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Diabetes: foot care for diabetics

Why are doctors so concerned about your feet?

Problems with the feet are one of the commonest complications that diabetics suffer from and that need special attention. A foot problem can be very difficult to heal once it has set in. Diabetes can decrease the circulation to your feet so that healing is relatively poor. Diabetes can also affect the nerves to the feet so that they are less sensitive to pain, touch and temperature. Diabetics are also prone to infection because the feet are almost 'out of sight and out of mind' and problems can develop without your being aware of it. Very special care of your feet is essential, and they should be checked every day.

What type of problems occur?

Pressure sores can develop on the soles of your feet from things such as corns, calluses and stones or nails in your shoes. Minor injuries such as cuts and splinters can become a major problem through poor healing. Problems with toenails such as paronychia (infection around the nail) and ingrowing nails can get out of control. Prevention of these problems is the best way.

What should you do?

1. Keep your diabetes under good control and do not smoke.

2. Check your feet daily. Report any ores, infection or unusual signs.

3. Wash your feet daily:

• Use lukewarm water (beware of scalds).
• Dry thoroughly, especially between the toes.
• Soften dry skin, especially around the heels, with lanoline.
• Applying methylated spirits between the toes helps stop dampness.

4. Attend to your toenails regularly:

• Clip them straight across.
• Do not cut them deep into corners or too short across.

5. Wear clean cotton or wool socks daily; avoid socks with elastic tops.

6. Exercise your feet each day to help the circulation in them.

How to avoid injury

• Wear good-fitting, comfortable leather shoes.
• The shoes must not be too tight.
• Do not walk barefoot, especially out of doors.
• Do not cut your own toenails if you have difficulty reaching them or have poor eyesight.
• Avoid home treatments and corn pads that contain acid.

Be careful when you walk around the garden and in the home. Sharp objects such as stakes in the garden, nails and sharp corners of beds at floor level should never be lying around or in the home of a diabetic.

• Do not use hot-water bottles or heating pads on your feet.
• Do not test the temperature of water with your feet.
• Take extra care when sitting in front of an open fire or heater.

Visit the expert

If you have problems with your foot care and especially if your physical condition makes attending to toenails, corns and calluses difficult, you should visit a podiatrist. Your doctor will advise you.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia