· What do I need to know?
Foot care is something you can control. Check your feet every day for any signs of redness, swelling, change of shape, dryness or cracks in the skin, sores, blisters or any other change. Pay attention to the way your feet feel – are they at all numb, painful or tingling? Do your feet or legs cramp up frequently? Any of these signs likely mean there is a problem that requires attention as soon as possible to reduce the risk of complications. Develop good habits like wearing protective footwear indoors. Most accidents to the feet happen inside the house and may be avoided by wearing footwear that offers protection. Closed toe shoes can help protect your feet from cuts and scrapes that you may not be able to feel.
· What does neuropathy mean?
People with diabetes are at higher risk of developing a condition called neuropathy, where nerve sensitivity is lessened, particularly in the feet. This means that a person may not be able to feel heat or cold, cuts or shoes rubbing against the foot. With time, small injuries that remain untreated may lead to complications or even amputations. Diabetic neuropathies are more common in people who are overweight and/or who have high blood pressure and blood fat levels and problems controlling their blood glucose.
· Who should I call?
There are a variety of people in your healthcare team. Family doctors have a general idea of your health, but not every doctor has special training in monitoring your feet. Chiropodists and podiatrists are healthcare professionals who specialize in foot care. Pedorthists specialize in orthotics, footwear and footwear modifications. Foot care nurses have special training in caring for your feet. For more information, please see the questions below.
· What are chiropodists and podiatrists?
Chiropodists and podiatrists are healthcare professionals with special training in recognizing and treating foot and ankle problems using therapy, surgery or other treatment if needed. Their goal is to reduce the negative impact of foot or ankle concerns on the patient's health, mobility, comfort and independence.
· What are pedorthists?
Pedorthists specialize in assessing the health of the lower leg and foot, making customized orthotics, modifying footwear and fitting shoes. It is especially important for people with diabetes to have a shoe that fits properly to reduce the risk of it rubbing against the skin. Pedorthists can help you select the style, type and size of shoe that will meet your needs while also taking care of your feet.
· What are foot care nurses?
Foot care nurses are regularly trained nurses who have specialized knowledge in caring for feet and recognizing the signs of potential foot concerns. They have also learned about ways to treat and care for foot health concerns.
· Where do I find foot health care professionals?
Find a Healthcare Professional in your region.
· Why can’t I just go see my family doctor?
Going to a family doctor is an excellent choice for monitoring your general health and to receive referrals to specialists in different areas of healthcare. Some family doctors may have special training in foot care; however, many do not. In order to ensure that you receive the best foot care possible, it is better to visit a healthcare professional who has received special training in foot health and treatment of foot issues. You should still ask your doctor to check your feet at every visit. Most doctors would then do a quick assessment to see if you are at risk of developing problems with your feet. They would also be able to suggest possible avenues for care if needed.
Who may be part of your Healthcare Team
Diabetes educators provide general information and educational materials to help you learn how to manage your diabetes and take the steps necessary to be as healthy as possible.
Since it can be difficult to figure out which foods make up a healthy diet, Registered dietitians are available to help you create a plan that meets your individual needs and goals.
Endocrinologists are doctors who specialize in treating disorders of the endocrine system, such as diabetes, hypothyroidism, and many others. In most provinces and territories, you will need to receive a referral to be seen by an endocrinologist.
Vascular surgeons are trained in diagnosing and treating health concerns affecting blood flow. Diabetes can affect the flow of blood to legs and feet and may delay the healing of wounds, and vascular surgeons would try to improve circulation. In most provinces and territories, you will need to receive a referral to be seen by a vascular surgeon.
Neurologists investigate potential complications of the nervous system. Approximately 60 to 70 percent of people with diabetes have some form of nerve damage, with the highest rates being among people who have had diabetes for at least 25 years.
Plantar warts come from a virus that can be found in public areas, including pools, hotels, etc. The virus can create a lesion that looks like a callous. It is important not to use any pumice stone or other product on it to avoid making it worse and causing it to spread. In order to treat plantar warts, please see a healthcare professional.
Blisters are small pockets or bubbles of fluid near the outer surface of the skin, typically caused by forceful rubbing, burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid; however, blisters can also be filled with blood or pus.
Calluses are especially rough areas of skin that have become relatively thick and hard as a result of repeated friction, pressure or other irritation. Calluses are generally not harmful but may sometimes lead to other problems, such as skin ulceration or infection. A chiropodist or podiatrist should be seen to look at the lesion before any action is taken to remove it.
· When should I stop trimming my own nails?
People with diabetes sometimes lose the feeling in their feet. If this is the case for you, by trimming your own nails, you may unintentionally cut or poke yourself without even realizing it. Once you lose any sensation in your foot, please have a trained friend or family member or a healthcare professional trim your nails for you.
· What do I do if I can’t check my own feet?
Sometimes, people are unable to bend down to their feet or lift their feet up for checking. If this is the case, you may find putting a mirror on the floor helpful in seeing the bottoms of your feet. If this doesn’t help, please ask a friend or family member to check your feet.
· How do I check my feet?
To check your feet, look at both the tops and bottoms of your feet for any of the following:
· Change of shape
· Dry or cracked skin
· Cuts or scrapes
· Ingrown toenails
· Any other change
· Why is it important to check my feet?
