Diabetes Foot Maintenance: An Introduction

If you have type-1 or type-2 diabetes, maintaining your feet is an important aspect of managing the disease. Whether the diagnosis is new or you have been managing metabolic syndrome for years, there are many helpful tips for maintaining healthy feet. It should be understood that problems in the diabetic foot can escalate quickly. At Healthmark Foot and Ankle we typically instruct patients to examine their feet twice per day. We encourage them to make it a part of their morning and evening routine. Regular self-examinations allow patients to become more familiar with their feet and can prevent the escalation of small manageable issues. If problems arise we suggest seeking the advice of an experienced podiatrist as soon as possible. At Healthmark Foot and Ankle we are available 24 hours a day, 7 days a week to assist you (after you’ve made an appointment and seen a doctor).

Below are some footcare tips to keep your feet happy and healthy.

Nail Management: When trimming your nails, use clippers or scissors with a rounded edge. Avoid the traditional “simple machine” push clippers with abrupt edges. Use sharp, curved scissors on the free edge of the nail. We like to suggest trimming nails after a shower or bath when the nail and nearby skin are soft. Cut the nail straight across and be sure to smooth out nails with a soft emery board instead of a hardened, metallic file. Avoid cutting into the corners to prevent ingrown toenails and infections.

Skin Care: Foot calluses, corns, blisters, warts, fungus, rash, wounds or open skin should be evaluated by a podiatrist. Skin on the diabetic foot is sensitive and more prone to skin breakdown than a non-diabetic foot. Skin breakdown can lead to serious infections.  We do not recommend attempting to treat these conditions yourself in any circumstance.

Socks: Change your socks regularly especially if you experience foot sweat or foot odor. Don’t hesitate to invest in new socks if you notice that your existing socks have become thin, rough, discolored, or full of holes. Avoid socks that do not provide uniform tightness. Be mindful of any bunching or rubbing of sock material against the foot when wearing shoes. Not only is a mangled sock uncomfortable, it can also result in blisters, hotspots, and rashes. We also recommend seamless socks to avoid creating pressure areas. Compression socks and socks that wick away moisture are very helpful for distributing blood flow and preventing cold feet.

Footwear: Function over fashion. While everyone is different and has varying styles it is important to opt for roomy, comfortable shoes with closed toes, cushioned insoles, durable tread, and secure fastening. Try to avoid hard-bottomed formal footwear, high heels, or flats whenever possible.

Avoid going barefoot as much as possible, even around the house. Open shoes such as sandals or flip-flops expose the foot to environmental hazards that can turn a small injury into something much more significant. Sandals, flip-flops, and water shoes are suggested for swimming activities, but protective footwear should be used outside at all times.

Make sure to replace your footwear every 1000 miles or every 8-10 months. Don’t be hesitant to get new shoes. If you have questions or are in need of recommendations ask your doctor. Old shoes should be discarded and not used for chores or as “yard work shoes.” Break in new shoes a few hours a day around the house.

Temperature: Partially due to circulation, the diabetic foot can be very sensitive to cold and hot conditions. Avoid using heating blankets and heating creams. Swelling and inflammation can occur with very hot waters including saunas, hot tubs, steam rooms, and pools. Stiffness and decreased mobility of the foot and legs can occur in cold water and colder climates. In Winter and in the cold, wear warm socks and be sure to check your feet regularly, especially if numbness or tingling begins to occur. The chance of developing frostbite increases when circulation is poor and temperatures drop. Massaging and flexing your feet can help increase positive blood flow during both cold and hot conditions.

Understand that the diabetic foot can be one of the most sensitive parts of the human body especially as we age. The feet support our entire body weight and propel us throughout the day. Our most important tools are our hands and feet. Keep them protected and functional. Don’t hesitate to bring any questions to your podiatrist; we are here to help!