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Diabetic Foot Care for the High Risk Foot

​​When you have diabetes you should ask your healthcare provider to examine your feet at least once a year.

Your foot exam shows you are at high risk for serious foot problems. Your healthcare provider will make a referral for you to see a foot care specialist. You should expect a phone call to book an appointment in 1 to 2 weeks. If you do not get an appointment, please call your healthcare provider to let them know you are still waiting for an appointment.

You are at high risk for serious foot problems (complications) if you have any of these:

  • problems with your skin or nails (e.g., redness over a toe or other area, ingrown toe nail)
  • corns or calluses
  • problems with sensation (e.g., a feeling of numbness or tingling in your legs and feet, or pain in your legs when you are walking that goes away when you rest)

plus you have any of these 3:

  1. loss of feeling (loss of protective sensation)
  2. less blood flow to your feet (poor circulation)
  3. have an open sore on your foot

If you see any of these problems, make an appointment to see your healthcare provider right away.

How to Lower Your Chances of Amputation

  1. Stay off your foot with the sore (ulcer) as much as possible. You might need to use crutches or special footwear to keep weight off the sore.
  2. If you smoke, try to quit or cut down. Smoking can cause less blood to flow to your foot making it harder for your foot to heal. If you want help call Alberta Quits at 1-866-710-QUIT (7848).
  3. Check your feet daily. Look between your toes and at the top and bottom of your feet. Use a mirror or ask someone to help if you can’t see your feet. Look for swelling, redness, new areas of breakdown, or changes to your sore. Check if there is more fluid leaking from the sore or there is a smell (odour). If you see these changes call your healthcare provider right away.
  4. Wash your feet daily and dry well especially between your toes. Check the water temperature if you have lost protective sensation by using your elbow or a thermometer. The temperature should be between 32 to 35°C (90 to 95°F). If you have a wound dressing that covers your sore, follow the directions from your healthcare provider to properly clean your feet.
  5. Have someone who is properly trained cut your toe nails.
  6. Apply a moisturizer (lotion) at the top and bottom of your feet every day. Do NOT apply between your toes or on any open sores, unless you are told to do so by your doctor. Use a moisturizer containing urea. Ask your healthcare provider for examples.

Steps toward good foot health

(Reproduced with permission from Diabetes Canada 2018 Clinical Practice Guidelines​)


  • Do wear shoes that fit well. Shoes should have good support, do not rub or pinch your feet, and have low heels (less than 5 cm or 2 in). Consider having your shoes “professionally fitted”.
  • Do buy your shoes late in the day. Your feet may swell slightly during the day.
  • Do wear socks at night if your feet get cold.
  • Do wiggle your toes and move your ankles for 5 minutes, 2 or 3 times a day, to help blood flow in your feet and legs.
  • Do put your feet up when you are sitting.
  • Do activity every day to improve blood flow through your body.


  • Do not use over-the-counter medicines to treat warts or corns. They are not safe for people with diabetes.
  • Do not wear anything tight around your legs such as tight socks or knee-highs. This is not good for your circulation.
  • Do not go barefoot. Always wear shoes inside and outside your home.
  • Do not use hot water bottles, heat bags, or heating pads on your feet.
  • Do not cross your legs or sit for long periods of time.
  • Do not use over-the-counter insoles unless recommended by your foot expert. They can cause blisters if they do not fit well.
  • Do not smoke. Smoking decreases blood flow and healing. It also increases the risk of amputation.

Your self-care management plan

As you take care of your feet, you need to closely watch your blood sugar levels, blood pressure, and cholesterol. Keep track of your results to make it easier to review and plan your care. Together you and your healthcare provider will decide on the best levels for you.

Indicator Present Level Goal Level
Blood sugar or AIC  
​Blood Pressure  

Warning Signs:

  • pain in your calves on walking that doesn’t go away when you rest
  • burning sensation or new pain in your feet
  • red areas over a toe or toes
  • getting corns, callus or blisters

Report any of these changes to your healthcare provider as soon as possible (within a week). Ask if you need more testing or a referral to another specialist.

Call your healthcare provider right away and request to be seen the same day, or go to the emergency department if you have any of these:

  • cold, painful, discoloured (pale, blue, or red) feet
  • red, hot, swollen feet that may or may not be painful
  • new or increasing pain in your lower legs or feet
  • any open sore on your foot that is draining.

Adapted from the New Brunswick Diabetes Foot Care Clinical Pathway

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

Current as of: April 15, 2020

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