Diabetes Foot Care: Daily Inspection, Socks, Shoes and Skin Care

Taking care of your feet is an important part of living with diabetes. Diabetes can damage the nerves in your feet and reduce blood flow. As a result, a blister, cut or sore may be harder to feel and slower to heal. Without treatment, even a small foot injury can sometimes become a serious infection or ulcer.

A simple daily routine can help you find foot problems early. Check your feet every day, keep the skin clean and protected, wear properly fitting socks and shoes, and contact your healthcare professional when you notice a problem.

Over time, diabetes can affect both the nerves and blood vessels in the feet. Nerve damage, also called diabetic neuropathy, may cause numbness or reduced sensation. This can make it difficult to notice an injury. Reduced blood flow may also make wounds slower to heal.

For example, a shoe that rubs against your heel may cause a blister. If you have reduced feeling in your feet, you might not notice the blister right away. Continuing to walk on the area can cause the injury to worsen.

Daily foot care helps you identify changes before they become more serious.

Inspect your feet at least once each day. Choose a time that is easy to remember, such as after bathing or before going to bed.

Look at the tops, sides, soles, heels and areas between your toes.

Watch for:

• Cuts or scratches.
• Blisters.
• Cracks or peeling skin.
• Redness or other changes in skin color.
• Swelling.
• Areas that feel unusually warm.
• Calluses or corns.
• Ingrown toenails or other nail changes.
• Drainage, bleeding or open sores.

Do not rely on pain alone to tell you something is wrong. Diabetic nerve damage may reduce your ability to feel pain, pressure or temperature changes in your feet.

If you notice a new problem, continue to monitor it and contact your healthcare professional when appropriate.

The soles and heels can be difficult to inspect, especially if you have limited flexibility, arthritis or vision problems.

A handheld mirror can make the examination easier. Sit in a safe, comfortable position and use the mirror to look at the bottom and back of each foot. You also can place a mirror on the floor if that makes it easier to see your soles.

If you cannot inspect your feet safely or clearly, ask a family member or caregiver to help. Mayo Clinic guidance recommends using a mirror or asking another person for assistance when areas of the feet are difficult to see.

Wear clean, dry socks every day.

Choose socks that:

• Fit comfortably without being too tight.
• Do not have tight elastic bands that leave deep marks.
• Have minimal or smooth seams.
• Help keep your feet dry.
• Do not bunch inside your shoes.

Mayo Clinic recommends clean, dry socks made with materials such as cotton or moisture-wicking fibers and avoiding socks with tight bands or thick seams.

Change your socks if they become damp or wet. Before putting socks on, check that the fabric is smooth and that nothing is caught inside them.

Proper footwear helps protect your feet from cuts, pressure, rubbing and other injuries.

Wear closed-toe shoes or protective slippers that fit comfortably. Your toes should have enough space to move without rubbing against the shoe. Avoid footwear that pinches, creates pressure points or allows your foot to slide excessively.

Before putting on your shoes, check the inside for:

• Pebbles or other small objects.
• Torn lining.
• Rough seams.
• Folded insoles.
• Other areas that could rub against your skin.

If you have reduced sensation, you may not feel an object inside your shoe until it has already injured your foot.

Properly fitted, cushioned shoes are particularly important for people with diabetic neuropathy. A podiatrist or other foot specialist can help you choose footwear if you have changes in the shape of your feet, calluses or a history of foot ulcers.

Wear shoes, slippers or other protective footwear, even inside your home.

Walking barefoot increases the chance of stepping on something sharp, burning your feet on a hot surface or developing small cuts that may be difficult to feel.

Mayo Clinic advises people with diabetes not to go barefoot, indoors or outdoors.

Also protect your feet from very hot pavement, sand and other surfaces that could cause burns.

Do not try to cut away corns or calluses yourself. Avoid chemical corn or wart removers unless your healthcare professional specifically recommends them. These treatments can injure the skin and may lead to sores or infection.

A healthcare professional or podiatrist can safely evaluate and treat troublesome corns and calluses.

