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22 December 2016

World Diabetes Day - 14th November

One of the day’s aims is to ensure people with diabetes are given appropriate advice and information including guidance about good foot care.

Diabetes and foot care

It is especially important to look after your feet if you have diabetes. Diabetes can reduce the blood supply to your feet and cause a loss of feeling known as peripheral neuropathy. This can mean foot injuries do not heal well and you may not notice if your foot is sore or injured.

Diabetes UK have produced the following fact sheet which contains help and advice about looking after your feet:

How do I look after my feet?

It is a good idea to check your feet every day, looking for signs of calluses (areas of thickened hard skin), changes in colour and breaks in the skin. You might want to use a mirror to see the soles of your feet. If this is difficult, or if your eyesight is not as good as it was, try to get someone else to check your feet for you.

Fortunately, you do not usually need to do anything very different from other people – general advice on foot care applies to you.

General hygiene

Wash your feet each day, use soap and warm water – check the temperature of the water before you put your feet in. Dry your feet carefully, especially between the toes. There is no advantage in soaking your feet: this just makes the skin soggy and increases the risk of damage.

Skin

To keep your skin healthy, use an emollient cream and discuss with your healthcare team which one is best for you. Do not apply any cream between your toes as this will make the area too moist and can make an infection such as athletes foot more likely.

If you use talc between your toes, be careful not to use too much as often it becomes clogged and can allow an infection to develop. You may find a pumice stone helpful for areas of hard skin, but it must be used with care. Never use a blade. If the hard skin is excessive, seek professional advice. Never use corn removal plasters: they contain acid which can cause the skin to break down.

Nails

Cut your nails regularly. Don't cut them down the sides or too short. Remember, your nails are there to protect your toes. It is safest to trim your nails with a pair of nail clippers and to use an emery board to file the corners of your nails. If it is difficult for you to care for your nails, you should seek help from a podiatrist. You may have to pay for this service. Cutting a ‘v’ shape in the nail to stop it in growing is an old fashioned idea which is incorrect.

If you feel your nail is rubbing on your shoe, it may not be the nail which is too long but the shoe which is too short.

Some people try to clean the edges and sides of their nails using the sharp point of nail scissors. This is very dangerous. If you feel that your nails need clearing of dirt and debris, simply use a nailbrush or an old toothbrush and brush from the base of the nail forward.

If it is difficult for you to care for your nails, you should seek help from a podiatrist.

Footwear

The right shoes and stockings/tights/socks will help to keep your feet healthy. This is why your choice of footwear is so important. It is not normally necessary to buy special or expensive shoes. As long as you follow the guidelines below, you should be able to buy the right footwear in a high street store and at a reasonable price.

Shoes that do not fit well, even those that feel comfortable, can cause corns, calluses, ingrowing toe-nails, blisters and ulcers. If you have neuropathy or poor circulation, wearing unsuitable shoes is likely to make even simple foot problems worse. Finding shoes that fit is not just a matter of buying a pair that feel comfortable or snug. Ideally, to ensure that the shoes you buy are suitable for you, you would have your feet measured for size and width by a trained shoe fitter each time you buy new shoes, but this is seldom available now. So take extra care.

Buy shoes which:

  • are broad fitting
  • have a deep and rounded toe area
  • are flat or low heeled
  • are fastened by a lace or buckle to keep the heel in the back of the shoe: the foot can then not slide forward and crush the toes at the end of the shoe.

If you are unsure of the fit or style that is most suitable for you, do ask a registered podiatrist for advice.

Always examine the inside of your shoes for sharp objects or stones before putting them on and replace ruffled innersole linings. Avoid socks, stockings or tights with wrinkles or prominent seams.

Garters and stockings or socks with elastic tops should also be avoided because they may restrict the circulation. Never wear socks with darned areas or holes.

How do I get help to look after my feet?

Your GP or practice nurse will give you advice and information, or help you to make an appointment with one of the following:

  • the podiatrist who works in the GP practice
  • the community podiatry service
  • the hospital podiatry service
  • the local diabetes centre
  • a registered podiatrist who works in private practice
  • the diabetes specialist nurse.

All these services are free of charge, except if you choose to see a registered podiatrist who works in private practice.

Always seek help with your feet if:

  • you notice any of the foot health danger signs
  • you have had diabetes for many years and have never had your feet checked
  • you find it difficult to check or care for your feet
  • you have any questions about caring for your feet.

Remember – once you turn 12 you should have a detailed foot check every year and be told your results.