Assessing your feet

An assessment helps your healthcare provider check the condition of your feet. The assessment includes a review of your diabetes history and overall health. It may also include a foot exam, X-rays, or other tests. These can help show problems beneath the skin that you can’t see or feel.

Health history

You will be asked about your overall health and any history of foot problems. You’ll also discuss your diabetes history, such as if your blood sugar level has changed over time. It also includes questions about feelings of pain, tingling, pins and needles, or numbness. Your healthcare provider will also want to know if you have high blood pressure and heart or kidney disease. Or if you smoke. Tell your provider about any past foot infections. Discuss all of the medicines including over-the-counter medicines, vitamins, supplements, or herbs you take.

Foot exam

A foot exam checks the condition of different parts of your foot. First, your skin and nails are checked for any signs of infection. Blood flow is checked by feeling for the pulses in each foot. You may also have tests to study the nerves in the foot. These include using a small, thin wire (monofilament) to see how sensitive your feet are. Dry skin on your feet may be a sign of damage to the nerves that control the moisture on your skin. Toenail fungal infections may lead to more serious bacterial infections. In certain cases, you will be asked to walk a short distance. This is done to check for bone, joint, and muscle problems.

Diagnostic tests

If needed, your healthcare provider will suggest certain tests to learn more about your feet. These include:

• Doppler tests. These measure blood flow in the feet and lower leg.

• X-rays. These can show bone or joint problems.

• Other imaging tests. These may include an MRI, bone scan, and CT scan. These can help show bone infections.

• Other tests. These may include vascular tests. These tests study the blood flow in your feet and legs. This is done by comparing the blood pressures in your arm and ankle. You may also have nerve studies to learn how sensitive your feet are.

Creating a foot care program

Based on the evaluation, your healthcare provider will create a foot care program for you. This may be as simple as starting a daily self-care routine. And changing the types of shoes you wear. It may also include education on how to treat minor foot problems, such as a corn or blister. In some cases, surgery will be needed to treat an infection. Or to treat mechanical problems, such as claw toes and hammer toes.

Preventing problems

When you have diabetes, it’s easier to prevent problems than to treat them later on. So see your healthcare team for regular checkups and foot care. Your healthcare team can also help you learn more about caring for your feet at home. For example, you may be told to not walk barefoot, even in your home. Or you may be told you need special footwear to protect your feet.

Have regular checkups

Foot problems can happen quickly. So follow your healthcare team’s schedule for regular checkups. During office visits, take off your shoes and socks as soon as you get in the exam room. Ask your healthcare provider to check your feet for problems. This will make it easier to find and treat small skin issues before they get worse. Regular checkups can also help keep track of the blood flow and feeling in your feet. You may have pain or lack of feeling in your feet (neuropathy). Then you'll need checkups more often.

Learn about self-care

The more you know about diabetes and your feet, the easier it will be to prevent problems. Your healthcare team can teach you how to check your feet every day. And teach you to look for warning signs. They can also give you other foot care tips. Before your office visits, write down any foot care questions you have. During office visits, ask any questions you have. To care for your feet:

1. Examine them daily using a magnifying hand mirror to check for cuts, blisters, redness, swelling, or nail issues. Check in-between your toes and the bottoms of your feet.

2. Manage your diabetes well through a healthy lifestyle and proper medicines.

3. Schedule regular foot exam with your doctor.

4. Avoid walking barefoot, even at home, to minimize the risk of injuries.

5. Wear socks to bed if your feet tend to get cold at night. Avoid using heating pads or hot water bottles.

6. Keep your feet dry and warm, especially during winter, and use an antiperspirant if you sweat heavily.

7. Before wearing shoes, shake them out and check the insides for any objects, as reduced sensation may prevent feeling them. This may lead to cuts, abrasions, or other foot injuries.

8. Wear clean, dry socks and change them daily. You may use socks with extra cushioning, no elastic tops, higher ankle length, and moisture-absorbing fibers.

9. Refrain from self-treating scratches, blisters, redness, corns or calluses; consult a doctor for appropriate professional treatment as soon as the skin change is noticed.

10. Trim your nails carefully, cutting them straight across and filing the edges. Avoid cutting nails too short to prevent ingrown toenails.

11. Apply moisturizer to your feet, excluding the areas between your toes, to prevent dry skin from itching or cracking.

12. Be gentle when bathing your feet. Use a soft washcloth or sponge, and carefully dry between the toes.

13. Bathe your feet in lukewarm water daily, avoiding hot water, and maintain cleanliness to prevent infections. Don't soak your feet.

14. Avoid smoking since it can hamper blood flow and create foot problems as well.