (numbness or tingling in your legs and feet)
• circulation (blood flow) in your legs and feet (pain in your legs when you’re walking that goes away when you rest)

If you see any of these problems, make an appointment to see your healthcare provider within 1 month or sooner if you need to. Your healthcare provider will talk with you about any extra appointments you might need for your feet.

Follow the advice below to help protect your feet.

Check your feet every day

• Look between your toes and at the tops and bottoms of your feet for swelling, redness, sores, corns, or calluses. Use a mirror or ask someone to help if you can’t see your feet. You can also use a selfie stick with your smart phone or a telescopic inspection mirror (available at most auto supply stores or online).
• Feel for temperature differences on your feet. Check if some areas are warmer or cooler than other areas. A change in temperature could be an early sign of inflammation or infection. To help check for this you can use a personal infrared thermometer (available at most pharmacies or online).
• Use the Diabetes Foot Health Self-Screening Tool to check your feet at home. It will also help you keep track of the condition of your feet and learn how to care for your feet.

Check your feet for sensation (feeling)

• You can test for sensation with the touch-the-toes test at home (use the link for step-by-step instructions). Do this test once a year. Have someone touch your toes and write down the results.
• The video “How to test for sensitivity in your feet” from Diabetes UK also shows how to test for sensation.
• If you lose feeling in your feet, you’re at higher risk for sores, infections, and other problems.

Wash your feet every day

• Wash your feet with warm water and mild soap.
• Make sure to dry well between your toes.

Apply a moisturizer (lotion) to your feet every day

• Cover the tops and bottoms of your feet with moisturizer. Don’t put moisturizer between your toes.
• Use a moisturizer with urea. Ask your healthcare provider what moisturizer is best for you.
• If it’s hard for you to reach your feet, you can use a moisturizer applicator. You can also use a plastic grocery bag: put the moisturizer on the outside of the bag and use the handles to move it around to get the moisturizer onto the bottom of your foot.

Take care of your toenails

• Cut your toenails straight across and not on an angle. Smooth the edges with a nail file. If you can’t cut you own toenails, consider finding a foot care nurse or a podiatrist. A pedicure is not a safe option when you have diabetes.
• Use this list of foot care nurses in Alberta to find a foot care nurse near you.
• Find a list of podiatrists in Alberta at albertapodiatry.com.

Foot care nurse: ______________________

Podiatrist: ___________________________

Wear shoes that fit well

• You can learn more about finding the proper shoe fit from Wounds Canada.
• Your shoes should support your feet and not rub or pinch. The heels should be lower than 5 cm (2 inches).
• Your feet swell slightly during the day, so it’s best to buy your shoes late in the day.

Get a foot checkup once a year

• A full foot checkup by your healthcare provider is important to help keep you healthy.

If you smoke, try to quit or cut down

• One cigarette lowers the blood flow to your legs for up to 4 hours. Smoking can put you at higher risk of losing your foot if you develop more serious foot problems.
• If you want help, call Alberta Quits at 1-866-710-QUIT (7848).

Practise good foot care habits

• Wear socks at night if your feet get cold.
• Put your feet up when you’re sitting.
• Wiggle your toes and move your ankles around for a few minutes several times a day to help blood flow in your feet and legs.
• Always check for objects inside your shoes before you put them on.
• Get some physical activity every day to help you have better blood flow.
• Always wear shoes, even indoors.
• Wear clothing that allows for good blood flow in your feet and legs. Tight clothing (such as tight socks or knee-high socks) can cause problems with blood flow.
• Sit with both feet on the ground, without crossing your legs, as this can decrease circulation
• Take standing or walking breaks so you aren’t sitting for long periods of time.
• Never use a hot-water bottle or heating pad on your feet.
• Only use custom-fit orthotics or insoles. Over-the-counter insoles can cause blisters if they don’t fit well.
• See your healthcare provider to treat warts or corns. Over-the-counter medicines for these foot problems aren’t safe for people with diabetes.

Get help with these warning signs

Talk to your healthcare provider as soon as possible (within 1 week) if you see any of these changes to your feet or legs:

• pain in your lower legs when you walk that doesn’t go away when you rest
• burning feeling or new pain in your feet
• red areas over any toes
• corns, calluses, or blisters, even if they’re just starting

Ask if you need to see a specialist or have more testing.

Know when to get urgent medical help

Call your healthcare provider right away for an appointment today or go to the emergency department if you have:

• cold, painful, or change in colour of your feet (pale, blue, or red)
• red, hot, swollen feet that may or may not be painful
• a swollen area that is red, even if it doesn’t hurt
• any open sore on your foot that is draining or leaking fluid

Follow your self-care management plan

To help care for your feet you’ll need to watch your blood glucose (sugar), blood pressure, and cholesterol closely. Keep track of your results to make it easier to review and plan your care. You and your healthcare provider will decide on what the best levels are for you.

To see this information online and learn more, visit https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=custom.ab_diabetes_lowriskfootcare_inst.

For 24/7 nurse advice and general health information call Health Link at 811.

References

Foot care checklist used with permission from Diabetes Canada 2018 Clinical Practice Guidelines.

Self-management table adapted from the New Brunswick Diabetes Foot Care Clinical Pathway.

Current as of: May 18, 2023

Author: Diabetes, Obesity & Nutrition Strategic Clinical Network, Alberta Health Services

This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.