Your Feet

Diabetes can lead to:

• Nerve damage in the feet and legs resulting in a loss of sensation, pins and needles or possible numbness and burning sensations. This is called neuropathy.
• A reduced blood supply to the feet and legs resulting in cold, painful feet. This is called ischaemia.

Both of the above points mean that injuries to the feet may go unnoticed, be slow to heal and can quickly become infected – you should seek help urgently from your General Practitioner, Podiatrist, Nurse or Hospital Diabetes Clinic if there is any sign of infection such as Pain/discomfort, Inflammation, Colour changes and or weeping. Self Foot Care

People with diabetes have an increased risk of foot problems and self care is the key to having healthy feet. It is therefore vital that people with diabetes know how to look after their feet properly.

People with diabetes should be advised to do the following:

• Wash feet with soap and warm water regularly. After you have washed them it is vital that you dry them properly (especially between the toes) to prevent the skin becoming soggy; an ideal site for infection.
• Moisturise your feet daily, especially areas of dry skin, but not between the toes.
• Cut nails to the shape of the toe and file smooth.
• Change socks or tights daily – natural material like wool or cotton is best.
• If you tend to get athlete’s foot, always wash your socks inside out.
• Chose the right footwear
• Check for any foot problems like inflammation, colour changes, corns or callus. If you find any or if you are injured in any way, no matter how insignificant it may seem, seek help immediately.
• Have an annual check up so a clinician can professionally review the condition of your feet. It is necessary to check that everything is normal and no problems need to be referred to a specialist. Because if a problem does arise which you do not notice, it can get a lot worse very quickly, and diabetes is the highest cause of leg or foot amputation outside trauma.
• Never treat any foot problem yourself. Corn pads and other cures contain acid that can damage healthy skin.
• Removing hard skin with an anything sharp is also a very bad idea.
• You should avoid walking barefoot if possible.
• Warming feet directly, for example with hot water bottles or by standing too close to a fire or radiator, is not recommended. Never step into a hot bath without testing the temperature with your elbow or a thermometer first.

Choosing the correct footwear

Choosing the correct footwear is important because poor fitting shoes cause ulcers. Some patients will need to have special footwear, made specifically to fit their feet; those who are neuropathic, or have vascular or structural problems definitely need this special footwear. Check with your practise nurse whether this applies to you. Some patients don’t want to wear special shoes because in the past they haven’t been attractive, but now your Orthotist can give you a wide range of styles and colours to chose from.

However, not all patients need special footwear; they can provide their own shoes. Remember; having the correct footwear can reduce your chance of ulceration by up to 50%. Below is some guidance on the type of shoes you should wear.

Your shoes should:

• Be velcro or lace up so the tightness of the shoes can be adjusted.
• Have a broad heel, that is no more that 2.5cm in height.
• Be made from a soft material such as leather.
• Have no prominent seams.
• Be padded with a thick tongue and collar.
• Have a thick, flexible outer sole to provide a cushion for your feet.
• Allow room for your toes.

Most male shoes are ok; it is women’s shoes which have proven to be more problematic.