Diabetes

Foot care for the moderate-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 moderate risk for foot problems because you have 1 or more of the following:

• skin or nail issues (ingrown toe nail)
• corns or calluses (areas of thick, hard, skin on your feet)
• problems with sensation (such as numbness, tingling, or burning in your legs and feet)
• changes to how your foot looks (bunions, overlapping toes, claw toes)

You should see your healthcare provider in 4 to 6 months to have your feet checked again. Go in 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 lower your chances of having serious foot problems.

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 you 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)

• Diabetes can cause you to lose sensation in your feet. For example, you may have a stone in your shoe that you don’t feel. This can cause a sore that can become infected and lead to more problems.
• You can test for sensation with the touch the toes test at home (use the link for step-by-step instructions). Do this test every 4 to 6 months. 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 daily

• Wash your feet with warm water and mild soap.
• Check the water temperature with your elbow or a thermometer. It should be no warmer than 32 to 35°C (90 to 95°F). This is important to avoid burns if you’ve lost any sensation in your feet.
• Make sure to dry well between your toes.

Apply a moisturizer (lotion) to your feet every day

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

Have someone who is properly trained cut your toenails

• A foot care nurse or podiatrist is important to help you keep your feet healthy. 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

• If you have lost feeling in your feet, have your shoes professionally fitted. Some specialized shoe stores offer this service. Shoes that don’t fit well can lead to pressure areas, corns, calluses, and blisters. These can all lead to sores on your feet or toes.
• Your feet swell slightly during the day, so it’s best to buy your shoes late in the day.
• Your shoes should support your feet and not rub or pinch. The heels should be lower than 5 cm (2 inches).

If you smoke, try to quit or smoke less

• Smoking can cause less blood to flow to your feet. If you have sores or ulcers this makes it harder for your foot to heal.
• 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 are 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 hot-water bottles, heat bags, or heating pads on your feet.
• Only use custom-fit orthotics or insoles. Use 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 have any of these changes to your feet or legs:

• pain in your calves 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 need 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/aftercareinformation/pages/conditions.aspx?hwid=custom.ab_diabetes_moderateriskfootcare_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.