Why is footcare important for a person with diabetes?

People with Diabetes have good reason to take care of their feet as Diabetes is a risk factor for foot problems. If Diabetes is undiagnosed or poorly managed, the high blood glucose levels over years can cause some nerve-ending damage or poor circulation which can cause potential problems such as foot ulcers and in extreme cases amputation.

Poor circulation in the feet is known as peripheral vascular disease. Damage to the nerves is known as neuropathy and can cause a loss of sensation in the feet – the loss of that protective pain sensation can put feet at risk of injury as the individual may not feel a problem occurring.

You can protect your feet and prevent damage to the blood vessels and nerves in your feet by keeping good control of your blood glucose levels as set by your doctor, stop smoking and keep active. You should also check your feet daily to ensure any problems are detected as early as possible. 

Foot hygiene

Wash your feet daily, bathe or shower but do not soak your feet. Soaking removes vital oils from the skin and causes cracking. Keep the skin smooth and soft with moisturising cream but avoid moisturising in between your toes. Wear clean cotton socks, ensuring they are not too tight, and change them daily.  

Choosing footwear carefully

To protect your feet, you should always wear soft, well-fitted shoes that allow a little extra room since feet expand, or sometimes swell. Shoes that are too tight can cause sores within just a few hours. Don’t wear shoes that squeeze your toes.

These may contribute to problems with damp feet, fungal infections, ingrown nails and skin problems such as corns and calluses. Check footwear before putting them on to ensure nothing has fallen into the shoe which may cause injury.

To ensure continuous foot care education tailored to your needs, it is important that you have a foot examination each year as part of your diabetes review with a doctor, nurse, or podiatrist. Examine your feet every day and report problems immediately to your GP or podiatrist. Look for cuts and for changes in skin and nails.

Signs of infection

Learn to spot the first signs of infection such as skin feeling hot, red areas and swelling or pain. Foot infections require immediate treatment by your Doctor or foot care team.

Reduced sensation

Be aware that your protective sensation may decrease or disappear due to neuropathy (nerve damage in the body's extremities such as hands or feet). Often there are no symptoms when this happens. Regular examinations by your diabetes team are important.

Be alert to signs of nerve ending damage such as prickly pain in the feet, numbness, and peculiar sensations, such as a feeling of walking on cotton or of wearing tight socks. Without a working pain alarm system, injuries and poor-fitting shoes may go unnoticed.

Trimming your toenails

Trim your toenails carefully (check with the diabetes care team, if you may do this yourself)

Trimming your toenails carefully is part of good foot care. It helps to avoid ingrown nails, which can become infected. Cut your nails straight across and not too short. They should be even with the ends of your toes. For most people with diabetes, they can cut their own nails. Thick nails and ingrown nails may require the attention of your chiropodist/podiatrist.

If you have ‘high-risk feet’ (your doctor or nurse will examine your feet and tell you if you have), you will need to attend a podiatrist for foot care.

Foot injuries may occur

Scratches, wounds, pressure sores, ingrown nails, blisters and cracked skin may occur, despite all efforts to protect your feet. It is important to clean any broken skin and cover it with a sterile dressing. If any wound is not healing or there are signs of infection, seek medical attention by going to your GP or diabetes team who can advise you. Early intervention is key.

How your Pharmacist can help?

The major goal of diabetic footcare is prevention. Your Pharmacist plays a very important role in providing their patients living with diabetes with key information regarding footcare. Your Pharmacist is the most accessible healthcare professional and is readily available to: 

• Counsel you on how to conduct a daily foot inspection to include the tops, sides, heels and between the toes of each foot,
• Advice on the safe and appropriate use of footcare products,
• Answer questions about diabetes and related health conditions.
• Offer guidance on the proper use of medications and other supplies used to treat diabetes.
• Reduce the risk of complications through early detection of diabetes and by contributing to the management of the risk factors for complications.

Ask your local CarePlus Pharmacist for help and advice in managing your Diabetes.

There are lots of supports available from Diabetes Ireland, see www.diabetes.ie or telephone 01-842 8118

Information from Diabetes Ireland