Having had one changes how closely your feet need to be watched. If you have had foot ulcers before, see your provider every 3 to 6 months.
The rest of prevention falls into four groups.
Looking. Check your feet every day — the tops, sides, soles, heels, and between your toes — for dry and cracked skin, blisters or sores, bruises or cuts, redness, warmth or tenderness, and firm or hard spots. If you cannot see well, ask someone else to check your feet. The warning signs are often absent because of nerve damage, which is why the looking has to be deliberate.
Washing and skin. Wash your feet every day with lukewarm water and mild soap, checking the temperature with your hand or elbow first, and dry gently, especially between the toes. Use lotion, petroleum jelly, lanolin, or oil on dry skin — but do not put lotion, oil, or cream between your toes unless instructed to by your provider.
Nails, corns and calluses. Ask your provider to show you how to trim your toenails, cutting straight across. Do not try to cut very thick toenails yourself, and if nails are thick and discolored do not trim them yourself. If your vision is poor or sensation is reduced, see a podiatrist for nail trimming. Most people with diabetes should have corns or calluses treated by a foot doctor; do not use medicated pads or shave or cut them away at home.
Shoes and socks. Wear shoes at all times to protect your feet from injury, and check inside them for stones, nails, or rough areas before putting them on. Wear shoes that are comfortable and fit well when you buy them — never buy shoes that are tight. Break new shoes in slowly, 1 to 2 hours a day for the first 1 to 2 weeks, and change broken-in shoes after 5 hours during the day to change the pressure points. Do not wear flip-flop sandals or stockings with seams. Wear clean, dry socks every day, and ask your provider if you need special shoes that give your feet more room.
And the things that do not involve feet at all. If you smoke, stop — smoking decreases blood flow to your feet. Keep your blood sugar under good control, which helps you heal faster and helps your body fight infections.
Two don’ts that cause real injuries: do not use a heating pad or hot water bottle on your feet, and do not walk barefoot, particularly on hot pavement, hot tiles, or hot sandy beaches. This can cause severe burns in people with diabetes because the skin does not respond normally to heat.