You can help your feet to stay healthy by doing the following:
Wash your feet with soap every day
Use water and soap to wash your feet and legs. Use a cloth to wash between all the toes. Give the soles of your feet some special attention too.
Wash the top of the feet and the legs.
Use a soft brush or an old tooth brush to brush around nails This can be part of the daily bath or the person with diabetes may like to find a special time of the day to attend to their feet.
Always be sure the temperature of the water is safe for the feet. Check the temperature of the water with fingers or your elbow before putting feet in the water. People with diabetes who have nerve damage can burn themselves from not knowing that the water is too hot.
Dry the feet off with a clean towel
Dry well between the toes.
Encourage the person with diabetes to sit near a sunny spot, in the warmth of the sun, which will help dry the skin. Stretch and flex the toes and ankles after drying them, this is a good opportunity to do some gentle flexibility exercises. “Look and Feel” as the skin is being dried.
Take a close look at your feet
“Look and Feel” with your fingers to see them
Have the person with diabetes:
Check for sores, scratches, swellings or blisters – anything that was not there previously “Look and feel” between all the toes “Look and feel” the soles of both feet Can they feel any warm or hot areas in the skin?
Can they see any changes to the colour of the skin?
If you can’t reach your feet or you can’t see your feet clearly, have somebody do it for you. Or, try to use a mirror to see under your foot. It is really important that your feet are cared for every day.
Feet are difficult things to see and reach at the best of times. Encourage the person with diabetes to get some assistance. The person needs to be regularly available and willing to lend help. It might be a member of their mob or a friend.
Ensure all areas of the foot are seen.
If you see thick hard skin, it is important to care for this.
This is often called a callous or a corn. Thick hard skin can cause damage and pain to the skin.
You need to have a pumice stone or a green pot scourer or fine sandpaper to help reduce this thick skin. Let’s call this a “sanding block”
- Place the foot back into the warm water
- Put some soap over the dry thick skin
- Reach down and carefully work the thick skin with the sanding block
- Check and be sure that the normal skin is not damaged by the grit of the sanding block, the sanding block should only contact the hard thick skin
- “Look and Feel” the skin to know when the thick skin has been reduced
- Have the Health Worker make an appointment with a podiatrist to have it checked out
Encourage the person with diabetes to repeat the process, each time re-applying the soap, work the sanding block, and then check. “Look and Feel” each time to ensure the callous has been reduced, and that the normal skin is okay
Remind the person with diabetes that if they have nerve damage they may not feel the discomfort if they thin down the skin too far If the thick skin has a dark colour with in it, or is a different colour, it is very important to have it looked at. Sometimes these corns don’t cause pain because the nerves to the foot have been affected by diabetes. The change of colour can be due to the damage the hard skin has caused.
See the Health Worker for an appointment with the podiatrist to have it checked out.
1. If you see dry skin or thick hard skin you need to rub in some cream
- Any cream you buy from the store, as a hand cream is suitable for your feet. Examples of cream include: Sorbolene and Glycerine, Lanolin [wool fat], Vitamin E cream, Vaseline Intensive Care. You could also use oils: Emu Oil, Baby Oil, or Coconut Oil. Other choices could be animal fat or lard
- It is good to use the cream after rubbing the thick hard skin with the sanding block
- It is good to use cream every day for dry skin
- The cream helps make the skin more flexible and less likely to crack and tear
2. If you see sores or that the skin has been injured it is important to help it heal
- Any blister, cut, or “red” crack in the skin, or where pus is present – must be looked after
- Wash with some salty clean water. Use a clean cloth or gauze pad or cotton wool ball to wipe the salty clean water over the area of the sore
- Repeat this a couple of times each time with a clean cloth or pad or cotton wool
- Dry the skin off
- Apply a bandaid or dressing from the health clinic
- To make salty water, boil the kettle and let the water cool. Make sure the water is cool before the next step – test the temperature of the water with your hand. Pour the water into a clean container [a plastic milk or cordial bottle would do], add a teaspoon of cooking salt, shake to dissolve, screw the lid on and it will keep okay. Throw the salty water out if it becomes cloudy or discoloured
- Check on the sore each day, wash it with salty water each day, and cover each day until healed
- Visit the health clinic or see a Health Worker if the sore is not improving. If you are at all concerned about a sore, see the Clinic
- Ask the health clinic if they could provide you with some first aid products to keep at home, just in case you need to care for these small sores
