Diabetes: Foot care

Diabetic 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 level of risk to have foot problems helps you know how to keep your feet healthy.

Your foot exam shows you are at moderate risk for having foot problems.

You’re at moderate risk 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 that could be from shoes that don’t fit well)
• problems with sensation (such as feeling of 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.

Lower your chances of having serious foot problems

Check your feet every day

• Look between your toes and at the top and bottom of your feet for swelling, redness, sores, corns, or calluses. Use a mirror to check the bottoms of your feet 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. This type of mirror is available at most auto supply stores or online.
• Feel for differences in the temperature of your feet. Check to see if some areas are warmer or cooler than other areas. A change in temperature may alert you to early signs of inflammation or infection. To help check for this you can use a personal infrared thermometer. This type of thermometer is available at most pharmacies or online.
• Use the Diabetes Foot Health Self-Screening Tool to examine 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 or feeling 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 feeling with the Touch the toes test at home (use the link for step-by-step instructions). This is a quick and easy test that should be done every 4 to 6 months. It can help you find out if you have sensation (feeling) in your feet. Have someone touch your toes and write down the results. This video shows how to test for feeling: Testing for sensitivity in your feet | Diabetes UK.
• If you lose feeling in your feet you’re at higher risk for sores, infections, and other problems.

Wash your feet every day

• Use warm water and mild soap. Make sure you dry well between your toes. Check the water temperature by using your elbow or a thermometer. The temperature should be no warmer than 32 to 35°C (90 to 95°F). This is very important if you’ve lost any feeling or protecting sensation to your feet.

Apply a moisturizer (lotion) to your feet every day

• Cover both the top and bottom of your feet but 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 may want to use a lotion applicator. You can also use a plastic grocery bag – put the lotion in the bad, put your foot in, and use the handles of the bag to move it around to get the lotion onto your foot.

Have someone who is properly trained cut your toe nails

• A foot care nurse or podiatrist is important to helping you keep your feet healthy. A pedicure is not a safe option when you have diabetes.
• Find a list of foot care nurses in Alberta at Alberta Foot Care Nurses.
• 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. Shoes that don’t fit well can lead to pressure areas, corns, calluses, and blisters. Any of these can 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. Shop at a well-known store with staff who know how to professionally fit your shoes.
• Your shoes should support your feet and not rub or pinch. The heels should be lower than 5 cm (2 inches).

Check for objects inside your shoes

• Look inside your shoes every time before you put them on.

If you smoke, try to quit or cut down

• 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).

Foot care checklist

Do:

• 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.
• Get some activity every day (helps you have better blood flow).

Don’t:

• Go barefoot, even indoors (consider having a pair of well-fitting shoes to only wear inside).
• Wear anything tight around your legs such as tight or knee-highs socks (these can cause problems with blood flow to your feet and legs).
• Cross your legs or sit for long periods of time.
• Use hot water bottles, heat bags, or heating pads on your feet.
• Use over-the-counter insoles (these can cause blisters if they don’t fit well).
• Use over-the-counter medicines to treat warts or corns (these aren’t safe for people with diabetes).

Warning signs that need attention

• 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 (may be from shoes that don’t fit well).
• Corns, calluses, or blisters – even if just starting (may be from shoes that don’t fit well).

Talk to your healthcare provider as soon as possible (within 1 week) if you have any of these changes to your feet or legs. Ask if you need to see a specialist or need more testing.

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

Your self-care management plan

To help care for your feet you’ll need to closely watch your blood sugar, blood pressure, and cholesterol. 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 MyHealth.Alberta.ca and type in diabetic foot care into the search bar.

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: September 17, 2021

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.