General Advice on Foot Care for Diabetes Patient

Since Type 2 diabetes is often not identified until quite a late stage, many people are already at risk of foot complications at the time of diagnosis. For this reason, very great emphasis is placed upon good foot care by diabetes clinical care staff. People with diabetes should receive information and advice on this subject, including access to specialist services such as chiropody, and they may require individually fitted, special shoes. Feet are examined on a regular basis during clinical visits so that potential problems can be identified and protective/preventive measures can be put into place. There is ample evidence that good care can prevent the occurrence of foot problems, even in those who are at risk. For example, the most common cause of ulceration is tight or poorly-fitting shoes and this is entirely avoidable with a little extra care. General advice on foot care for people with diabetes is as follows.

• Wash feet daily in warm water that does not exceed 37 °C. (It is best to use a thermometer to check the temperature, especially if thermal sensation is impaired.) Only use mild soap and do not soak the feet for more than 10 minutes.
• Dry the feet thoroughly, especially between the toes. Trim nails to the shape of the toe, if required, after bathing (but follow specific advice given by the clinic) when they are softer and easier to cut. If the skin is very dry, use a moisturizing cream recommended by the diabetes clinic.
• Inspect feet carefully once a day - a long-handled mirror is needed to examine the soles. (Some people may need help with this.) Note any changes, however slight, such as an area of redness which might indicate an early-stage lesion or infection. Seek prompt advice if you think that there may be a problem. Corns, calluses, blisters etc. require special attention and should be dealt with according to clinical advice.
• Wear cotton or wool socks that are a good fit but are not too tight.
• Never walk around the house barefoot but always wear slippers or shoes.
• Check the inside of shoes before putting them on for small stones or grit, etc.
• Choose shoes carefully. They need to have plenty of room, especially in the toe and the uppers should be made of leather. (However, some people find good quality, 'breathable' trainers to be a comfortable alternative.) Shoes need to have firm fastenings - laces, buckles or Velcro™ - so that the feet do not slip about inside. Soles should be thick so that stones that are walked on cannot harm the sole of the foot. New shoes need to be 'worn in' - they should only be worn for brief periods at first to make sure that they fit well and do not rub.
• Feet may swell through the day, especially in hot weather. It is necessary to be aware of this and change them for a larger pair, if necessary.
• If you have 'high risk' feet, do not walk excessively especially if you are not accustomed to walking or if the weather is hot or if you are on holiday.

See more diabetic complications information.