What are three key points you want to teach any diabetic regarding diabetic foot care?

Diabetes: Foot care

Diabetic foot care for the high risk foot

Taking care of your feet is an important part of staying healthy when you have diabetes. Knowing your level of risk to have foot problems helps you know how to keep your feet healthy.

Your foot exam shows you are at high risk for serious foot problems.

You’re at high risk because you have 1 or more of the following:

• blister, fissure or crack, or a sore (ulcer)
• problems with circulation to your legs and feet
• redness over any part of your foot such as bunions, overlapping toes, claw toes (this could be from shoes not fitting well and rubbing)

Your healthcare provider will talk with you about any extra appointments you might need for your feet.

Lower your risk of losing your foot

Stay off your foot when you have a sore

• If your foot has a sore (ulcer) limit walking and standing as much as possible.
• You might need to use crutches or special footwear to keep your weight off the sore.

Eat a balanced diet to help your wound heal faster

• To find information on eating well for wound healing go to Eating Well for Wound Healing.

Check your feet every day

• Look between your toes and at the top and bottom of your feet. Use a mirror or ask someone to help if you can’t see your feet. You can also use a selfie stick with your smart phone, or a telescopic inspection mirror. This type of mirror can be found at most auto supply stores or online.
• Look for swelling, redness, new areas of skin breakdown, or changes to your sore.
• Check if there is more fluid leaking from the sore or there is a smell (odour).
• Feel for temperature differences of your feet. Check to see if some areas are warmer or cooler than other areas. A change in temperature may alert you to early signs of inflammation or infection. To help check for this you can use a personal infrared thermometer. This type of thermometer is available at most pharmacies or online.
• Use the Diabetes Foot Health Self-Screening Tool to examine your feet at home. It will also help you keep track of the condition of your feet and learn how to care for your feet.

Check your feet for sensation (feeling)

• Diabetes can cause you to lose sensation or feeling in your feet. For example, you may have a stone in your shoe that you don’t feel. This can cause a sore that can become infected. You may then be at risk of amputation (having your foot cut off).
• You can do the Touch the toes test at home (use the link for step-by-step instructions). This can be once a month if you’re at high risk. This is a quick and easy test to help you find out if you have sensation (feeling) in your feet. Have someone touch your toes and write down the results. This video shows how to test for feeling: Testing for sensitivity in your feet | Diabetes UK.

Wash your feet daily

• Use warm water and be sure to dry well between your toes. Check the water temperature by using your elbow or a thermometer. The temperature should be no warmer than 32 to 35°C (90 to 95°F). This is very important if you’ve lost any feeling or protecting sensation to your feet.
• If you have a wound dressing that covers your sore, follow the directions from your healthcare provider to properly clean your feet.

Apply a moisturizer (lotion) to your feet every day

• Cover the top and bottom of your feet. Don’t put lotion between your toes or on any open sores, unless you are told to do so by your healthcare provider. Use a moisturizer containing urea. Ask your healthcare provider which one is best for you.
• If it’s hard for you to reach your feet, you may want to use a lotion applicator. You can also use a plastic grocery bag – put the lotion into the bag, put your foot in, and use the handles of the bag to move it around to get the lotion onto your foot.

Have someone who is properly trained cut your toe nails

• A foot care nurse or podiatrist is important to helping you keep your feet healthy. A pedicure is not a safe option when you have diabetes.
• Find a list of foot care nurses in Alberta at Alberta Foot Care Nurses.
• Find a list of podiatrists in Alberta at albertapodiatry.com.

Foot care nurse: _________________________

Podiatrist: ______________________________

Wear shoes that fit well

• Shoes that don’t fit well can lead to pressure areas, corns, calluses, and blisters which can lead to sores on your feet or toes.
• Have your shoes professionally fitted especially if you’ve lost feeling in your feet. Shop at a well-known store with staff who can professionally fit your shoes.
• Your feet swell slightly during the day so it’s best to buy your shoes late in the day.
• Your shoes should support your feet and not rub or pinch. The heels should be lower than 5 cm (2 inches).

Always check for objects inside your shoes

• Check inside your shoes every time before you put them on.

If you smoke, try to quit or cut down

• Smoking can cause less blood to flow to your feet. This makes it harder for any sores (ulcers) on your feet or legs to heal. This then puts you at higher risk for amputation.
• If you want help call Alberta Quits at 1-866-710-QUIT (7848).

Get your feet checked by your healthcare provider often

• Remember to take off your shoes and socks every time you visit your healthcare provider.

Foot care checklist

Do:

• Wear socks at night if your feet get cold.
• Put your feet up when you are sitting.
• Wiggle your toes and move your ankles around for a few minutes several times a day to help blood flow in your feet and legs.
• Get some activity every day (helps you to have better blood flow).

Don’t:

• Go barefoot, even indoors – always wear shoes inside and outside your home.
• Wear anything tight around your legs such as tight or knee-high socks (this can cause problems with blood flow to your feet and legs).
• Cross your legs or sit for long periods of time.
• Use hot water bottles, heat bags, or heating pads on your feet.
• Use over-the-counter insoles (can cause blisters if they don’t fit well).
• Use over-the-counter medicines to treat warts or corns (these aren’t safe for people with diabetes).

Warning Signs that need attention

• Pain in your calves when you walk that doesn’t go away when you rest.
• Burning feeling or new pain in your feet.
• Red areas over any toes (may be from shoes that don’t fit well).
• Corns, calluses, or blisters – even if they’re just starting (may be from shoes that don’t fit well).

Talk to your healthcare provider as soon as possible (within 1 week) if you have any of these changes to your feet or legs. Ask if you need to see a specialist or have more testing.

When to get urgent medical help

Call your healthcare provider right away and ask for an appointment today, or go to the emergency department if you have:

• cold, painful, pale, or purple feet
• red, hot, swollen feet that may or may not be painful
• a swollen area that’s red, even if it doesn’t hurt
• any open sore on your foot that’s draining or leaking fluid

Your self-care management plan

To help care for your feet, you’ll need to closely watch your blood sugar, blood pressure, and cholesterol. Keep track of your results to make it easier to review and plan your care. You and your healthcare provider will decide on the best levels for you.

To see this information online and learn more, visit MyHealth.Alberta.ca and type in diabetic foot care into the search bar.

For 24/7 nurse advice and general health information call Health Link at 811.

References

Foot care checklist used with permission from Diabetes Canada 2018 Clinical Practice Guidelines.

Self-management table adapted from the New Brunswick Diabetes Foot Care Clinical Pathway.

Current as of: September 17, 2021

Author: Diabetes, Obesity & Nutrition Strategic Clinical Network, Alberta Health Services

This material is not a substitute for the advice of a qualified health professional. This material is intended for general information only and is provided on an "as is", "where is" basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. Alberta Health Services expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use.

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