If you trim your own toenails, cut them straight across and gently smooth sharp edges. If you have difficulty seeing or reaching your feet, thick or unusually shaped toenails, poor circulation or reduced sensation, ask your healthcare professional whether professional nail care would be safer for you.

An open foot ulcer should be evaluated promptly rather than treated only at home. Mayo Clinic also advises seeking care for sores or other foot problems that do not begin to heal within a few days.

Seek medical attention promptly for an open wound that is deep, swollen, unusually warm, draining pus or showing other signs of infection. Fever along with redness, warmth or tenderness can also signal infection.

New burning, tingling, weakness or numbness in the feet also should be discussed with your healthcare professional, particularly when these symptoms interfere with daily activities or sleep.

In addition to checking your feet at home, have your feet examined by a healthcare professional regularly.

Mayo Clinic recommends a thorough foot examination at least once a year. People who have a higher risk of ulcers or other complications may need examinations more often. Your healthcare professional may check sensation, blood flow, skin condition, foot structure and other factors that can increase the risk of injury.

Ask your healthcare professional how often your feet should be checked based on your individual risk.

A daily routine doesn't need to take long.

Look at the tops, bottoms, heels and sides of both feet.

Check between your toes.

Use a mirror for areas you cannot easily see.

Look for cuts, blisters, sores, redness, swelling and skin changes.

Wash your feet with lukewarm water.

Dry carefully, especially between the toes.

Moisturize dry skin, but not between the toes.

Put on clean, dry socks.

Check the inside of your shoes before putting them on.

Wear properly fitting shoes or protective slippers rather than going barefoot.

For people with diabetes, small foot problems can sometimes become serious because nerve damage may reduce sensation and poor blood flow may slow healing. Daily inspection gives you an opportunity to spot changes early.

Check every part of your feet each day, using a mirror or another person's help when necessary. Keep your feet clean and dry, moisturize dry skin appropriately, choose comfortable socks and properly fitted shoes, and avoid walking barefoot.

Most importantly, don't ignore a wound because it seems small or doesn't hurt. If you notice an open sore, signs of infection, a wound that isn't healing or another concerning change, contact your healthcare professional.

Should people with diabetes check their feet every day?

Yes. A daily foot inspection can help identify cuts, blisters, redness, swelling, cracks and sores that may otherwise go unnoticed, particularly when diabetic neuropathy has reduced sensation.

How can I check the bottom of my feet?

Use a handheld mirror or place a mirror where you can safely see the soles of your feet. If you still cannot see them clearly, ask a family member or caregiver for help.

What kind of socks are best for people with diabetes?

Choose clean, dry socks that fit comfortably and do not have tight bands or thick seams. Moisture-wicking fabrics can help keep feet dry.

Should I put lotion between my toes?

No. Moisturizer can help prevent dry, cracked skin on the tops and bottoms of the feet, but lotion between the toes can trap moisture and increase the likelihood of fungal growth.

Can people with diabetes walk barefoot at home?

It's safer to wear protective footwear. Even at home, walking barefoot can expose the feet to cuts, punctures and other injuries that may be difficult to feel.

When should a person with diabetes see a healthcare professional about a foot problem?

Seek professional care for an open sore, wound that is not healing, increasing swelling or warmth, drainage, significant skin-color changes, signs of infection or other concerning changes. Foot ulcers should receive prompt medical attention.

*This article is intended for informational purposes only and should not be substituted for medical advice. For medical questions and advice, it is always best to consult with your trained physician.

Sources: 

Centers for Disease Control and Prevention. (n.d.-b). Tips for healthy feet graphic. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/communication-resources/tips-for-healthy-feet.html 

Centers for Disease Control and Prevention. (n.d.-c). Your feet and diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-your-feet.html

Mayo Foundation for Medical Education and Research. (n.d.-a). Amputation and diabetes: How to protect your feet. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/amputation-and-diabetes/art-20048262 

Mayo Foundation for Medical Education and Research. (n.d.-c). Diabetes care: 10 ways to avoid complications. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-management/art-20045803 

Mayo Foundation for Medical Education and Research. (n.d.-c). Diabetic neuropathy. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580 

U.S. Department of Health and Human Services. (n.d.). Diabetes & Foot Problems - Niddk. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems