Footcare Advice: Low, Medium and High Risk

Some useful advice to help you to after your feet.

 

Content: 

Diabetes is a lifelong condition which can cause foot problems. Some of these problems can occur because the nerves and blood vessels supplying your feet are damaged. This can affect:

  • the feeling in your feet (peripheral neuropathy); and
  • the circulation in your feet (ischaemia).

These changes can be very gradual and you may not notice them. This is why it is essential you have your feet screened every year.

These leaflets will give you advice which will help you to look after your feet. This advice will depend on what risk you are of developing a foot problem:

Foot care advice - Low risk 

If your foot screening has shown that you do not have nerve or blood vessel damage at present you are currently at low risk of developing foot complications because of your diabetes.

Controlling your diabetes, cholesterol and blood pressure, and having your feet screened every year by a suitably-trained professional, will help to reduce the risk of developing problems with your feet.

If you smoke, you are strongly advised to stop.

As your feet are in good condition, you may not need regular podiatry treatment.

If you follow the simple advice in this leaflet, you should be able to carry out your own foot care unless you develop a specific problem.

Check your feet every day

You should check your feet every day for any blisters, breaks in the skin, pain or any signs of infection such as swelling, heat or redness.

Wash your feet every day

You should wash your feet every day in warm water and with a mild soap. Rinse them thoroughly and dry them carefully, especially between the toes. Do not soak your feet as this can damage your skin.

Moisturise your feet every day

If your skin is dry, apply a moisturising cream every day, avoiding the areas between your toes.

Toenails

Cut or file your toenails regularly, following the curve of the end of your toe. Use a nail file to make sure that there are no sharp edges which could press into the next toe. Do not cut down the sides of your nails as you may create a 'spike' of nail which could result in an ingrown toenail.

Socks, stockings and tights

You should change your socks, stocking or tights every day. They should not have bulky seams and the tops should not be elasticated.

Avoid walking barefoot

If you walk barefoot you risk injuring your feet by stubbing your toes and standing on sharp objects which can damage the skin.

Check your shoes

Check the bottom of your shoes before putting them on to make sure that nothing sharp such as a pin, nail or glass has pierced the outer sole. Also, run your hand inside each shoe to check that no small objects such as small stones have fallen in.

Badly-fitting shoes

Badly-fitting shoes are a common cause of irritation or damage to feet. The professional who screened your feet may give you advice about the shoes you are wearing and about buying new shoes.

Minor cuts and blisters

If you check your feet and discover any breaks in the skin, minor cuts or blisters, you should cover them with a sterile dressing and check them every day. Do not burst blisters. If the problems do not heal within a few days, or if you notice any signs of infection (swelling, heat, redness or pain), contact your podiatry department or GP.

Over-the-counter corn remedies

Do not use over-the-counter corn remedies. They are not recommended for anyone with diabetes as they can cause damage to the skin that can create problems.

If you discover any problems with your feet, contact your local podiatry department or GP for advice.

Foot care advice - Moderate risk

You will be assessed as being at moderate risk of developing foot ulcers if your foot screening has shown that you have one or more of the following risk factors:

  • You have lost some feeling in your feet.
  • The circulation in your feet is reduced.
  • You have hard skin on your feet.
  • The shape of your foot has changed.
  • Your vision is impaired.
  • You cannot look after your feet yourself.

Controlling your diabetes, cholesterol and blood pressure and having your feet assessed every year by a podiatrist will help to reduce the risk of developing more problems with your feet.

If you smoke you are strongly advised to stop as smoking affects your circulation.

As your feet are at moderate risk of developing ulcers, you will need to take extra care of them. You may need treatment by a podiatrist or podiatry technician.

If you follow the advice and information in this leaflet, it will help you to take care of your feet between visits to your podiatrist. Hopefully it will help to reduce the problems in the future.

Check your feet every day

You should check your feet every day for any blisters, breaks in the skin, pain or any signs of infection such as swelling, heat or redness.

Wash your feet every day

You should wash your feet every day in warm water and with a mild soap. Rinse them thoroughly and dry them carefully, especially between the toes. Do not soak your feet as this can damage your skin. Because of your diabetes, you may not be able to feel hot and cold very well. You should test the temperature of the water with your elbow, or ask someone else to test the temperature for you.

Moisturise your feet every day

If your skin is dry, apply a moisturising cream every day, avoiding the areas between your toes.

Toenails

Cut or file your toenails regularly, following the curve of the end of your toe. Use a nail file to make sure that there are no sharp edges which could press into the next toe. Do not cut down the sides of your nails as you may create a 'spike' of nail which could result in an ingrown toenail.

Socks, stockings and tights

You should change your socks, stocking or tights every day. They should not have bulky seams and the tops should not be elasticated.

Avoid walking barefoot

If you walk barefoot you risk injuring your feet by stubbing your toes and standing on sharp objects which can damage the skin.

Check your shoes

Check the bottom of your shoes before putting them on to make sure that nothing sharp such as a pin, nail or glass has pierced the outer sole. Also, run your hand inside each shoe to check that no small objects such as small stones have fallen in.

Badly-fitting shoes

Badly-fitting shoes are a common cause of irritation or damage to feet. The professional who screened your feet may give you advice about the shoes you are wearing and about buying new shoes.

Minor cuts and blisters

If you check your feet and discover any breaks in the skin, minor cuts or blisters, cover them with a sterile dressing. Do not burst blisters. Contact your podiatry department or GP immediately.

Over-the-counter corn remedies

Do not use over-the-counter corn remedies. They are not recommended for anyone with diabetes as they can cause damage to the skin that can create problems.

Hard skin and corns

Do not attempt to remove hard skin or corns yourself. Your podiatrist will provide treatment and advice where necessary.

Avoid high or low temperatures

If your feet are cold, wear socks. Never sit with your feet in front of the fire to warm them up. Always remove hot water bottles or heating pads from your bed before getting in.

If you discover any problems with your feet, contact your local podiatry department or GP for advice immediately.

Foot care advice - High risk 

You will be assessed as being at high risk of developing foot ulcers if your foot screening has shown that you have one or more of the following risk factors:

  • You have lost some feeling in your feet.
  • The circulation in your feet is reduced.
  • You have hard skin on your feet.
  • The shape of your feet has changed.
  • Your vision is impaired.
  • You cannot look after your feet yourself.
  • You have had ulcers before.
  • You have had an amputation.

Keeping good control of your diabetes, cholesterol and blood pressure will help to control these problems.

If you smoke, you are strongly advised to stop as smoking affects your circulation.

As your feet are at high risk, you will need to take extra care of them. You will need regular treatment by a podiatrist. If you follow the advice and information in this leaflet it will help you to take care of your feet between visits to your podiatrist. Hopefully this will help to reduce problems in the future.

Check your feet every day

You should check your feet every day for any blisters, breaks in the skin, pain or any signs of infection such as swelling, heat or redness. If you cannot do this yourself, ask your partner or carer to help you.

Wash your feet every day

You should wash your feet every day in warm water and with a mild soap. Rinse them thoroughly and dry them carefully, especially between the toes. Do not soak your feet as this can damage your skin. Because of your diabetes, you may not be able to feel hot and cold very well. You should test the temperature of the water with your elbow, or ask someone else to test the temperature for you.

Moisturise your feet every day

If your skin is dry, apply a moisturising cream every day, avoiding the areas between your toes.

Toenails

Do not cut your toenails unless your podiatrist advises you to.

Socks, stockings and tights

You should change your socks, stocking or tights every day. They should not have bulky seams and the tops should not be elasticated.

Avoid walking barefoot

If you walk barefoot you risk injuring your feet by stubbing your toes and standing on sharp objects which can damage the skin.

Check your shoes

Check the bottom of your shoes before putting them on to make sure that nothing sharp such as a pin, nail or glass has pierced the outer sole. Also, run your hand inside each shoe to check that no small objects such as small stones have fallen in.

Badly-fitting shoes

Badly-fitting shoes are a common cause of irritation or damage to feet. The professional who screened your feet may give you advice about the shoes you are wearing and about buying new shoes.

Prescription shoes

If you have been supplied with shoes, they will have been made to a prescription. You should follow the instructions your podiatrist or orthotist (the person who makes the shoes) gives you. These should be the only shoes you wear. Shoes will normally be prescribed with insoles. These are an important part of your shoes and you should only remove them if your orthotist or podiatrist advises you to. Whoever provided your shoes will carry out all repairs or alterations to make sure that they will match your prescription.

Minor cuts and blisters

If you check your feet and discover any breaks in the skin, minor cuts or blisters, cover the area with a sterile dressing. Do not burst blisters. Contact your podiatry department or GP immediately. If these people are not available and there is no sign of healing after one day, go to your local accident and emergency department.

Hard skin and corns

Do not attempt to remove hard skin or corns yourself. Your podiatrist will provide treatment and advice where necessary.

Over-the-counter corn remedies

Do not use over-the-counter corn remedies. They are not recommended for anyone with diabetes as they can cause damage to the skin that can create ulcers.

Avoid high or low temperatures

If your feet are cold, wear socks. Never sit with your feet in front of the fire to warm them up. Always remove hot water bottles or heating pads from your bed before getting in.

A history of ulcers

If you have had an ulcer before, or an amputation, you are at high risk of developing more ulcers. If you look after your feet carefully, with the help of a podiatrist, you will reduce the risk of more problems.

If you discover any problems with your feet, contact your podiatry department or GP immediately. If they are not available, go to your nearest accident and emergency department. Remember, any delay in getting advice or treatment when you have a problem can lead to serious problems.

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