A daily foot check for people with diabetes: a simple 2-minute routine

Diabetes can change how your feet feel. Over time, high blood sugar can damage the nerves in the feet (neuropathy) and narrow the small blood vessels that bring healing blood to the skin. The result is a risky combination: you may not feel a blister, a pebble in your shoe or a small cut, and when a wound does appear it can heal slowly and become infected. Most serious foot problems in diabetes start as something small and unnoticed.

The good news is that a short daily look at your feet catches most of these problems early, when they are simple to deal with. Major diabetes foot-care guidance recommends daily foot inspection for exactly this reason. You do not need special equipment. You need good light, two minutes and the habit.

When and how to check

Pick the same time every day. Evening works well, after washing and before you put on socks or slippers. Tie it to something you already do, such as brushing your teeth.

Use good light and a seat you can reach your feet from. If you cannot see or reach the soles of your feet, put a small unbreakable mirror on the floor, or ask a family member to look. If your eyesight is poor or you cannot bend easily, make the check a shared routine rather than skipping it.

Look at every part of both feet:

1. Soles and heels. Cracks, calluses, hard patches, cuts or blisters.
2. Between the toes. Redness, white or soggy skin, small splits. Moisture trapped here invites infection.
3. Tops of the feet and toes. Rubbing marks from shoes, blisters, scratches.
4. Toenails. Nails growing into the skin, thick or discoloured nails, dark patches under a nail.
5. Colour. Skin that looks unusually pale, red, bluish or very dark.
6. Temperature. One foot, or one area, that feels much warmer or colder than the other.
7. Swelling. Puffiness, shiny tight skin, or a sock mark that is deeper than usual.

Also run a hand along the skin. Dry, rough or peeling areas, and any spot that hurts, are worth noting.

Check your shoes too

Before you put shoes on, feel inside them with your hand. A stone, a fold in the insole or a rough seam can rub a hole in skin that cannot feel the rubbing. Wear socks without tight bands or thick seams, and change them daily. Choose shoes that fit properly, with room for the toes. Avoid going barefoot, including at home, on the beach and around the pool.

Everyday habits that protect your feet

• Wash your feet daily in lukewarm water. Test the water with your elbow or a thermometer, not your foot. Diabetes can hide the heat of water that is too hot.
• Dry carefully, especially between the toes.
• Moisturise the tops and soles to prevent cracks, but not between the toes.
• Do not cut calluses or corns yourself, and do not use medicated corn plasters or chemical removers. These can damage skin that you cannot feel properly. Ask a podiatrist or your clinician.
• Do not use hot-water bottles, heating pads or heaters on your feet.
• Trim toenails straight across and file sharp corners (see how to cut your toenails safely). If your nails are thick, or you cannot see or reach them, have a professional do it.
• Do not smoke. It further reduces blood flow to the feet.

What to do if you find a problem

Do not wait to see whether it goes away, and do not treat it yourself with strong antiseptics or home remedies.

Contact your doctor, diabetes team or podiatrist the same day if you notice:

• any break in the skin, blister or cut that is not clearly healing;
• redness that is spreading, warmth, swelling or pain that is new;
• pus, drainage or an unpleasant smell;
• a nail that is growing into the skin or has become sore (read ingrown toenail: what to do);
• black, blue or very pale skin, or a sore on the heel or toe.

Seek urgent care straight away if a foot wound comes with fever, chills, red streaks moving up the leg or a foot that suddenly looks very different. These can be signs of a spreading infection.

Professional care is part of the plan

A daily self-check does not replace professional examinations. People with diabetes should have their feet examined by a healthcare professional at least once a year, and more often if they have reduced feeling, poor circulation, foot deformities, past ulcers or other risk factors. Your clinician can tell you how often is right for you. A podiatrist can also deal safely with calluses, corns and thick nails, and advise on footwear.

A checklist you can print

• ☐Soles and heels
• ☐Between all toes
• ☐Tops of feet and toes
• ☐Toenails
• ☐Colour and temperature
• ☐Swelling
• ☐Inside of shoes, before wearing them
• ☐Any new cut, blister, sore or redness: contact a clinician today