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The Diabetic Foot

Diabetes can be particularly dangerous to the feet, causing nerve damage, loss of feeling, foot ulcers and serious infections which can lead to amputation of the toes or foot. If you have recently been diagnosed with, or care for someone with diabetes, make sure you are doing all you can to protect feet and keep toes healthy too. The Joslin Clinical Guidelines recommend that you have your feet checked at least annually by a podiatrist for altered sensation, decreased circulation and/or infection.

How does Diabetes affect feet?

Having diabetes means you’re at much greater risk of developing foot problems. 

This is because raised blood glucose, also known as blood sugar, can damage the nerves in your feet, also known as Neuropathy. This can cause tingling, pain (burning or stinging), or weakness in the foot. It can also cause loss of feeling in the foot, so you can injure it and not know it.

Diabetes affects your circulation by causing blood vessels of the foot and leg to narrow and harden which affects the blood supply to your feet. Without a good blood supply, you may have problems with cuts and sores healing. You may also get cramps and pain in your legs or feet. 

Diabetes can cause changes in the skin of your foot. At times your foot may become very dry. The skin may peel and crack. The problem is that the nerves that control the oil and moisture in your foot no longer work.

Diabetes can also cause a change in your foot shape. A change in foot shape leads to high-pressure areas under the foot. Calluses occur more often and build up faster on the feet of people with diabetes.  Too much callus may mean that you will need therapeutic shoes and inserts. Calluses, if not trimmed, get very thick, break down, and turn into ulcers (open sores).

If you don’t get these problems treated, they could lead to foot ulcers, infections and, at worst, amputations. Most foot problems can be prevented with good, regular foot care.

How Can Firefly Foot and Ankle Clinic Help?

At Firefly Foot and Ankle Clinics we offer neurological and vascular assessments designed specifically for people with Diabetes to ensure good foot health. All our podiatrists can give you advice to keep those feet healthy.

What is Involved in an Assessment?

There are several parts of a foot exam. First, the podiatrist performs a visual inspection, looking for skin colour changes, cuts and any deformities. The podiatrist will then look between your toes, because often infections can start there. The podiatrist will also palpate pulses at key points of the foot to determine the level of circulation. There will also be a test of sensation, where the podiatrist will use a tuning fork and a monofilament to evaluate your awareness of touch and levels of sensation. All of these findings will be recorded and sent to your General Practitioner (GP). The podiatrist will then carry out routine care.

How can you prevent related complications?

Check Your Feet Everyday

Little cuts, scrapes or blisters can turn into something more insidious in a diabetic foot so it is important to check your feet every day. Look carefully at the tops and bottoms of your feet. Have someone else do it if you can't see them. Check for dry or cracked skin. Look for blisters, cuts, scratches or other sores. Important to check for redness, increased warmth or tenderness when you touch an area. Watch for ingrown toenail, corns and calluses. If you get a blister of a shoe from your shoes, don’t ‘pop’ it. Put a bandage over it, wear a different pair of shoes and go to one of our clinics for a Podiatrist to check the sore.

Get Into a Good Daily Care Routine

As a diabetic who is vulnerable to infections it is vital to pay special attention to bathing and washing your feet with mild soaps and warm water. Thoroughly dry your feet by patting the skin dry and not rubbing. Once they are dry apply a moisturiser to the top and bottom of your feet, paying attention to the heels. Never moisturise between the toes as this can cause an infection.

Keep Nails Trim

It is best to cut toenails after bathing, when they are soft. Trim them straight across, then smooth with a nail file. Avoid cutting into the corners of toes and make sure not to cut your cuticles. Be very mindful of ingrown toenails or redness around the nail. We would recommend you visit one of our podiatrists to cut your nails if you are unsure how to cut them or cannot properly reach the nails.

Keep Your Feet Protected

You should do everything you can to ensure that your feet aren’t damaged or hurt in anyway. It is best not to go barefoot and protect your feet with wearing shoes, hard-soled slippers or similar footwear. It is important to wear comfortable shoes that don’t rub, chafe or pinch – always wear socks! Before you put your shoes on check your shoes for stones, grit or loose laces. Choose shoes that are well lined or padded – try running shoes with cushioned insoles. Change your socks daily. Wear natural-fibres: cotton, wool, or a cotton-wool blend. Avoid tight socks. Try on new footwear with the type of socks you usually wear. Don't wear new shoes for more than an hour at a time. If you are unsure of appropriate footwear our podiatrists can give you advise on footwear.

Make Sure Your Shoes Fit

Are your shoes too narrow? Is your foot crammed into the shoe? If you have neuropathy (nerve damage), you may not notice that your shoes are too tight. Our Podiatrists can ensure your shoes are fitting properly by taking measurements for width and length on weightbearing.

Cuts, Bumps, Sores and Burns

Don't wait to treat a minor foot problem if you have diabetes. Report foot injuries and infections right away. Follow your podiatrist's guidelines. Don't self-treat your corns, calluses, or other foot problems. Go to your podiatrist to treat these conditions. Check water temperature with your elbow, not your foot to prevent burning the skin.

When to Talk to Your Podiatrist

Your podiatrist should look at your feet during each visit. Give him a call when you notice problems such as:

Athlete's foot (cracking between the toes)

Sores or wounds on your feet

Ingrown toenails

Increasing numbness or pain



Blackening of skin


Hammer toes (when the middle joint of toes is permanently bent downward)