THE WHY, WHAT, AND HOW OF DIABETES FOOT CARE

When you were diagnosed with diabetes you may have been told that it’s important to look after your feet. But do you really know what this means? In this blog post, Credentialled Diabetes Educator, Dr Kate Marsh, explains exactly what it means to care for your feet, why it matters and what you can do to keep your feet healthy and happy.

'Why do I need to look after my feet when I have diabetes?'

Over time, diabetes can affect different parts of the body, including the feet. This can increase the risk of foot ulcers and amputations. According to Diabetes Australia, there are 4400 amputations every year in Australia as a result of diabetes.

Diabetes can affect the feet by:

• Causing damage to the nerves in your feet, which can make it more difficult to detect any injuries to your feet
• Affecting the blood flow to your feet, which can make it harder for wounds to heal
• Increasing the risk of infections

These complications are more likely if you have had diabetes for a long time, if your blood glucose levels have been high for an extended period of time, if you smoke or if you are inactive.

The good news is that there are many things you can do to keep your feet healthy and reduce the chances of developing these complications. In fact, Diabetes Australia estimates that 85% of diabetes-related amputations are preventable if wounds are detected early and managed appropriately. 

'What exactly does looking after my feet mean?'

Looking after your feet is about taking steps to reduce the risk of developing foot problems, detecting problems early if they do arise and treating them promptly.

You can do this by:

• Having a daily self-care routine for your feet – we explain what this means below.
• Having your feet checked regularly (at least annually) by your doctor, credentialled diabetes educator or podiatrist.
• Seeing a podiatrist regularly (at least every 3-6 months) if your feet are found to be at high risk (for example, if you have had an ulcer or amputation in the past or have poor feeling or blood flow to your feet). You can find a podiatrist in your area by visiting the Australian Podiatry Association website or asking your doctor for a recommendation.
• Treating any injuries to your feet immediately and seeking medical advice if there isn’t any improvement within 24 hours. 

'How do I look after my feet when I have diabetes?'

Fortunately, there are many things you can do yourself to keep your feet healthy. 

Check your feet daily. Look for any signs of redness, swelling, cuts, splinters, blisters, cracked or broken skin, corns, calluses or ingrown toenails. Particularly check between your toes, around the edges of your nails, your heels and the soles of your feet. If you can’t see your feet, get someone else to check for you.

Keep them clean. Wash your feet daily in warm (not hot) water and dry them well, including between the toes.

Moisturise regularly. This helps to avoid dry skin which can lead to cracks and infection. But avoid using moisturiser between the toes as this can increase the risk of fungal infections. If you have dry and cracked skin, consider a specialist foot care cream designed to treat these problems.

Cut nails carefully. Cut toenails straight across and not into the corners of your toe then gently file any sharp edges. Avoid cutting them too short as this can lead to ingrown toenails. If you can’t reach or see your feet well then get someone else to do this for you.

Avoid home treatments. Don’t treat corns or calluses yourself, including with over-the-counter corn cures. Instead, see your doctor or podiatrist for treatment, to avoid the risk of infection or ulcers.

Wear diabetes-friendly socks. Look for socks with flat seams, no elastic tops, extra cushioning and moisture-wicking fibres to keep feet cool and dry.

Choose the right footwear. Shoes need to fit well to protect the feet and avoid excess pressure and rubbing. Your podiatrist can provide advice on choosing the best shoe to meet your needs. If you have high-risk feet they may recommend special footwear and insoles.

Check your shoes. Before putting on your shoes each day, shake them out and feel inside to ensure there are no stones, pins or other foreign objects that could damage your feet.

Avoid going barefoot. This can increase the risk of an injury and is particularly important if you have high-risk feet. Always wear shoes, even around the house.

Protect your feet from heat. If your feet are cold, pull on some warm socks but avoid putting your feet close to heaters, hot water bottles or electric blankets.

Seek medical advice early. If you notice any problems with your feet, see your doctor or podiatrist promptly to avoid the problem getting worse. Even minor foot infections can become a problem when you have diabetes so it’s best to seek help early.

Don’t smoke. Smoking can cause reduced blood flow to your feet which slows down healing from infections. If you need help to quit smoking, speak to your doctor, visit the Quitline or call them on 13 78 48.

Keep your blood glucose levels in target. When blood glucose levels are high for long periods of time this can increase the risk of diabetes-related complications. Work with your diabetes team to manage your blood glucose levels and keep them within your target range.

Move more. Being active helps blood flow to your feet and can also help to manage blood glucose levels. Build in some regular exercise and try to break up sitting time regularly.

To help you care for your feet, Diabetic Foot Australia have developed a free Daily Foot Care Checklist. You can download a copy here.

Remember: diabetes can lead to serious complications with your feet but by taking the steps above you can significantly reduce this risk. Make caring for your feet a daily habit, get your feet checked by a health professional regularly and seek help early if you detect problems. Your feet will thank you for it! 

Remember to always seek advice from your medical practitioner before changing anything about your diabetes management. The above information is NOT medical advice.