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see also www.diabetes.usyd.edu.au/foot/Fcare1.html (with pictures)

FOOTCARE AND FOOTWEAR  

Footcare for people with diabetes
People with diabetes are at a greater risk of developing foot problems. It is most important that you are aware of the problems that can occur and take steps to prevent or minimise these.

How does Diabetes affect the feet?
It is thought that high blood glucose readings over a period of time leads to complications some of which affect the feet.

• Poor circulation / reduced blood supply to the feet, which means that healing can be delayed.
• Nerve damage (neuropathy) which means there may be loss of sensation or numbness in your feet. You may receive an injury and not notice and therefore not attend to it as soon as you should.

How to avoid these problems?

• Good Diabetic Control
• Daily Foot Care.

These are your feet and you must get to know them.

• Inspect feet daily
• Look at them, feel all over. Check to see if there are any cuts or scratches, any redness, swelling , hot spots or pain.
• Look between toes, is the skin soggy or red?
• If necessary ask a friend to help or use a mirror.
• Injuries such as cuts, scratches or blisters should be cleaned with soap and water, a safe antiseptic like Betadine® and covered with a clean dressing. If not healed within a couple of days seek medical advice. (Do not use mercurochrome as the colour can mask signs of infection and /or inflammation).
• Wash feet daily in warm, never hot, water and a mild soap. Rinse well and pat dry with a soft towel especially between toes. Methylated spirits can be wiped between toes to ensure they stay dry.
• Massage moisturiser into your feet and legs daily (never use cream between toes).

Nail Care

Nails should be level with the end of your toes. Check your nails daily and file weekly as necessary. Check that the nails are smooth and not cutting into other toes and that they can't catch on socks or stockings.
Clean nails with a soft nail brush only.
Ingrown, thick or fungal nails should be attended to by your Podiatrist.

Corns and calluses

Corns are caused by pressure over bony parts of the foot.
Calluses are caused by shearing forces over the skin, generally under your foot.

Corns and calluses should be treated by a Podiatrist. Never use corn plasters as they contain acid and can severely burn your skin.
Corns and calluses are symptoms of problems with your feet, see your Podiatrist for help.

Other foot problems

Bunions, hammer toes, sore feet, sore heels and other problems, consult your Podiatrist for advise and / or treatment.
Circulation

• Exercise regularly, within your limits, and use exercise shoes that support and protect your feet. Always check with your doctor before commencing new activities.
• Avoid tight socks, stockings or garters as they can restrict your circulation.
• Do not sit close to fires or heaters. Before going to bed, turn off electric blankets and / or remove hot water bottles.

Footwear

• Shoes must fit your feet and protect your feet from injury.
• Check that they are deep, wide and long enough. Make sure that you can wriggle your toes.
• Do not wear 'slip on' shoes. A shoe requires some type of fastening in order to hold your foot firmly and securely. They should be light weight , flexible and have a good shock absorbing sole.
• Always seek the advice of a qualified shoefitter. Don't forget that your feet can change shape as you grow older.
• Shop for your shoes in the afternoon or after exercising, in case your legs or feet swell.
• Don't walk around without shoes.
• Avoid wearing slippers for any length of time as they encourage a shuffling gait and offer no support.
• Always check inside your shoes before wearing them.

Podiatric Assessment

• Visit your Podiatrist at least yearly for an assessment and checkup. Your Podiatrist will perform a Diabetes Assessment, which would include; Vascular, Neurological, Biomechanical and footwear assessment.

KEY POINTS

• Get to know your own feet.
• Inspect feet and shoes daily.
• See your Podiatrist if there are any problems.
• Have a full Diabetes Foot Assessment yearly.

FEET AND FOOTWEAR

When buying shoes remember:

• Have both feet measured,
• Have shoes fitted at end of day or after exercise when your feet may be swollen,
• Walk around the shoe shop for 10 - 20 minutes and not only on the carpet.
• While walking, check that your foot remains well seated in the shoe and doesn't slip up and down.
• Buy the shoe to fit now - don't expect it to stretch.
• Shoes should not need to be 'worn in', however it is a good idea to wear new shoes for a short time only for a couple of days and check carefully for any red marks, pain or rubbing from the shoes.
• Shoes that are too big can cause problem as do shoes that are tight, narrow or short.
• Always take the socks or stockings you intend to wear with the shoes to the fitting.
• Always take your orthotics with you when buying new shoes.
• Court shoes / 'slip on' shoes only stay on your feet if they are firm or too short.
• Slippers encourage a shuffling gate and offer no support for your feet