- Store the products in an air-tight container or plastic bag
3. How to look after your toe nails
- Firstly it is important to understand that nails come in all shapes and sizes and that they do change shape and thickness during your lifetime
- The length of your toenail should be as long as the tip of your toe. The nail is there to protect your toe
- If your nails are too long they can cause pressure and cut into the toe or the next toe. Long toe nails can scratch the skin on legs when sleeping and that can cause sores
- If your nails are too short they can hurt the sides of the toe and cut this area and cause infections to occur
- Trim the nails straight across, or so the length of the nail follows the curved shape of the toe. Don’t cut the corners down into the sides of the toe
- Use a file or rasp or sanding block to thin down excessively thick nails
- Avoid contact with the delicate skin down the sides of the nails, use a nail brush or soft toothbrush to clean around these areas
- Use a clean pair of scissors or clippers or file to trim the nails
- Avoid tearing the nails off or using razors or knives – this is dangerous for your toes
- If you can’t reach or see your nails ask a family member of friend
- If your nails are too difficult to safely care for, see the Health Worker to arrange an appointment to see a podiatrist
4. Your feet need protection, to make sure they don’t get cut and damaged from things we might walk on. Remember if you don’t have good feeling in your feet and they are numb – injury can occur without you knowing.
- Wear some form of footwear at all times
- It is really important to wear shoes that fit – if not, the shoe can cause sores and make your feet worse
- If necessary make an outline of your foot with a pen onto a piece of paper and make your feet worse then trace over the outline of the shoe and see if the shoe is long enough, wide enough, and enough room for your toes? Check that the shoe is deep enough if you have crooked toes.
- Wear clean socks to give added protection to your skin
- With closed shoes, empty the contents of the shoe before putting them on -sand, stones, spiders or toys might have found their way in there since you took them off
- Check the linings of the shoe – put your hand inside the shoe and feel for torn linings check the insole material is in good condition
- Open shoes, reef sandals, scuffs and thongs protect you from the ground, but do stones, spiders or toys might have found their way in there since you took them off linings check the insole material is in good condition not help your foot as you walk around. The more enclosed the shoe the more the shoe and the foot work together. Try to get a shoe that has a closed – in back or a strap around the heel
- Whenever you are wearing new shoes, check your feet after one hour of wearing
- Don’t wear shoes that damage and hurt your feet
5. Diabetic foot problems can happen if your diabetes control is not as good as it could be.
The longer you have had diabetes the more important it is to look after your feet. All people with diabetes should look after their feet every day. At least once a year, everyone with diabetes should have a foot examination. See the Health Worker to make arrangements for you.
This check-up involves:
- Checking the pulses of both feet
- Checking the nerves and sensation in both feet
- Checking for foot problems that need treatment
- Checking your understanding of how to look after your feet
- Making sure your feet are getting appropriate care, and
- Establish a plan to ensure your feet get the care they require
6. It is very important for you to:
- Take the tablets that the Doctor gives you for your diabetes
- Make sure you never run out of tablets
- Attend the health clinic to have your blood sugar monitored regularly
- See the doctor if your blood sugar is too high
- If you have high blood pressure, make sure you take your blood pressure tablets them. Look at your feet and check that they are not damaging your feet too. Blood pressure and diabetes are closely related, and to keep healthy you need to look after your diabetes and blood pressure
- Make sure you never run out of blood pressure tablets
- Attend the health clinic to have your blood pressure taken regularly
- See the doctor if your blood pressure is not good
- Have blood tests done regularly to check your diabetes, to check your fats in the
- See the doctor after the tests have been done and find out the results. The doctor blood, to check on how your kidneys are functioning might need to change your medications. Ask the doctor to explain your results and ask the doctor what you can do to improve your health
7. People with diabetes need to eat well, and to have healthy foods.
See the Health Worker for some advice about what foods are the best for your health. The Health Worker maybe able to make an appointment with a Nutritionist who could provide additional information about healthy foods.
8. Keep active every day.
Walk to the store, enjoy getting out, go visit some friends – by walking and keeping active it improves your blood flow to your feet, and helps control your diabetes. Get a pair of well- fitting joggers and enjoy a daily walk.
Care for your feet and they will keep you going.