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Feet

Diabetes can cause damage to the nerves and the blood supply, and this puts the health of your feet at risk of complications. The nerve damage that diabetes can cause is called ‘peripheral neuropathy’, and poor circulation in your feet is called ‘peripheral vascular disease’.

High blood glucose levels over time can cause nerve damage which makes it hard for people with diabetes to feel sensation in their feet. This lack of sensation can mean that you might not feel it if you have injured your feet.

Diabetes leads to changes in the blood vessels, including arteries. This reduces blood flow to the hands and feet. Without enough blood supply, you may have problems with wound healing, cramps and pain in your legs or feet. Severe infections may even lead to amputation.

Take good care of your feet to prevent serious complications.

You can reduce this risk if you:

At least once a year, have a foot check-up with a health professional—usually a doctor, podiatrist or diabetes educator. They will check for existing problems and also any problems that may be developing. The check-up will include looking at the following:

  • blood flow to the feet (circulation)
  • feeling and reflexes (nerves)
  • unusual foot shapes (including bunions, claw toes and hammer toes)
  • toenails
  • dryness, calluses, corns, cracks or infections

Read more in our fact sheet Looking after your feet.

Tips for foot care

Take the time and get to know your feet.

  • At least once a year, have a foot check-up by a doctor, podiatrist or diabetes educator. They will check for existing problems and any problems that may be developing.
  • Clean your feet regularly. Keeping your feet clean will help reduce the risk of infection. Dry all areas thoroughly especially between toes. Apply moisturiser every day—but not between the toes, as this area needs to be kept dry. Unsure how to clean feet? Discuss options with your health professional and carer.
  • Check your feet every day. Have difficulty reaching your feet? Use a mirror or ask family or carer to help. Don’t know what to look for? Ask your health professional to show you.

Why are my feet at risk?

Your feet are at risk, because diabetes can cause damage to the nerves and the blood supply. This damage is more likely if:

  • you have had diabetes for a long time
  • your blood glucose levels have been too high for an extended period of time
  • you smoke
  • you are inactive.

There are two types of risk to feet—high risk and low risk. Knowing the risk and taking care of your feet can prevent serious problems like amputation. A health professional can carry out an easy and painless check on your feet. They can determine whether your feet have a low or high risk of developing more serious problems.

Low-risk feet have regular sensation and healthy blood flow. Feet can become high risk without symptoms, so regular checks are important.

High-risk feet have had a foot ulcer or amputation in the past. Risk increases if the feet have:

  • calluses or deformities like claw toes
  • poor feeling and/or decreased blood flow.

When to have foot checks

When to get your feet checked by a health professional(a)
low-risk feetevery year
high-risk feet(b)every 3–6 months

Notes:

  1. See a health professional if you notice any changes in your feet.
  2. In some cases, you may be referred to a specialist or high-risk foot clinic.

How are you going with your cycle of care?

See our cycle of care checklist below to make sure you are on track.

Cycle of care checklist
How oftenChecks to carry out
Daily self-checksFoot check—Look for signs of infection, swelling, redness or skin breaks
3–6 monthsFoot check (high-risk feet)—with podiatrist, doctor or diabetes educator
12 monthsFoot check (low-risk feet)—with podiatrist, doctor or diabetes educator

How are you going with your diabetes health checks?

Regular checks can help prevent serious diabetes complications like problems with your feet, eyes, heart and kidneys. Individual members of your health care team will let you know how often you need checks, so you can schedule them into your calendar.

Nerve damage

Diabetes can affect the blood flow and nerves to your feet.

See your podiatrist, doctor or diabetes educator if you have any of these symptoms:

  • numbness
  • coldness of the legs
  • a tingling, pins and needles sensation in the feet
  • burning pains in the legs and feet—usually more noticeable in bed at night

These symptoms can result in a loss of sensation in the feet. This increases the risk of accidental damage because you can’t feel any pain. An injury to the feet can develop into an ulcer on the bottom of a foot which can penetrate to the bone. This could lead to infection in the bones and joints. If an infection isn’t treated at the earliest signs, this could result in:

  • ulceration (an infected open sore)
  • and eventual amputation (removal of a toe, foot or limb).

Blood supply

Poor blood glucose control can cause a reduced supply of blood to the feet. Changes to circulation may delay your ability to heal cuts or sores. If an injury breaks the skin, you will be more prone to infection.

See your podiatrist, doctor or diabetes educator if you have any of these symptoms:

  • sharp leg cramps after walking short distances or up the stairs
  • pain in the feet, even at rest (often in the early hours of the morning)
  • feet feeling cold
  • feet looking a reddish-blue colour
  • cuts that are slow to heal

Check your feet daily

Never ignore a problem with your feet. Know your feet well—wash, dry and check them every day. Be careful to look between your toes, as well as around your heels and nail edges and at the soles of the feet. A mirror may be helpful for examining the bottom of your feet. If you have difficulty with your vision, get someone to check for you.

Check for:

  • blisters
  • cuts
  • pus discharge
  • redness
  • splinters
  • swelling

Care for your feet

Cutting your nails well

Cut your toenails straight across—not into the corners—and gently file any sharp edges. If you can’t properly see or reach your feet to cut your toenails, ask someone to do it for you.

Moisturise your feet daily to avoid dry skin

Apply moisturiser every day, but not between the toes (as this area needs to be kept dry). Regularly moisturising your skin will help prevent cracks or fissures.

Never use over-the-counter corn cures

These can damage your skin and cause more problems for your feet. If you have corns, a health professional should deal with them.

Make sure your socks and shoes fit

Cover your feet with a clean sock or stocking—without rough seams.

Don’t wear tight socks or stockings. As they could further resist blood flow.

Protect your feet in shoes that fit well—the right length (a thumb width longer than your longest toe), width and depth. Before wearing, check shoes for stones, pins, buttons or anything else that could cause damage to your feet.

If you lose feeling in your feet, be extra careful

If your nerves are not working properly, you might not feel when you have cut your foot or burned yourself.

Try not to go barefoot, especially on hot sand or gravel. Keep your feet away from direct heat such as heaters, hot water bottles and electric blankets

Get medical advice early if you notice any change or problem.

Find a FootSmart workshop or event at your local diabetes organisation

Injuries

If you find an injury, including a cut, blister, sore, red area or open crack, immediately:

  • wash and dry the area
  • apply antiseptic (for example, Betadine)
  • cover with a sterile dressing, available from pharmacies.

If any injury does not improve within 24 hours, make an urgent appointment to see your doctor to avoid serious complications.

Seek urgent medical advice for even the mildest foot infection. This includes any sore, open wound or crack that:

  • is oozing
  • contains pus or any type of discharge
  • does not heal within a week.

Podiatry

Podiatry is a field of health care devoted to the study and treatment of disorders of the foot, ankle, and the knee, leg and hip, collectively known as the lower extremity.

Some health services and local councils offer subsidised podiatry services. Call your local hospital, council or community health centre to find out more.

The Podiatry Association in your state will help you to find a podiatrist with specialised knowledge about diabetes.

A doctor can refer people with diabetes and serious foot problems (such as ulcers or neuropathy) to high-risk foot clinics.

For more information:

Rebates

Medicare may provide a rebate on a podiatrists’ fees if your referring doctor has developed a GP Management Plan (GPMP) and a Team Care Arrangement (TCA) to help you manage your chronic condition.

Department of Veterans’ Affairs (DVA) gold card holders are entitled to free podiatry services from private podiatrists.

Private health funds cover some podiatry services.