If you live with diabetes, your feet need more attention than most people's. High blood sugar over many years can dull the feeling in the feet and slow down healing, so a small blister or a cut from trimming a nail can go unnoticed and turn into a wound that takes a long time to close. Most of the protection happens at home and takes a few minutes a day: you look, you notice, and you get help early when something changes.
Why diabetes changes the rules for foot care
The first problem is reduced sensation. Many people with diabetes gradually lose some feeling in their toes and soles. A stone in the shoe, a seam that rubs or water that is too hot may simply not hurt the way it should, and pain is the signal that normally makes us stop and look.
The second is circulation. When blood flow to the feet is weaker, skin heals more slowly and infections can spread more easily. That is why problems that would be a minor nuisance for someone else, such as a callus, a crack in the heel or an ingrown toenail, deserve careful attention when you have diabetes.
Not everyone with diabetes has these changes, and they develop differently in different people. Only your doctor can assess your nerves and blood vessels. What you can do yourself is daily care.
A daily foot check that takes two minutes
Look at your feet every day, ideally at the same time, for example in the evening after you take off your shoes. Sit down in good light and check:
- the soles, heels and the skin between the toes;
- redness, swelling or areas that feel warmer than the rest of the foot;
- blisters, cuts, scratches or cracks in the skin;
- new or growing calluses and corns;
- changes in the nails: thickening, discolouration, a nail edge digging into the skin;
- any discharge or marks on your socks.
If it is hard to see the soles, use a mirror on the floor or ask a family member to help. Many people with diabetes are older, and for them bending down to their feet is not easy, so involving someone close is completely normal.
Everyday habits that protect your feet
- Wash your feet in lukewarm water and check the temperature with your elbow or a thermometer, not your foot. Dry carefully between the toes, because moisture there can lead to skin problems.
- Dry skin on the heels cracks more easily, so a plain foot cream helps. Keep it out of the spaces between the toes.
- Wear something on your feet even at home. It is easy to step on something without feeling it.
- Before putting shoes on, run your hand inside to find small stones, folded insoles or rough seams.
- Shoes should not press anywhere. Socks without tight elastic or thick seams are kinder to the skin. Break in new shoes gradually.
- Hot water bottles, heating pads and sitting close to a heater can cause burns you may not feel.
What not to do yourself
With diabetes, some common home treatments are riskier than they look. Better to skip:
- cutting calluses or corns with blades or scissors;
- corn plasters and pads with acid, which can damage healthy skin;
- digging out an ingrown nail edge or cutting deep into the corners of the nail;
- treating a wound, blister or infected-looking area on your own for days in the hope that it will pass.
Trimming nails is fine for many people, as long as you cut them straight across, not too short, and file the edges gently. If your nails are thick, your eyesight is poor or you cannot reach your feet comfortably, nail care is a good reason to visit a podiatrist rather than struggle at home.
Hard skin on feet with diabetes: what to do about it
Hard skin is the skin's response to pressure and friction. It builds up where a shoe rubs or where the foot presses hardest when you walk, most often on the heels and soles.
With diabetes it needs closer watching. If the feeling in your feet is reduced, a hard callus can go a long time without hurting, and dry, thick skin on the heel cracks more easily. Any crack or rub then heals more slowly.
At home, a few things are enough:
- during your evening check, look for new or growing patches of hard skin and compare both feet;
- put ordinary foot cream on dry heels, but keep it out from between the toes;
- check whether a shoe presses where the callus is forming, and if it does, change the shoe.
Don't cut hard skin with a razor blade or scissors, and don't use acid corn plasters. With reduced feeling it is easy to cut deeper than you meant to, and that kind of wound is slow to heal.
A podiatrist can remove thick skin, calluses and heel cracks safely, with sterile instruments. At the same visit they look at your nails and the skin between your toes, then tell you how to care for your feet at home and when to come back. Regular podiatry care helps keep your feet healthy. It doesn't replace visits to the doctor who manages your diabetes, and if you see redness, a wound or discharge near the hard skin, see the doctor first.
When to see a doctor and when to see a podiatrist
Contact your doctor promptly if you notice:
- a wound, ulcer or blister that is not getting better;
- redness, swelling, warmth or pus around a nail or on the skin;
- a change in the colour of the toes or the foot;
- new numbness, tingling or pain in the feet;
- a change in the shape of the foot.
Do not wait for these to pass on their own.
A podiatrist is the right specialist for regular care of skin and nails: removing calluses and corns safely, thinning thickened nails, dealing with an ingrown nail edge, caring for cracked heels and giving advice on daily foot care. A podiatrist does not treat illnesses and does not replace your doctor. When a problem needs treatment, the podiatrist will tell you so and advise you to see a doctor.
What happens at a podiatry visit
At the first visit, the podiatrist looks at your skin and nails, asks about your health and the shoes you wear, and tries to find out what is causing the problem. Then the care itself is done with sterile instruments: for example, gentle removal of hard skin, cleaning and shortening of nails or care for a painful nail edge. At the end you usually get advice on home care and on how often it makes sense to come back.
At PODOKOM in Rzeszów, people who look after older parents often come to us, and we also look after the feet of people with various health conditions, including diabetes. We work with sterile instruments and cooperate with doctors, including an endocrinologist, when a case needs it.
If you remember one thing from this, make it the evening look at your feet.