Dr Praveen Ramachandra
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If you have diabetes, nerve damage, circulation problems, and infections can lead to serious foot problems. However, there are precautions you can take to maintain healthy feet.

FIG 1: Difference between healthy foot and diabetic foot

Good management of your diabetes and an overall healthy lifestyle helps to keep this disease under control. This should include regular medical exams, monitoring of blood sugar, regular exercise, and a balanced diet rich in fruits and vegetables.

Daily Foot Care

There are a few steps you should follow and try to do every day. 

  •        If you are physically unable to inspect your own feet, use a mirror or ask someone to help.
  •        Don’t sit with your legs crossed or stand in one position for long periods of time.
  •       Check your feet and toes, inspecting the top, sides, soles, heels, and the area in between the toes. Contact your doctor immediately if you discover any sores, redness, cuts, blisters, or bruises.
  •       Wash your feet every day in warm water with mild soap. Hot water and harsh soaps can damage your skin. Check the water temperature with your fingers or elbow before putting your feet in because your diabetes may make it difficult to sense water temperature with your feet.
  •       Dry your feet thoroughly and pat dry gently. Infections tend to develop in moist areas, so make sure you dry the area between your toes well.
  •       If the skin on your feet feels rough or dry, use lotion or oil. Do not use lotion between your toes.

FIG 2: Diabetic Foot Care

Healthy Foot Habits

Adherence to good foot care habits will go a long way toward keeping your feet healthy:

  •     Antiseptic solutions can burn your skin—so never use them on your feet without doctor supervision.
  •       Never use a heating pad, hot water bottle, or electric blanket on your feet.
  •        Avoid walking barefoot on hot pavement or sandy beaches.

FIG 3: Healthy foot habits

  •          Protect your feet from heat and cold.
  •       Never attempt to remove corns, calluses, warts, or other foot lesions yourself. Don’t use chemical wart removers, razor blades, corn plasters, or liquid corn or callus removers. See your doctor or podiatrist.

Toenail Care

It is possible for people with diabetes to perform routine toenail care, but visual difficulty, nerve problems, or circulatory changes in the legs or feet can make this unsafe.

If you do trim your toenails properly, you will avoid getting an ulcer or foot sore. Please consult with your health care provider to see if it is safe for you to perform routine toenail care and ask him/her to show you the correct way. Here are a few steps to be followed:

  •       Trim your toenails after washing your feet, when your nails are soft.
  •            Cut straight across rather than in a curved fashion to help prevent ingrown toenails. Don’t cut into the corners. Use an emery board to smooth the edges.

FIG 4: Nail cutting method in diabetes

  •     Be careful not to cut toenails too short.
  •        Have your toenails trimmed by a foot doctor or another health care provider if you can’t see well or, if yo
Footwear: Shoes and Socks

If you have neuropathy, or nerve damage that has affected foot sensitivity, you may overlook cuts or bumps. You can help protect your feet by wearing shoes at all times.


  •        Choose comfortable, well-fitting shoes with plenty of room, especially in the toe box. Never buy tight shoes hoping they will stretch.
  •        Do not wear shoes made out of plastic or other materials that do not breathe. Choose leather, canvas, or suede.
  •        Avoid thong sandals, flip flops, pointed-toe and open-toe shoes, and very high heels.
  •        Wear shoes that can be adjusted with laces, buckles, or Velcro.
  •        Inspect the inside of your shoes every day, looking for tears or bumps that may cause pressure or irritation.

FIG 5: Tips for shoes selection


  •            If you have nerve damage, give your feet a break or change shoes after five hours to change the pressure points on different areas of your feet.
  •        If you experience repeated problems with your feet, ask your doctor if special shoes would help.


  •        Socks can provide an extra layer of soft protection between your foot and your shoe.
  •        Wear clean, dry socks, or non-binding pantyhose. Avoid socks or hosiery with seams that can cause additional pressure points or are too tight on the leg.

FIG 6: Elastic free socks

  • ·      Wear socks while sleeping if your feet are cold.

Signs and Symptoms of Foot Problems

It is important to recognize early warning signs of foot problems, such as:

  •        burning, tingling, or painful feet
  •        loss of sensation of heat, cold, or touch
  •        changes in color or shape of your feet
  •        loss of hair on the toes, feet, and lower legs
  •        thickening and color change (yellow) of the toenails
  •        onset of blisters, sores, ulcers, infected corns, or ingrown toenails

FIG 7: Signs and symptoms of diabetic foot

If you have any of these symptoms, call your doctor immediately. Delay may result in serious health complications.

Potential Complications

Following the guidelines which are given above can help you to avoid foot problems.  As stated above, high blood sugar levels can over time cause nerve damage and circulation problems that damage your feet.  Left unnoticed or untreated, sores, ingrown toenails, and other problems can lead to infection. 

FIG 8: Foot gangrene

Infections that do not heal can cause skin and tissue to die (gangrene). The dead tissue turns black. Treatment can involve surgery to remove a toe, foot, or part of a leg (amputation).

Regular follow-ups

A doctor should examine your feet at every visit and do a thorough foot exam once a year. If you have a history of foot problems, you should be checked more often. Your health care provider should also give you information on foot care and answer all your questions. Report any corns, calluses, sores, cuts, bruises, infections, or foot pain.

FIG 9: Regular foot examination

If necessary, your doctor can recommend a podiatrist who specializes in diabetic foot care or give you information about special shoes that may help.

Remember: Diabetes-related foot problems can worsen very quickly and are difficult to treat, so it is important to seek prompt medical attention.