FEET & DIABETES 

I have been working as a practice nurse for many years, specialising mainly in diabetes care, and therefore have a great deal of experience in helping patients to look after themselves in order to lead a long and healthy life with their diabetes. Having diabetes means that you are at much greater risk of developing foot problems. Diabetes may reduce the blood flow and change the sensations felt in your feet. For this reason it is important that you look after your lower legs and feet by maintaining good control of your diabetes and by taking a few simple measures regularly to ensure good foot health. You should have a routine diabetic foot check at least annually by your diabetes nurse, doctor, foot health practitioner or podiatrist. 
 
Reduced blood flow to your lower limbs may affect your ability to heal an injury or reduce your natural ability to fight bacteria. This can make it harder for blisters, sores and cuts to heal. Diabetic foot ulcers may develop spontaneously, especially if you are also a smoker. 
 
Loss of feeling in the feet caused by peripheral neuropathy means damage to the feet often is not noticed unless you look for it. If you do notice a reduction in feeling, numbness, tingling, burning or pain in your feet, please speak to your diabetes nurse, doctor or foot care specialist. 

FEET & DIABETES 

I have been working as a practice nurse for many years, specialising mainly in diabetes care, and therefore have a great deal of experience in helping patients to look after themselves in order to lead a long and healthy life with their diabetes. Having diabetes means that you are at much greater risk of developing foot problems. Diabetes may reduce the blood flow and change the sensations felt in your feet. For this reason it is important that you look after your lower legs and feet by maintaining good control of your diabetes and by taking a few simple measures regularly to ensure good foot health. You should have a routine diabetic foot check at least annually by your diabetes nurse, doctor, foot health practitioner or podiatrist. 
 
Reduced blood flow to your lower limbs may affect your ability to heal an injury or reduce your natural ability to fight bacteria. This can make it harder for blisters, sores and cuts to heal. Diabetic foot ulcers may develop spontaneously, especially if you are also a smoker. 
 
Loss of feeling in the feet caused by peripheral neuropathy means damage to the feet often is not noticed unless you look for it. If you do notice a reduction in feeling, numbness, tingling, burning or pain in your feet, please speak to your diabetes nurse, doctor or foot care specialist. 
 
 

Tips for everyday foot care 

Go to your annual foot check - a trained professional should check your bare feet at least once a year. It’s a good chance to check anything you might have spotted with them yourself. But don’t wait a whole year to ask them. If you notice a problem get it seen as soon as you can. 
 
Know your foot risk - once you’ve had your annual foot check, you need to find out your risk of developing a serious foot problem. If you’re moderate or high risk, your healthcare professional should explain exactly what this means. They’ll also tell you if you need to see a foot specialist. Feel free to ask them questions. The more you know, the more you can keep an eye on any changes in your feet. 
 
Check your feet every day - because of your diabetes, foot problems can get worse quickly. That’s why we’ve got some guidance on what signs to look out for when you check your feet. Get into the habit of feeling inside your shoes and slippers before putting them on. Whether you’re about to put your socks on, or you’re taking them off before bed, have a good look. Any changes, and you should see a healthcare professional straight away. If you struggle to lift your feet up, then you might want to use a mirror to see the soles of your feet. If this is too hard, or if your eyesight is not as good as it was, try to get someone else to check your feet for you. And if you need help but live alone, it’s good to speak to a healthcare professional about how to check your feet. 
 
Be careful if you lose sensation - if you have lost any sensation in your feet, you need to look out for them a bit more. Things like walking barefoot or sitting too close to radiators or heaters are risky. Try to be careful. You might not notice straight away if you hurt yourself. If you’re unsure if you’ve lost any sensation, speak to a healthcare professional. 
 
Watch out cutting your nails - cutting your nails seems simple. But if you have diabetes, piercing the skin by mistake can lead to other injuries. And you might not even notice you’ve done it. 
 
When you cut your toenails it’s: 
 
good to cut them often but not too short or down the side 
safest to trim them with nail clippers and then use an emery board to file any corners 
best to clean them gently with a nail brush. Don’t use the sharp points of scissors to clean as this is not safe. 
 
Washing daily is also a simple way to keep your feet and toenails clean and away from infection. Just a simple mix of soap and warm water will do, but always check the temperature before you put your feet in. Be careful not to soak your feet as this just makes the skin soggy and more likely to get damaged. 
 
If you’ve lost some sensation in your feet or you’re worried about things like ingrown toenails, see a foot specialist. They’re used to helping with these things. 
 
Don’t use blades or corn plasters - your skin needs to stay healthy. Don’t use plasters to remove corns or blades on your corns or tough skin as they could damage your skin. Pumice stones can also help with tough skin, but use them with care. If you need help with corns or other skin problems, it’s always a good idea to speak to a foot health practitioner or podiatrist. Using emollient cream will keep your skin healthy. It’s best to talk to your healthcare team about which emollient cream is right for you. Don’t put cream between your toes, as this can cause problems. The same for talcum powder - if it gets clogged up between your toes, it could also cause excessive dryness. 
 
Make sure your footwear fits - if your shoes or socks are too tight, too loose or rub, then don’t wear them. Shoes that don’t fit well, even those that feel comfortable, can cause all sorts of problems. As can things like old insoles, or socks with holes or thick seams. This is why you need to choose footwear carefully. It’s good to buy shoes that are broad fitting, have a deep and rounded toe area, are flat or low heeled and are fastened by a lace or buckle to stop your feet sliding around. If you’re unsure of the fit or style that is best for you, then ask your foot health specialist for advice. You may like to consider having your shoes made to measure; this may not be as expensive as you think. 
 
Manage your diabetes - keeping your blood sugar within target will help prevent damage to your feet and can stop things getting worse. Easier said than done. Maybe you need help knowing how to eat well and stay active? Or your medication isn’t working as well as it could be? Or perhaps it just feels like things are getting on top of you? Speak to your healthcare professional to see how they can help. Or find out about possible courses in your area, local support groups or contact Diabetes UK via www.diabetes.org.uk or tel 0345 123 2399. Together, we can help you manage your diabetes. 
 
Aim to stop smoking – if you have diabetes, you already have an increased risk of developing cardiovascular disease such as heart attack, stroke or circulatory problems of the legs. Combine this with smoking, which can also double your risk of complications, and you make your chances of developing these diseases even higher. Giving up smoking is one of the most positive things you can do to both improve your health and reduce your risks of the long-term complications associated with diabetes. If you think you might need help to stop smoking, take the first step and ask your healthcare team for advice. 
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