The earlier you notice changes to your feet and seek help, the more likely you are to treat any problem that may arise before they lead to potentially severe complications. People with diabetes are at higher risk of developing a condition called neuropathy, where they lose sensitivity in your nerves, especially in their feet. If you do not have this sense of feeling in your feet, you may hurt your foot and not realize it. Left untreated, these injuries can possibly lead to complications, perhaps even amputation. It is important to notice these issues as soon as possible so that you can have them treated and improve your foot health.
· How do I reduce the risk of complications for my feet?
There are many things you can do to protect your feet. Check your feet daily and always ask your doctor or health care worker to check your feet at every visit. Wash your feet with warm water and mild soap everyday, and then dry thoroughly. Moisturize your feet with unscented cream, and be careful not to put any lotion between your toes. Wear closed toe shoes to protect your feet from cuts and scrapes that you may not be able to feel. Check your feet everyday for any signs of redness, change of shape, dryness or cracks in the skin, sores, blisters or any other change. Also pay attention to the way your feet feel – are they at all numb, painful or tingling? Any of these signs likely mean there is a problem that requires attention as soon as possible to reduce the risk of complications.
· Why is it not enough for shoes to be comfortable and soft?
As the nerves in your foot change, the messages they send are not always correct. This means that your shoes may feel comfortable even if they are too tight. If you have some feeling loss in your foot, having your footwear professionally fitted is very important to ensure a good fit.
· Why can’t I wear open toe shoes?
People with diabetes often lose sensitivity in the nerves in their feet, making them more likely to receive a cut, scrape or rubbing on the foot without realizing it. Left untreated, this wound might get worse, potentially leading to complications or even amputation.
· How do I know if my shoes fit properly?
Redness on your foot may be a sign that your shoes do not fit properly and are rubbing your skin. You can also have a pedorthist measure your foot to ensure that your shoes fit properly.
What do I do if…?
· What do I do if I can’t feel my feet?
Monitor and control your blood glucose levels. Have someone professionally care for your feet skin and nails so that you do not hurt yourself unintentionally. Have your shoes professionally fitted to ensure a good fit. See a member of your healthcare team as soon as possible.
· What do I do if my feet are red?
Sudden change in foot color can be an indication of one of many foot health concerns. It may be a sign of blood flow changes, infection, bone problems within the foot or another health issue. Occasionally, contact with synthetic materials, such as polyester, may cause the foot to turn red. If possible, identify the type of products that cause this reaction so that you can avoid them in future. Redness that appears only on the sides of the feet may indicate that your shoes are too tight. Wear adjustable shoes with laces, Velcro or buckles so that you can adjust them as your foot expands slightly during the day. Have your shoes checked for size, and make sure that nothing is stuck in the shoe.
· What do I do if I have a callus on my foot?
A callus is your skin’s way of protecting itself from pressure. It is important to identify the reasons the callus developed to be able to reduce the risk of another one developing. Apply a foot moisturizer to soften the callous and then use a gentle file or pumice stone to carefully remove the hard skin. Avoid corn plasters, and never try cutting the callous off using a blade or scissors. If you have nerve damage and loss of feeling in your foot, do not try to remove the callus on your own. Avoid walking on your injured foot, and see a healthcare professional as soon as possible.
· What do I do if the skin on my foot is cracked?
Cracks in the skin are often due to dryness or calluses. They can be very painful and can lead to more severe problems if left untreated. Wash your feet and then dry them gently and well. Make sure the cracks are clean. You can use an antiseptic such as betadine and saline (salt water) to clean the cracked area. Keep the crack/fissure covered using a bandage dressing so that it doesn’t get dirty and infected. Avoid walking on your injured foot, and see a healthcare professional as soon as possible.
· What do I do if I have a blister on my foot?
Avoid walking on your injured foot, and see a healthcare professional as soon as possible. Try not to pop the blister, and remember that it is important to find the cause of the blister to reduce the risk of more serious problems developing. Keep the blister and surrounding area clean and protected using a bandage or similar dressing.
· What do I do if I have something stuck in my foot?
Seek help immediately from your emergency foot care clinic or walk-in physician clinic. Neglecting or leaving the foreign object in your foot can potentially lead to further severe problems such as major ulceration, infection and possible amputation. Avoid walking on your injured foot, and see a healthcare professional as soon as possible.
· What do I do if the shape of my foot is changing?
It is especially important for people whose feet are changing shape to have their shoes professionally fitted to ensure that they fit the foot’s new shape. If you notice that the shape of the foot is changing, there is some swelling and the foot feels warm, see your health care worker immediately to prevent possible further complications. A condition called “Charcot foot” may be present which leads to permanent deformity of the foot if not treated early.
· What do I do if I have pain in my foot?
Once you feel pain in your foot, seek help as quickly as possible in order to reduce the risk of complications. Foot pain can result from one of many potential causes, such as an injury (a sprain for example) to more chronic conditions such as the development of hard calluses on the feet. It can feel like an ache or dull pain or a sharp, shooting, throbbing sensation. Be as descriptive as possible when telling your health care worker what you feel to help the healthcare professional determine what is causing the pain.
· What do I do if I have a cut or scrape on my foot?
Wash the cut or scrape with warm water, and then cover it with a bandage. Avoid walking on the injured foot, and see a healthcare professional as soon as possible.