Diabetic Foot Care Tips: 8 Daily Habits That Protect Your Feet

A small blister on the foot can cost a person with diabetes a leg. Researchers estimate that as many as one in three people with diabetes will develop a foot ulcer in their lifetime, and most diabetes-related amputations begin with one. Fortunately, nearly all of this is preventable. These diabetic foot care tips take about five minutes a day and can save your limbs.

Why diabetes puts your feet at risk

Years of high blood sugar damage the nerves in the feet. As a result, you may not feel a stone in your shoe, a burn or a cut. Diabetes also narrows the blood vessels, so wounds heal slowly, and it weakens the body’s defence against infection. Poor circulation and tight or worn footwear add to the danger.

Together, these changes mean that a small, unnoticed injury can become an ulcer, then an infection, then gangrene. In Nigeria, many people arrive at hospital late because they first try home remedies or herbal dressings.

Early signs that nerves or circulation are affected

Damage usually builds slowly. Therefore, learn to recognise the early signals:

• Tingling, burning or pins and needles, often worse at night
• Numbness, or a feeling of walking on cotton wool
• Sharp, shooting pains in the feet or lower legs
• Cold feet with shiny, hairless skin
• Cramping in the calves when walking, which eases with rest
• Dry, cracked skin, because the nerves that control sweating are affected

However, many people have no symptoms at all. That is why a yearly test of sensation is so important, and why daily checking with your eyes replaces what your nerves can no longer tell you.

Eight diabetic foot care tips for every day

• Check your feet daily. Look at the tops, soles, heels and between the toes for cuts, blisters, redness, swelling or colour changes. Use a mirror or ask a family member to help.

• Wash and dry carefully. Use lukewarm water and mild soap. Test the water with your elbow first, then dry gently, especially between the toes.

• Moisturise dry skin. Apply cream to the tops and soles, but not between the toes, where moisture encourages fungal infection.

• Never walk barefoot. This applies indoors as well.

• Wear shoes that fit. Choose closed, cushioned shoes with room for your toes, and wear clean cotton socks. Buy shoes in the afternoon, when feet are slightly larger, and avoid tight slippers with a toe post. Always check inside your shoes for stones before putting them on.

• Cut nails straight across. File sharp edges and do not cut into the corners.

• Leave corns and calluses alone. Do not use razor blades, corn plasters or hot water soaks. Because of nerve damage, hot water can burn you without warning.

• Control your numbers. Good blood sugar, blood pressure and cholesterol control protects nerves and blood vessels. Stopping smoking does the same. Take your medicines every day and keep your clinic appointments.

Foot care in everyday Nigerian life

General diabetic foot care tips need local detail. These situations cause many of the injuries seen in clinics:

• Going barefoot at home, church or mosque. Wear clean sandals with a back strap wherever it is permitted. After ablution, dry carefully between the toes.
• Flip-flops and tight shoes. Slippers with a toe post rub the skin, and narrow shoes cause blisters.
• Hot ground and hot water. Sand, tiles and bath water can burn numb feet. Check the temperature with your hand or elbow.
• Heat rubs and hot massage. Menthol balms, hot water bottles and hot compresses cause burns that you may not feel.
• Salon pedicures. Tell the attendant that you have diabetes, and do not allow blades or sharp scraping.
• Farm work and flood water. Wear boots, and wash and inspect your feet afterwards.

In addition, change your socks daily in hot weather, since damp skin breaks down quickly.

Know your risk level

Not everyone needs the same level of care. Health workers group people into three levels:

• Low risk. Feeling and pulses are normal. A foot check once a year is enough.
• Moderate risk. There is nerve damage or poor circulation. Checks are needed every three to six months.
• High risk. There has been an ulcer or amputation before, or there is foot deformity or kidney disease. Checks are needed every one to three months, often with special footwear.

Ask your doctor which group you are in. The diabetic foot care tips in this article apply to everyone, but they matter most as risk rises.

Warning signs that need a doctor within 24 hours

• A cut, blister or sore that has not started to heal after two days
• Redness, warmth, swelling, pus or a bad smell
• Skin that turns black or blue
• New numbness, burning or tingling
• A hot, swollen foot that is changing shape

A foot wound with fever is an emergency, so go to hospital immediately. Meanwhile, cover the wound with a clean, dry dressing and keep weight off the foot. Do not apply herbal mixtures, engine oil, hot water or any powder to it.

Early treatment with proper wound care, antibiotics where needed and rest for the foot heals most ulcers. Late treatment is what leads to amputation.

What happens if an ulcer develops

An ulcer is treatable, especially when caught early. Treatment has several parts:

• Cleaning the wound. A health worker removes dead tissue so that healthy skin can grow.

• Dressing. Clean dressings are changed regularly. The type depends on the wound.

• Taking pressure off. This is essential. You may need crutches, a special shoe or a cast, because walking on an ulcer stops it from healing.

• Treating infection. Antibiotics are prescribed when there are signs of infection.

• Controlling blood sugar. High sugar slows healing and feeds bacteria.

• Checking circulation. Poor blood flow may need specialist care.

Healing takes weeks, and sometimes months. Therefore, patience and regular clinic visits matter more than any single cream or powder.

Get a professional foot check every year

At least once a year, ask your doctor or nurse to examine your feet. They will test sensation, feel the pulses and look at your footwear. However, if you already have nerve damage or a previous ulcer, you need a check every one to three months. Bring your everyday shoes to the appointment and ask which diabetic foot care tips matter most for your level of risk.

A common myth

“If it does not hurt, it is not serious.” With diabetes, the opposite is often true. Painless wounds are the most dangerous ones, because nerve damage has removed the warning signal. Therefore, look at your feet even when they feel perfectly fine.

The numbers that protect your feet

Foot care starts with overall control. Ask your doctor for your personal targets, then track them:

• HbA1c, the three-month average of your blood sugar
• Blood pressure
• Cholesterol

Smoking deserves special mention. It narrows the small blood vessels in the legs and can double the harm caused by diabetes. Stopping is therefore one of the most effective ways to protect your feet.

Frequently asked questions

Is it good to soak my feet?

No. Soaking softens the skin and makes it break more easily. A quick wash is better.

Can nerve damage be reversed?

Usually not completely. However, good blood sugar control slows it, and medicines can ease nerve pain.

Should I still exercise?

Yes. Walking, cycling and swimming improve circulation. Wear well-fitting shoes and check your feet afterwards. If you have an open ulcer, ask which exercises keep weight off the foot.

Do I need special shoes?

Not always. Most people do well with roomy, cushioned shoes. Custom footwear is recommended after an ulcer or when the foot has changed shape.

What should be in a home foot kit?

To follow these diabetic foot care tips, keep a mirror, mild soap, a soft towel, moisturising cream, a nail file, clean dressings and a thermometer.

Make it a habit

Link these diabetic foot care tips to something you already do every day, such as your evening bath. Five minutes of attention each night is a small price for keeping both feet for life.

Getting help

Following these diabetic foot care tips works best alongside steady blood sugar control. HubPharm pharmacists can review your medicines, arrange refills and advise on wound care supplies. For more guidance, read our tips on preventing diabetes complications or the World Health Organization’s diabetes fact sheet.