Diabetes foot care

Diabetes can affect the blood vessels and nerves in your feet and cause symptoms such as:

• loss of sensation (feeling)
• numbness, pins and needles or tingling
• not feeling when your feet are touching something hot or cold
• pain or burning sensation
• dry, thin or discoloured skin
• slow healing of cuts or skin breaks. 

If you cannot feel things like pain or heat, you can injure your foot without realising. Just a small crack or cut can lead to a serious infection if you don’t notice and get treatment quickly.  

Conditions affecting your feet that can be caused by diabetes include:

• foot ulcer 
• bacterial or fungal infection of your foot
• peripheral vascular disease (blockage of the blood vessels in your legs) 
• gangrene (tissue death due to lack of blood supply)
• Charcot foot (foot deformity with or without pain).

Some of these conditions can be very serious and if not caught early enough can lead to amputation (an operation to remove a limb).

Your healthcare provider will tell you at your diabetes check-up if you are at higher risk of getting diabetes foot problems.

There is more chance of getting diabetes foot problems if:

• you have had diabetes for many years
• you smoke
• you are older (>70 years)
• you are Māori or Pasifika
• you have other diabetes complications such as nerve damage (neuropathy), blood vessel damage (artery or heart disease), kidney disease or eye disease (retinopathy).

Everyone with diabetes should have a foot check once a year with your doctor or healthcare provider. They will look at your feet, check the sensations (feelings) and pulses in your feet.

If you have been told you have a high risk of diabetic foot disease, you should get your feet checked every time you see your healthcare provider. 

Looking after your feet involves checking them every day, caring for them properly and wearing proper shoes. You should also avoid doing things that could damage your feet. 

Foot checks

Check your feet every day for:

• blisters
• breaks in your skin
• pain
• any signs of infection, such as redness, heat or swelling.

If you can't do this yourself, perhaps because your eyesight isn't good or you have problems reaching and seeing your feet, ask your partner or carer to help you. 

If you discover any breaks in your skin, minor cuts or blisters:

• cover the area with a sterile dressing
• contact your podiatrist or GP immediately
• go to your local after-hours clinic if it is after hours and there's no sign of healing after one day.

Foot care

Wash your feet every day.

• Use warm water and mild soap.
• You may not be able to feel hot or cold well, so test the water temperature first with your elbow or ask someone to do it for you.
• Rinse your feet thoroughly.
• Don't soak your feet, as this may damage your skin.
• Dry your feet carefully, especially between your toes.

If your skin is dry, apply a moisturising cream every day. Avoid the areas between your toes. Wear socks and change them every day. Choose socks without thick seams or tight elastic. Always remove hot water bottles or heating pads from your bed before getting in.

Shoes

Always wear shoes, even indoors. You could use slippers indoors or keep special ‘inside’ shoes.

Make sure your shoes fit well, are comfortable and protect your whole foot, eg, a cushioned sports shoe. Wearing jandals puts you at risk of getting cuts and scrapes on your feet. A podiatrist can advise you about shoes, including buying new shoes or getting prescription shoes.

Before you put on your shoes, check the bottom to make sure nothing sharp has pierced the outer sole. Run your hand inside each shoe to check that no small objects such as small stones have fallen in.

If your podiatrist or orthotist (the person who makes the shoes) has supplied you with prescription shoes:

• follow the instructions they give you
• only wear these shoes
• only remove insoles if your orthotist or podiatrist advises you to
• contact your podiatrist or orthotist if the shoes are damaged or not fitting well.

Things to avoid

• Don’t walk barefoot, even indoors, as you could stub your toes or stand on something sharp.
• Don't cut into the corners of your toenails, as this can lead to ingrown nails. 
• Don’t burst blisters or try to remove hard skin or corns yourself. A podiatrist can provide advice and treatment.
• Don’t use over-the-counter corn remedies, as they can damage your skin and cause ulcers.
• Don’t sit with your feet in front of a fire or heater to warm them up. If your feet can’t feel heat well they can easily get burnt without you realising.

• Monitor your blood glucose levels  regularly and aim for your target range.
• Go to your GP regularly for your diabetes checks.
• Take your diabetes medicines and/or insulin regularly as prescribed.
• Keep your blood pressure and cholesterol in your target range.
• Eat a healthy balanced diet.
• Get support to quit smoking.
• Keep active.
• Get treatment for infections as soon as possible.

If you need financial help to pay for shoes or podiatry or orthotics appointments you may be eligible for support through a disability allowance.(external link) If you are a veteran you may be able to apply through Veterans' Affairs.(external link)