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Why is diabetes a risk to your feet?

Diabetes is a lifelong condition which can cause life and limb-threatening problems. Some of these problems can occur because the nerves and blood vessels, including those supplying your legs and feet, are damaged.

This can change:

  • the feeling in your feet (peripheral neuropathy); and
  • the circulation in your feet (ischaemia).

These changes can be very gradual and you may not notice them. This is why it is essential you have your feet checked (screened) every year by a suitably trained health-care worker.

What is my foot score and what does it mean?

Your foot check has shown that you are currently at a moderate risk of developing wounds that won’t heal or amputation because of your diabetes due to one of the following.

  • You have lost some feeling in your feet
  • The circulation in your feet is reduced
  • You cannot look after your feet or do not have help to do so
  • You have severe kidney disease
  • You have developed problems with the shape of your toe or foot

The development of foot wounds in people with diabetes is serious as they are linked to an increased risk of heart attacks, strokes, amputations of the foot or leg and early death. Controlling your diabetes, cholesterol and blood pressure, stopping smoking, increasing cardiovascular exercise and controlling your weight helps to reduce the risk of these life-and limb threatening problems.

Note: You may be at further risk of cardiovascular problems if you have a family history of heart disease.

As your feet are now at moderate risk of developing developing wounds which won’t heal or could lead to an amputation, you may also need an assessment or treatment by a podiatrist.

If you follow the advice and information in this leaflet, it will help you to take care of your feet between visits to your podiatrist. This will help you to reduce the risk of developing life-and limb-threatening problems.

What should I do if I have a concern or problem with my feet?

If you develop any of the following problems, it is important that you contact your Multi-disciplinary Foot Care Team, local Podiatry Department or GP for advice as soon as possible (within 24 hours).

  • A red, hot, swollen toe or foot
  • A new break or wound in the skin
  • New redness or discolouration of your toe or foot
  • New or unexplained pain in your foot

If they are not available, go to your nearest accident and emergency department. Remember, any delay in getting advice or treatment when you have a problem can lead to serious problems.

What can I do to reduce my risk of developing problems?

Check your feet every day
You should check your feet every day for any blisters, breaks in the skin, pain or any signs of infection such as swelling, heat or redness. If you discover any breaks in the skin or blisters, cover them with a sterile dressing. Do not burst blisters. 
If you cannot do this yourself, ask your partner or carer to help you. If your skin is dry and cracks, use 25% urea cream once a day until this improves.
Depending on your need, you may be assessed for prescription footwear, insoles or both.

Skin care for your feet
You should wash your feet every day in warm water and with a mild soap. Rinse them thoroughly and dry them carefully, especially between the toes. Do not soak your feet as this can damage your skin. Because of your diabetes, you may not be able to feel hot and cold very well. You should test the temperature of the water with your elbow, or ask someone else to test the temperature for you. If your skin is dry, apply a moisturising cream, avoiding the areas between your toes.

Toenail care
Cut or file your toenails regularly, following the curve of the end of your toe. Use a nail file to make sure that there are no sharp edges which could press into the next toe. Do not cut down the sides of your nails as you may create a ‘spike’ of nail which could result in an ingrown toenail.

Socks, stocking and tights
Change your socks, stockings or tights regularly.They should not have bulky seams and the tops should not be elasticated.

Avoid walking barefoot
If you walk barefoot you risk injuring your feet by stubbing your toes and standing on sharp objects which can damage the skin.

Check your shoes
Check the bottom of your shoes before putting them on to make sure that nothing sharp such as a pin, nail or glass has pierced the outer sole. Also, run your hand inside each shoe to check that no small objects such as small stones have fallen in.

Download our leaflet on Moderate risk of non-healing wounds and amputation

This series of information leaflets for people with diabetes was developed, approved and ratified by the following organisations:

Association of British Clinical Diabetologists, British Association of Prosthetists and Orthotists, The College of Podiatry, Diabetes UK, Diabetes Inpatient Specialist Nurses UK Group, Foot In Diabetes UK, Diabetes Foot Network Wales, Primary Care Diabetes Society, Royal College of Nursing and Scottish Diabetes Foot Action Group.