For people with diabetes, the feet are where complications show up most easily, and where they’re most easily overlooked. A small blister from a tight shoe, or a pebble lodged inside it, may not hurt at all, so the person never knows, until the spot has become an ulcer and gotten infected. The good news is that most of these complications can be prevented with simple habits done consistently every day.
Why Are the Feet So Vulnerable?
According to the U.S. Centers for Disease Control and Prevention (CDC) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), two main mechanisms are at work:
- Nerve damage (peripheral neuropathy): CDC says about half of people with diabetes have some nerve damage, most often in the feet and legs. It can cause numbness, tingling, or pain, or no symptoms at all. The danger is that the ability to sense pain, heat, and cold is dulled, so cuts and sores can go unnoticed and worsen. Nerve damage can also change the shape of the foot (for example, Charcot’s foot, which may start with redness, warmth, and swelling).
- Poor blood flow: reduced circulation makes sores and infections slow to heal. Combined with nerve damage, the risk of foot ulcers rises. Ulcers can become infected, and severe or unresponsive infections can lead to gangrene and amputation of a toe, foot, or part of the leg (CDC, NIDDK).
CDC lists risk factors including hard-to-control blood sugar, having diabetes for many years, excess weight, being over 40, high blood pressure, and high cholesterol. The most important preventive step is keeping blood sugar within target, along with not smoking, eating healthily, staying active, and taking medication as prescribed.
7 Daily Foot Care Habits
1. Check your feet every day
Do it in the evening, looking at the tops, soles, heels, and between the toes. Look for cuts, redness, swelling, blisters, sores, corns, calluses, ingrown nails, fungus, or unusually warm spots. If it’s hard to see the bottoms of your feet, use a mirror or ask someone to help (CDC, NIDDK).
2. Wash your feet the right way
Wash daily in lukewarm water, don’t soak for long, and dry thoroughly, including between the toes. Moisturize the tops and bottoms of your feet, but not between the toes, to avoid moisture that invites fungus (CDC, NIDDK).
3. Never go barefoot, even indoors
Always wear shoes or closed slippers and socks, even at home. On hot surfaces such as a beach, wear footwear to avoid burns and scrapes (CDC, NIDDK).
4. Choose the right shoes and socks
- Shop for shoes late in the day, when your feet are at their largest.
- Pick well-fitting, breathable shoes with room for your toes. Avoid vinyl or plastic shoes, pointed toes, and high heels.
- Break in new shoes gradually, an hour or two at a time at first.
- Always check inside your shoes for objects and make sure the lining is smooth before putting them on.
- Choose clean, seamless socks with light padding that aren’t too tight.
- If your feet have changed shape, ask your doctor about special shoes or inserts (NIDDK).
5. Trim nails safely
Trim nails after washing and drying your feet, cutting straight across without cutting the corners, then smooth the edges with a file. If you can’t reach your feet, or your nails are thick, yellowed, or curving into the skin, have a podiatrist trim them. If you get pedicures, bring your own tools (NIDDK, CDC).
6. Don’t treat corns and calluses yourself
Don’t cut them or use medicated pads or liquid removers. If your doctor approves, gently smooth with a pumice stone. A callus with dried blood inside can signal a sore underneath and needs to be examined (NIDDK, CDC).
7. Keep blood flowing
Elevate your feet when sitting, move your toes and ankles often during the day, avoid tight socks, and don’t smoke. Choose low-impact activities such as walking, cycling, or swimming, and ask your doctor which are safe for you (CDC, NIDDK). Avoid heating pads, hot water bottles, and keeping your feet near heaters, since reduced sensation makes burns easy to miss (NIDDK).
Signs That Mean See a Doctor Promptly
According to NIDDK, contact a healthcare provider if you have:
- A cut, blister, or bruise that doesn’t begin healing within a few days.
- Skin that turns red, warm, or painful, which may signal infection.
- A callus with dried blood inside.
- A foot infection that turns black or smells bad, which may indicate gangrene (needs urgent care).
CDC also advises getting checked promptly for leg pain or cramping during activity, tingling, burning, or pain in the feet, reduced sense of touch or of heat and cold, changes in foot shape, skin color, or temperature, hair loss on the toes and lower legs, dry cracked skin, thick yellow toenails, fungal infections, or blisters, sores, ulcers, and ingrown toenails.
Regular Foot Exams
CDC recommends having your feet checked at every primary care visit and seeing a podiatrist at least once a year, more often if you have nerve damage. The exam should test sensation and blood flow. Don’t wait for your next appointment if you notice warning signs.
The Bottom Line
Foot care for people with diabetes doesn’t need to be complicated, but it does need to be consistent: look closely every day, wash and dry properly, always wear shoes and socks, choose well-fitting footwear, trim nails safely, and get checked early when something seems off. The foundation of all of it is still good blood sugar control. A few minutes each evening can help you catch problems while they’re small, before they become serious complications.
This article synthesizes and paraphrases the sources below and is for general educational purposes only; it does not replace professional medical advice. Talk with your doctor about a foot care plan suited to your situation.
Sources referenced:
- CDC, Your Feet and Diabetes (cdc.gov/diabetes/diabetes-complications/diabetes-and-your-feet.html)
- NIDDK, Diabetes and Foot Problems (niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems)