Diabetes and your feet

Footcare for patients with diabetes

Diabetes can have an effect on the blood and nerve supply, which can lead to complications in the leg and foot. This can slow down the healing process in the body and reduce the sensation to pain, temperature and pressure.

Not everyone will develop these problems, but ALL people with diabetes should follow the same rules of footcare to prevent problems developing.

Maintaining good blood sugar and weight control is very important, as is avoiding smoking.

LOOK AT YOUR FEET DAILY

Your Diabetes Team will advise if you need to see a State Registered Chiropodist (Podiatrist).

INSPECT YOUR FEET DAILY

• Look especially in between your toes and around your heels
• If you cannot manage to bend, ask a friend or relative to help, or put a mirror on the ground.
• Be aware of any cuts or anything unusual.
• Tell your Chiropodist (podiatrist) or one of your Diabetes team about any changes in your feet.

INSPECT YOUR FOOTWEAR

• Are there any rough seams or small objects caught in the shoe?
• Do these shoes still have the same support
• Are the soles still thick enough to protect your feet?

PAY ATTENTION TO HYGIENE

• Wash feet daily with warm water and mild toilet soap.
• Dry thoroughly, especially in between your toes. Separate toes carefully.
• Use only a light dusting of talcum powder.
• Change hosiery daily

LOOK AFTER DRY SKIN

• Apply a moisturising cream after washing to help keep skin supple and avoid cracking, but take care not to put cream between your toes.
• Avoid using corn or hard skin remedies

LOOK OUT FOR MOIST SKIN

• This is found mostly in between the toes and may lead to ‘Athlete’s Foot’.
• If athlete’s foot occurs, ask the chemist or your GP for advice on how to treat this.

NAIL CARE

• Only attempt to cut your nails if you can see and reach your feet quite easily. Trim nails straight across, not too short, and file any rough edges.
• If you are unsure or have any difficulties, contact your Chiropody (Podiatry) Department.
• Never poke down the edges or try to cure in-grown toenails yourself.

DEALING WITH CUTS

• Breaks in the skin should be bathed in warm water and a very dilute antiseptic solution. Cover with a dry sterile dressing.
• If there is swelling, redness, throbbing pain or pus, consult your Chiropodist (Podiatrist), GP, Practice Nurse or Diabetes Clinic immediately.
• Do not burst blisters but seek help.

FOOTWEAR

• Always ask for your feet to be measured.
• Wear a well fitting shoe, with soft uppers
• Always watch the depth and width and allow plenty room for your toes.
• Watch the seams around the shoes; they may rub your toes and allow corns to develop.
• Slippers should be worn for short periods only. They give no support or protection.
• If you have any loss of sensation in your feet, try to avoid sandals as they provide no protection.
• Do not wear garters and make sure socks and stockings are big enough, especially bed socks.
• Always look inside your shoes before putting them on to check that the seams are even and that nothing has fallen inside.
  

PREVENTING ULCERS

Diabetes can affect the nerves to your feet causing numbness and loss of pain sensation. This means that you may be unaware of an injury or an ulcer forming.

You may also have a change in the shape of your feet which means that you are much more likely to develop blisters or ulcers.

Good control of your diabetes can help prevent ulcers.

If you have had a previous ulcer or have problems with the nerves or blood supply to you feet, your Diabetes Team may advise you to see a State Registered Chiropodist

If you develop any ulcers, cuts, blisters or ingrown toenails, contact your nurse or GP immediately.

• Use a razor or any corn remedies on your feet.
• Wear poorly fitting shoes
• Go barefoot
• Sit too near heaters or use a hot water bottle to heat your feet up quickly.

• Add cold water to the bath first, then hot water.
• Check the temperature of the water with your elbow before bathing your feet.
• Switch off electric blankets and remove hot water bottles before going to bed.
• Follow all of this advice and get your feet checked regularly.

HOLIDAY FOOTCARE

Going on holiday can cause foot problems, so follow these simple precautions to ensure a trouble-free time.

THE JOURNEY

Long journeys on trains, buses and planes can make your feet swell. Walk up and down the aisle every half hour - the exercise will help keep the swelling down. Make sure your shoes don’t become too tight - take a pair of loose sandals for the journey.

FOOTWEAR

If you normally wear hospital supplied shoes, then wear them on holiday too. Remember that changing over to ordinary shoes could cause an ulcer - and ruin your holiday.

Avoid walking barefoot. On the beach, and in the sea, wear plastic sandals.

SUNBURN

Avoid sunburn to your feet and legs. Use a sun screen with a high protection factor - or keep covered.

FOOT CARE

If your skin gets very dry in the hot weather, you may need to apply more moisturising cream, such as E45, than usual. Pay special attention to your heels - dry skin here cracks easily.

FIRST AID

Take small sterile dressings, antiseptic and micropore on holiday. Clean any small blisters, cuts or grazes with diluted antiseptic and tape in a dry dressing.

FOOT CHECK

Examine your feet daily for sores, swelling and colour changes. If any of these problems develop, then visit the local state registered chiropodist.

Remember: delays in seeking treatment may make foot problems worse. Seek early treatment for all holiday foot problems.