Having diabetes increases your risk for foot sores, infections, and injury. The problems can range from minor sores to permanent damage to the foot. Itâ€™s important to learn how to care for your feet and legs to lower the risk of infection and injury.
What is the cause of foot problems?
When you have diabetes, you may have poor blood flow to your feet. This makes it harder for your feet to fight infections and heal from injuries. As a result, infections and sores on your feet are more likely to become serious. Because diabetes can damage nerves (neuropathy), you may not feel pain if you hurt your foot or get an infection. This can make it hard for you to know when your foot needs medical treatment. This is why itâ€™s so important for you to check your feet every day.
Without treatment, severe infections can cause the flesh of your foot to die (gangrene). People who have diabetes are much more likely to have gangrene in the foot than people who do not have diabetes. Sometimes foot problems can get so bad that your foot or leg may have to be amputated.
What are the symptoms?
The first symptoms of an injury or infection may be swelling, redness, or a blister. If you have had diabetes for awhile, you may or may not feel pain. You may get sores:
On the bottom of your foot or on your toes
Where a seam or wrinkle in your sock or a shoe rubs your foot
From an injury (even a sharp corner of a toenail can break the skin)
Sores may heal but later come back in the same place. If sores are not treated, the skin on your foot or lower leg may die and turn black. Or the infection may spread. If the infection spreads to your blood, it can cause death.
How are they diagnosed?
Your healthcare provider will ask about your symptoms and medical history and examine you. You may have blood tests.
Sometimes sores are much larger than they look. Your provider will need to see how deep the sore is. You may need an X-ray or other imaging tests to make sure your bone is not infected.
How are they treated?
Your provider may prescribe antibiotics or other medicines to put on the sore or infected part of your foot. The medicine will help fight infection and help new, healthy flesh to grow. Your provider may also prescribe an antibiotic to be taken by mouth.
You may have to stay off your feet for a while to keep the sores or infection from getting worse. You may need to keep your foot raised on a stool or pillow to help prevent swelling and keep good blood flow to the foot. Your provider may prescribe wound care treatment or physical therapy, such as whirlpool baths, to help your foot heal. The therapist may also check how you are walking and how well your shoes fit. Sometimes a foot specialist may help with your foot care.
In some cases you may need to stay in the hospital for treatment. You may need surgery to remove parts of your foot or leg if:
Antibiotics do not help.
The infection spreads to the bone.
You have gangrene.
How can I help prevent foot problems?
Check your feet every day.
Look at your feet daily to check for reddened areas, cuts, or scrapes that could get infected. A mirror can help you see all surfaces of your feet, or you can ask someone for help. You can also use your hands to feel for hot areas, bumps, or sore spots. Check for such things as:
Changes in the color or temperature of your toes or feet
Changes in the bony shape of the toes or feet (you may have a broken foot bone and not be able to feel it)
New numbness or loss of feeling in the toes or feet
A buildup of tough, thickened skin (corns or calluses)
Dry or cracked skin, or skin that does not look normal
Look for signs of infection in a cut or blister. Signs of infection include new or worse redness, swelling, pain, warmth, or drainage from the area wound.
Tell your healthcare provider as soon as you have any sign of a foot problem.
Keep your feet clean and dry.
Wash your feet every day with soap and warm (not hot) water. Then dry your feet carefully with a soft towel, especially between the toes. After your feet are dry, put petroleum jelly, lanolin, or a lotion recommended by your provider on your feet to keep the skin soft and smooth. Do not put lotion between your toes because it will keep the skin in that area too moist.
If your feet sweat a lot, keep them dry by dusting them with talcum powder. You may need to change your socks more than once a day.
Treat corns and calluses.
Don’t treat corns or calluses yourself. These problems should be treated by your healthcare provider or a foot specialist. Tell your healthcare provider right away if you have a corn or callus.
Donâ€™t use nonprescription products for these problems unless your healthcare provider says itâ€™s OK.
Care for your toenails.
Clean and cut your toenails carefully. Cut them straight across. Do not cut the corners of the nails, the hardened skin at the corner of the nail, or the cuticles.
If your nails are hard to trim, ask your healthcare provider or foot specialist for help.
Protect your feet from hot and cold.
Donâ€™t use hot water bottles, electric blankets, or electric heaters to warm your feet. Because you may not feel hot and cold with your feet, you may burn your feet accidentally and get an infection. Wear cotton socks to bed if you need extra warmth for your feet.
Be careful not to burn your feet, for example, on hot sand at the beach; in hot bath water, hot tubs, or whirlpools; or near a fireplace.
Choose good footwear.
Never walk barefoot even around the house. Keep slippers by your bed to use as soon as you get up. Always wear shoes or slippers both indoors and outdoors. Donâ€™t wear sandals or flip-flops. They donâ€™t protect your feet from injury.
Wear shoes that fit properly and will protect your feet from injury. This is even more important if you work in construction or are on your feet for long hours.
Ask your healthcare provider about specially made shoes if you have foot problems.
Avoid wearing new shoes for more than an hour a day until they are thoroughly broken in.
Wear clean cotton socks and change them at least once a day.
Keep good blood flow in your feet.
Stand up if you have been sitting for a long time, for example, at a desk.
Wiggle your feet and toes several times a day.
Exercise your feet to get the blood flowing. Put your feet on the floor and lift your heels 10 times. Do this several times an hour, especially if you are traveling in a bus or airplane. If you are traveling by car, stop every 1 to 2 hours to stretch your legs and walk a bit.
Avoid sitting with your legs crossed.
Do not smoke. It causes poor blood flow and slows the healing of wounds.
Be careful when you exercise.
If you have nerve damage or a foot problem, ask your healthcare provider how much weight-bearing activity, like walking, is OK. If you canâ€™t feel things on the skin of your feet, then you will need to be extra careful to prevent injury. Activities like bicycling or swimming may be safer for you.
In addition to these foot care guidelines, keeping good control of your blood sugar, blood pressure and cholesterol help prevent foot problems.
Your provider should check your feet at least once a year. See your provider before your next regular exam if you have a red area or sore. If you have trouble with your feet, you may need to have more than one foot exam each year.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2015-01-05 Last reviewed: 2015-01-05
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.