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Foot care for People with Diabetes

Knowing your risk for foot problems

​Knowing your level of risk to have foot problems helps you know how to keep your feet healthy. Your healthcare provider will check your feet (do a foot screen or foot exam) to find out your level of risk.

You should have a foot exam at least once a year if you have no concerns and more often if you have concerns. It’s a good idea to make your own notes about your foot exam results every time you see your healthcare provider. To do this, you can print the document My foot exam results (PDF), fill it out, and keep it for your records.

There are many factors that go in to your level of risk to develop foot problems. Your level of risk guides the care you need to give your feet. Depending on your needs, you might also be referred to different healthcare providers. Examples are:

  • a high risk foot team
  • a therapeutic footwear provider
  • a professional nail care provider

Do you know your level of risk?

Each risk level is described below, along with tips to care for your feet based on your risk.

Low risk

Your foot exam shows you have a low risk of having foot problems. You have a normal foot, with no open sores, normal feeling, and no changes to the shape of your foot. There are no concerns with your toenails or nail care. If your healthcare provider tells you you’re low risk, here’s what you should do to protect your feet:

  • Check your feet daily. Look between your toes, and at the top and bottom of your feet for any swelling, redness, sores, corns, or calluses. Use a mirror or ask someone to help if you can’t see your feet.
  • Care for your feet daily. Wash your feet daily with warm water and mild soap. Dry well between your toes.
  • Cut your toenails straight across and use a nail file to file any rough edges to the shape of your toes.
  • Apply a moisturizer (lotion) at the top and bottom of your feet every day. Do not put moisturizer between your toes. Ask your healthcare provider to recommend a moisturizer.
  • Have your healthcare provider check your feet once a year. If you feel numbness, tingling, or pain in your feet, or if your feet change shape, see your healthcare provider as soon as possible. Remember to remove your shoes and socks when seeing your healthcare provider.
  • Wear shoes that fit well. Shoes should feel snug but not tight and have wiggle room for your toes. The heels should be lower than 5 cm (2 inches). You can learn more from about finding the proper shoe fit from Wounds Canada.
  • If you smoke, try to quit or cut down. One cigarette reduces blood flow to your legs for up to 4 hours. If you want help quitting, try AlbertaQuits.ca.

Moderate risk

Your foot exam shows you have a moderate risk of foot problems. You’re at moderate risk because you have 1 or more of these:

  • problems with your skin or nails (such as redness over a toe or other area, ingrown toe nail)
  • corns or calluses (areas of thick, hard, skin on your feet due to poorly fitting shoes)
  • problems with sensation and circulation (such as feeling numb or tingling in your legs and feet, or pain in your legs when you’re walking that goes away when you rest)

Your healthcare provider will talk with you about your extra care needs and any changes in your foot care that you need to do. You will likely be referred to other healthcare providers such as a:

  • foot care nurse
  • podiatrist (foot doctor)
  • therapeutic shoe provider
  • vascular surgeon (a doctor who specializes in veins and arteries)

If your healthcare provider tells you you’re at moderate risk, follow all the foot care advice for people at low risk and add the following:

  • Have someone who is properly trained cut your toenails. This could be a foot care nurse or a podiatrist. A pedicure is never a safe option. If needed, ask your healthcare provider for suggestions.
  • Use a moisturizer if your healthcare provider suggests one.
  • Have your feet measured to make sure your shoes fit properly.
  • Have your healthcare provider check your feet every 4 to 6 months.

Remember to take off your shoes and socks every time you visit your healthcare provider.

High risk

Your foot exam shows you’re at high risk for serious foot problems. You’re at high risk because you’re at moderate risk plus you have lost feeling in your feet, have reduced blood flow in your feet, or have a sore (ulcer) on your foot.

People at high risk need to see a foot care specialist or a high risk foot team. Your healthcare provider will refer you to one of these services.

When your healthcare provider refers you to a foot care specialist or a high risk foot team, you can expect a call to book an appointment in 1 to 2 weeks. If no one has called you after 2 weeks, call your healthcare provider to tell them you’re still waiting for an appointment.

If your healthcare provider tells you you’re at high risk, follow all the foot care advice for people at low and moderate risk and add the following:

  • Stay off your foot with the sore as much as possible. You may need to use crutches or special footwear to keep your weight off the sore.
  • Call your health care provider for an appointment right away if you notice any new changes in your feet.
  • Follow the special directions from your healthcare provider for how to properly clean your feet.


Current as of: June 23, 2020

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