Foot problems are among the most preventable complications of diabetes. However, patients must take an active role in helping to prevent disorders.

It is essential that patients keep their glucose (blood sugar) levels near normal. A good diet, regular exercise and glucose monitoring can help achieve this goal.

Patients should make sure their glucose level is regularly assessed with a glycohemoglobin test to ensure their readings are in the normal range. Quitting smoking will also have a major health impact, as smoking impairs circulation.

There are several other steps patients can take to decrease the odds of suffering foot problems:

• Foot inspections. It is critical that people with diabetes perform daily foot inspections. Patients should keep the following in mind:
  
  
• • Examine the feet every day.
    
    
  • Look for blisters, cuts, scratches or cracks in the skin, especially in the heel.
    
    
  • Check between the toes.
    
    
  • Use a mirror if needed to check the bottom of the feet, or ask a family member or friend to help.
    
    
  • Flu-like symptoms or increased glucose (hyperglycemia) can be symptoms of a foot infection. Patients who experience these symptoms should check their feet.
    
    
• Foot hygiene. It is essential to prevent cuts and other wounds from occurring, and to promptly treat them when they do occur. Poor circulation prevents prompt healing, making proper hygiene and care even more important for people with diabetes.
  
  
• • Wash feet daily with a mild soap. Dry the feet carefully, paying particular attention to the spaces between the toes.
    
    
  • Apply moisturizing cream everywhere except between the toes. Dry skin can become cracked and bleed, which increases the risk of infection. The National Skin Care Institute recommends that people with diabetes use shielding lotions, which preserve moisture, rather than oil-based lotions, which can impede the skin’s creation of natural oils.
    
    
  • Trim toenails straight across. Round the edges with an emery board or nail file.  
    
    
  • Do not cut corns and calluses. Instead, consult a physician about the best way to treat such abnormalities.
    
    
  • See a physician regularly. People with diabetes should have their feet examined by a physician at least four times a year, according to the U.S. Centers for Disease Control and Prevention (CDC). This is especially important for those who have difficulty seeing or who have difficulty trimming their nails. Also, people with diabetes should not try to treat foot problems by themselves, such as attempting to fix an ingrown toenail.
    
    
  • Never walk barefoot. It is important to avoid the danger of potentially walking on pins, needles, tacks, glass or other items. Even in the house, it is best to wear slippers or other footwear. Something as minor as stubbing a toe can lead to a foot ulcer.
    
    
• Medical devices. Foot thermometers and many other products are available that may help diabetic individuals reduce their risk of foot problems. For example, clinical trials show that use of special protective insoles and a noninvasive infrared device that monitors skin temperature can prevent 80 percent of foot ulcers and amputations, according to the U.S. National Institutes of Health (NIH). Infrared energy and light devices have been used with diabetic foot problems, but studies have shown mixed results. Patients are advised to ask their physician which devices are recommended and which may be ineffective or even harmful.
  
  
• Footwear. People with diabetes can also reduce the likelihood of suffering foot problems by getting the correct shoes and socks. Shoes should serve four major functions, according to the American Orthopaedic Foot and Ankle Society:
  
  
• • Relieve areas of excess pressure. Excessive pressure often leads to ulcers.
    
    
  • Reduce shock and shear. Shoes should lessen the vertical pressure on bottom of the foot (shock) and horizontal movement of the foot within the shoe (shear).
    
    
  • Accommodate, stabilize and support deformities. Many deformities need to be stabilized to reduce pain and lessen further damage.
    
    
  • Limit the motion of joints. Restricting the motion of certain joints can reduce inflammation and pain and result in a more stable foot.
    
    
  Patients should also keep the following in mind when buying shoes:
  
  
• • Shoes should be comfortable right away. They should not need to be “broken in.” Shoes that cause blistering or calluses should not be worn.
    
    
  • Try to wear shoes built for comfort, such as athletic shoes or those with a soft leather upper.
    
    
  • Buy shoes at the end of the day, when feet tend to be more swollen. This will ensure that the shoes will be comfortable in all situations.
    
    
  • Wear new shoes for an hour around the house. Remove them and check for redness or blisters. For the first week, wear the shoes for longer and longer periods around the house. If the shoes do not feel right at the end of the week, return them.
    
    
  • Avoid sandals with thongs between the toes. These can cause gashes in the skin. Also, do not wear shoes or sandals without socks. Other shoes to avoid include clogs, flip-flops and pointy shoes (which squeeze the toes).
    
    
  • Change socks daily, and do not wear socks that have holes or have been mended. Some socks are built with extra padding in the heel. These are good options for people with diabetes. Avoid tight socks.
    
    
  • Change shoes once a day. By wearing more than one pair of shoes each day, patients can minimize the risk of damaging a spot on the foot that is under pressure from a certain shoe.
    
    
  • Before wearing shoes, slip a hand inside and feel for pebbles and other foreign objects.