Foot care is part of living with diabetes, just as regular monitoring of blood glucose.
Over time, diabetes can cause a decrease in the sensitivity of the feet, resulting in a wound or burn being overlooked. Circulatory problems can also arise due to thickening of the arteries and loss of arterial elasticity, which can adversely affect wound healing and increase the risk of gangrene.
However, several studies show that preventive measures can greatly reduce foot complications, help keep your skin healthy and prevent injury to your feet.
You should apply these preventive measures above and beyond such general recommendations as: consulting a dietitian to help you design a balanced diet and manage your weight, regular physical activity, maintaining your glycemia as close as possible to target values, having your blood pressure regularly monitored by a health care professional, taking your medication as prescribed, and not smoking.
Preventative measures can greatly reduce the chances of foot complications.
- Wash your feet in warm water with a mild soap. Dry them well, especially between and under the toes. Avoid foot baths for more than 10 minutes.
- If your skin is dry, apply a thin layer of unscented, hydrating lotion or cream every day. Avoid getting it between the toes.
- Carefully inspect your feet under good lighting to detect any calluses, cracks, wounds, blisters, redness or abnormal discolouration. If your vision is not sharp enough or you lack flexibility, use a mirror or ask someone to help you.
- After a shower or bath, get comfortably seated. Use an emery board to file the edges of your toenails. Always file in the same direction, not back and forth. Your toenails should never be filed shorter than the end of the toes.
- Do not cut your toenails with a nail clipper or any other sharp instrument.
- If your toenails are thick, ingrown or abnormally shaped, consult a podiatrist or foot-care nurse. If necessary, they can refer you to a doctor.
- Never apply plasters containing salicylic acid, liquids or special ointments.
- After showering or bathing, use a pumice stone or an exfoliating file on your damp skin. Always wet the pumice first. Rub gently, always in the same direction, never back and forth. Do not try to remove calluses completely at one go.
- If necessary, consult a podiatrist, foot-care nurse or your doctor.
Your doctor, a nurse at the diabetes centre, a podiatrist or a foot-care nurse should examine your feet at least once a year — more often if there is a risk or presence of complications. This exam includes a sensitivity test using a short polymer fibre called a monofilament.
Socks and Shoes
- Wear properly fitting, white or light-coloured cotton socks, avoiding tight elastic that constricts blood flow or seams that put pressure on the skin. Change your socks every day, turn them inside out when you wash them, and dry them on the hot cycle.
- Wear soft shoes that are comfortable as soon as you buy them. Shop for shoes late in the day when your feet are at their most swollen. The sole should be flexible and the heel not higher than 5 cm. Before putting on your shoes, check inside them by hand for any small objects (e.g., a pebble, nail, key), or tears or creases in the lining.
- Always wear rubber sandals or flip flops in public spaces such as swimming pools, beaches and showers. Never walk barefoot.
- If necessary, consult a podiatrist, foot-care nurse, or an orthotist (a person certified to prescribe orthotics) for custom-made shoes.
Clean the wound with cooled salt water and cover it with a dry dressing, taking care not to squeeze the foot. Do not apply adhesive tape directly to the skin.
Check every day for signs of infection, such as redness, heat (to the touch), swelling, odour or discharge. If you detect any of these, see your doctor or get to a walk-in clinic as soon as possible.
If you’re experiencing foot pain, see your doctor or go to a walk-in clinic to be assessed and to obtain prescription painkillers, if required.
If your feet get cold, wear wool socks. Never put a hot-water bottle or heating pad directly on your feet. Bundle up against the cold to prevent frostbite.
Move your toes often and make circular motions with your feet.