Diabetes can lead to serious foot complications, including ulcers that increase the risk of infections and even amputations. However, with proper diabetic foot ulcer prevention strategies, many of these issues can be avoided. The Foot Institute’s podiatrists emphasize proactive care like daily routines, smart footwear choices, and early detection of warning signs to keep feet healthy.
For individuals with diabetes, nerve damage (neuropathy) and poor circulation make the feet vulnerable to injuries that may go unnoticed until they become severe. By prioritizing diabetic foot ulcer prevention, patients can reduce risks and maintain mobility. Below are key steps to safeguard foot health.
Daily Foot Care Routines for Diabetics
Consistent foot care is the foundation of diabetic foot ulcer prevention. A structured daily routine helps identify minor issues before they escalate.
1. Inspect Feet Daily
Check the entire foot, including between toes and the soles, for cuts, blisters, redness, swelling, or changes in skin texture. Use a mirror or ask a caregiver for help if visibility is limited. Even small abrasions can develop into ulcers if untreated. For those with limited mobility, handheld mirrors with extended handles or smartphone cameras can aid in thorough inspections. Pay special attention to areas bearing weight (heels, balls of feet) where pressure ulcers often begin.
2. Wash and Moisturize Properly
Wash feet daily with lukewarm water (test temperature with your elbow or a thermometer to avoid burns) and mild soap, avoiding soaking, which can dry the skin. Dry thoroughly, especially between toes, to prevent fungal infections. Apply moisturizer (excluding between toes) to prevent cracks, but avoid greasy products that may cause slippage. Look for urea-based creams (10–20% concentration), which are clinically shown to reduce dry, thickened skin common in diabetics. Avoid alcohol-based products, as they can exacerbate dryness.
3. Trim Nails Carefully
Cut nails straight across and file edges to avoid ingrown toenails. If vision or dexterity is impaired, a podiatrist at The Foot Institute can assist with professional trimming. Never attempt to cut corns or calluses at home—this can lead to accidental cuts or infections. Schedule regular medical pedicures with a podiatrist for safe removal.
4. Avoid Barefoot Walking
Even indoors, stepping on small objects or hot surfaces can cause unnoticed injuries. Wear well-fitted slippers or shoes at all times. Consider shoes with antimicrobial linings to reduce bacterial growth, especially for those prone to sweating. The Foot Institute’s podiatrists can recommend diabetic-friendly indoor footwear with non-slip soles.
Footwear Tips to Reduce Ulcer Risks
Ill-fitting shoes are a leading cause of diabetic foot ulcers. Proper footwear minimizes pressure points and friction.
- Proper fit. Shoes should have ample toe room (about a thumb’s width from the longest toe), a wide toe box, and no tight seams. Shop later in the day when feet are naturally swollen. Custom-molded shoes may be necessary for severe foot deformities (e.g., bunions, hammertoes).
- Supportive design. Opt for cushioned soles, arch support, and breathable materials. Avoid high heels or flat, unsupportive shoes. Look for shoes with a rocker-bottom sole, which reduces pressure on the forefoot and heel—ideal for those with existing neuropathy.
- Seamless socks. Wear moisture-wicking socks without tight elastic bands. Some diabetic socks have extra padding for high-pressure areas. Silver-infused or copper-fiber socks can provide additional antimicrobial protection for high-risk patients.
- Orthotic options. Custom orthotics from a podiatrist can redistribute pressure and correct abnormal gait patterns that contribute to ulcers. Prescription orthotics can significantly reduce ulcer recurrence rates in high-risk patients.
Warning Signs and When to Seek Help
Early intervention is critical. Diabetics should consult a podiatrist if they notice:
- Persistent redness or swelling. Could indicate infection or inflammation. Red streaks radiating from a wound or pus drainage are emergency signs of spreading infection.
- Corns/calluses with discoloration. May hide deeper tissue damage. Black or brown tissue under a callus suggests necrosis (tissue death) and requires immediate care.
- Unusual pain or warmth. Even mild discomfort warrants evaluation. Sudden painless swelling could indicate Charcot foot, a severe diabetic complication requiring urgent treatment.
- Slow-healing sores. Any break in the skin that doesn’t improve within 2–3 days needs professional care. A non-healing ulcer smaller than a pencil eraser can progress to osteomyelitis (bone infection) without prompt intervention.
The Foot Institute’s podiatrists use advanced tools like vascular Doppler ultrasound and monofilament testing to assess nerve function and circulation. Regular screenings (every 3–6 months for high-risk patients) can detect problems before symptoms arise.
Additional Preventive Measures
- Manage blood sugar levels. Consistent glucose control improves circulation and nerve health. HbA1c levels should ideally stay below 7% to significantly reduce foot complications (per ADA guidelines).
- Stay active. Gentle exercises like walking boost blood flow, but avoid high-impact activities that stress the feet. Water aerobics or stationary cycling are excellent low-impact alternatives. Consult a podiatrist before starting new workouts.
- Quit smoking. Smoking impairs circulation, delaying healing. Research shows smokers with diabetes have a 3x higher amputation risk than non-smokers.
- Elevate feet. Reduces swelling and improves blood flow when sitting. Avoid crossing legs, which restricts circulation. Use a footstool to keep feet level with the heart.
Diabetic foot ulcer prevention hinges on diligence and partnership with health care providers. By adopting daily foot inspections, proper footwear, and prompt attention to changes, diabetics can significantly lower ulcer risks. The Foot Institute’s podiatrists are available to create personalized care plans, such as diabetic neuropathy treatments, ensuring long-term foot health.