If you live with diabetes, you've probably been told to "just check your feet." That's good advice, but by evening the shoes are off by the door and the soles are hard to see without twisting around. Daily foot care for diabetes comes down to a short look each evening, gentle washing and drying, and shoes that fit. It matters because nerve damage and slower blood flow can hide small problems until they grow.
This is education, not a personal plan. Your medications, your targets and any change in how you care for a cut or callus stay with your own clinician or podiatrist, a doctor who specializes in feet. I work alongside that team, never instead of them.
Why do feet need extra attention with diabetes?
With diabetes and your feet, reduced feeling can hide a pebble or blister, so a quiet evening check is worth it.
Over time, diabetes can cause nerve damage that brings tingling or pain, and it can also take away feeling. That means a pebble in your sock or a new blister might go unnoticed. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) explains on its page about diabetes and foot problems that cuts and sores can become infected when feeling is reduced.
Diabetes can also lower blood flow in the feet, so a sore may be slow to heal. The CDC's page on your feet and diabetes notes that about half of people with diabetes have some kind of nerve damage, often in the feet and legs. Some people feel numbness or pain, while others have no symptoms at all. Nerve damage can also dry out the skin so it peels and cracks, as the American Diabetes Association (ADA) describes on its foot complications page.
None of this is a grade on how well you're managing. It's simply why a quiet evening check is worth adding to your routine.
What does a daily foot check look like?
A daily check of diabetes and your feet takes about two minutes once you sit in good light and look at both feet.
It takes about two minutes once you get the hang of it. Here's a simple routine:
- Sit somewhere with good light and take off both shoes and socks.
- Look at the tops, bottoms, heels and between every toe for cuts, redness, swelling, sores, blisters, corns, calluses, warm spots or nail changes (CDC; NIDDK).
- If bending is hard, use a hand mirror or ask someone you trust to look with you.
- Wash with soap in warm, not hot, water. NIDDK suggests about 90 to 95 F, or you can test the water with your elbow. Don't soak your feet.
- Dry every surface, including between the toes.
- Moisturize the tops and bottoms only, never between the toes. A little talcum powder or cornstarch can help keep that space dry (NIDDK; CDC; ADA on foot complications).
- Trim toenails straight across without cutting into the corners. If you can't see, feel or reach well, or your nails are thick or curve into the skin, ask a foot doctor to help (NIDDK).
- Don't cut corns or calluses yourself, and skip corn plasters and liquid removers. Cover a blister, cut or sore with a clean bandage and let your care team know.
If that feels like a lot, start with the look and add the rest as it fits into your evening.
Shoes, socks and protecting your feet
Shake out your shoes and feel the lining before you put them on, because diabetes and your feet need that extra protection.
Don't go barefoot, even at home. Wear shoes and socks or slippers, and before you put shoes on, shake them out and feel the lining for anything inside (NIDDK; CDC).
Choose socks that fit without squeezing. Clean, lightly padded, seamless socks are a good default. The ADA's 8 tips to protect your feet also suggests moisture-wicking fabric and light colors, so it's easier to spot any drainage from a sore.
Pick shoes that breathe and leave room for your toes. Walking or athletic shoes are usually better than vinyl, plastic, pointed toes or high heels. Shop later in the day, when feet are at their largest. The ADA suggests about a thumbnail of space between your big toe and the end of the shoe.
Protect your feet from heat and cold. If feeling is reduced, you may not notice a burn. Wear shoes on hot pavement and at the beach, keep your feet away from heaters and open fires, and skip hot water bottles or heating pads on your feet (NIDDK).
Helping blood flow to your feet
When you sit, raising your feet and moving your ankles helps blood flow for diabetes and your feet.
Small things help. Raise your feet when you sit, wiggle your toes and move your ankles, and ask your clinician which kinds of activity are right for your feet. The CDC notes that 10 to 20 minutes of activity a day is better than one long session once a week.
Smoking reduces blood flow to the feet, and NIDDK points people who want to quit to 1-800-QUIT-NOW. Keeping your blood glucose in the range your clinician set also helps protect your nerves and feet over time (CDC; NIDDK). Think of your numbers as information for the plan you already have with your medical team.
When should you call about your feet?
Call your clinician right away if diabetes and your feet show a sore, redness, or pain that isn't starting to heal.
Call your health care provider right away if you notice:
- A cut, blister or bruise that doesn't start to heal after a few days
- Skin that becomes red, warm or painful
- A callus with dried blood inside
- A foot infection that turns black and smells bad
Ask for a podiatrist referral if you need one (NIDDK on diabetes and foot problems). The CDC also says not to wait if you have pain or cramping in your legs during activity; tingling, burning or pain in your feet; loss of feeling for touch, heat or cold; a change in the shape of your foot; dry, cracked skin; a change in color or temperature; thick, yellow toenails; fungus between the toes; or a blister, sore, ulcer, infected corn or ingrown toenail.
At your regular visits, take off your shoes and socks and ask for a foot check. NIDDK recommends at least one thorough foot exam a year that includes checking feeling and pulses, and more often if you've lost feeling, your foot shape has changed or you've had an ulcer. In an emergency, call your local emergency number.
Steady habits, not fear
Most people with diabetes can lower their chance of serious foot problems with home care and regular visits. That's the spirit of the CDC's guidance on your feet and diabetes and its tips for healthy feet. Two minutes with a mirror, or with someone who'll look with you, is enough to turn "just check your feet" into something that fits real life.
Two quiet minutes with a mirror can make checking diabetes and your feet a habit that fits your real life.
You can find more at chronichealthwisdom.com.
Cheri Sacks, RN, CDCES
Your Neighbor, The Nurse
Educational only. This article is not medical advice, diagnosis, or treatment. Always partner with your own clinician before changing medications, diet, or exercise.
Related reading
- Walking after meals
- Living well with type 2 diabetes
- What is a CDCES
- 5 small changes that lower blood sugar
Frequently asked questions
Yes. Feeling can fade before you notice. A quiet foot is exactly when a small cut or warm spot can hide.
Try this: "Can you look at my feet at this visit, and do I need a yearly exam with a foot doctor?" Pair that with one small step this week: when the shoes come off, give the soles and the spaces between the toes a two-minute look.
