Living with diabetes comes with its own set of challenges. But one that often goes under the radar is foot care. Many people with diabetes are aware of how it impacts their blood sugar levels and other organs, but they often overlook the health of their feet. After all, a well-functioning foot is something we tend to take for granted until there’s a problem, right?
As a podiatrist, I see firsthand how diabetes can affect the feet, and I can’t stress enough how important proper foot care is to prevent complications that could have lasting consequences. Feet can seem like the most overlooked part of the body in terms of self-care, but neglecting them can lead to serious issues like infections, ulcers, or even amputations.
Why Is Diabetic Foot Care Important?
In my years of experience working with diabetic patients, one thing is clear: Diabetic foot care is critical for reducing the risk of infection and complications. Here’s why:
- Reduced Blood Flow
When diabetes narrows the arteries, blood flow to the feet is compromised. This means that any injury or cut heals much slower, increasing the risk of infection. Without sufficient blood circulation, the body has trouble fighting off bacteria, which makes even minor wounds more dangerous.
- Neuropathy (Nerve Damage)
Diabetes is notorious for causing nerve damage, which leads to a loss of sensation in the feet. This means that you might not feel a cut, a blister, or even an infection until it’s too late. I often see patients come in with severe wounds simply because they couldn’t feel the injury happening in the first place. - Compromised Skin Integrity
The skin on a diabetic foot is often dry and fragile. It cracks and breaks more easily, which can lead to open sores or infections. These tiny skin breakdowns are all it takes for bacteria to find an entry point and cause bigger issues.
3 Things You Should Never Do to Your Feet if You Are Diabetic
Now, let’s dive into three of the biggest “don’ts” when it comes to foot care for diabetics, based on my clinical experience and the cases I’ve seen throughout my career:
1. Never Walk Barefoot
I’ve had more patients than I can count come into my clinic with foot injuries that could have easily been avoided. Walking barefoot is a huge no-no for anyone with diabetes. Here’s why:
- Increased Risk of Injury: Even a tiny pebble on the ground can cause a painful injury. If you’re walking barefoot and you step on something sharp, you might not feel it because of neuropathy. The problem is, by the time you realise there’s an issue, it could already be infected. I remember one patient who stepped on a small nail while walking barefoot in their backyard. They didn’t feel it because of nerve damage, and by the time they came in, they had developed a severe infection that took months to treat.
- Exposure to Infections: Fungi, bacteria, and viruses thrive on the ground. Going barefoot exposes your feet to infections like athlete’s foot or plantar warts, which are particularly dangerous when blood flow and sensation are already compromised. I’ve seen patients who unknowingly walked through puddles, picked up infections, and ended up with ulcers that required long-term care.
- Pressure and Friction: Without shoes, you’re putting more pressure and friction on your feet, leading to blisters, calluses, and sometimes even ulcers. A blister might seem like a small issue, but for someone with diabetes, it can quickly turn into an ulcer, especially if it’s not noticed or treated right away.
- Extreme Temperatures: Whether it’s a scorching hot pavement in the summer or a cold floor in winter, walking barefoot exposes your feet to temperature extremes that could cause burns or frostbite. Diabetic neuropathy means you might not even realise you’re putting your feet in harm’s way.
Prevention: Always wear protective footwear. If you’re at home, consider soft slippers or indoor shoes, even on tile or hardwood floors. This simple step can prevent so much damage in the long run.
2. Never Use Corn Pads or Abrasive Exfoliants
When people think of foot care, many jump straight to products like corn pads or rough exfoliating scrubs to remove calluses. But here’s the thing—these products can actually do more harm than good for diabetics:
- Skin Damage: Corn pads often contain salicylic acid, which, while effective at removing corns, can also burn healthy skin. I’ve had patients who used these pads and ended up with severe skin irritation or burns, especially when their skin was already compromised by diabetes. Abrasive exfoliants can cause microtears in the skin, which is a direct gateway for infections.
- Delayed Healing: For diabetics, wounds or cuts heal much more slowly due to reduced blood flow. The chemicals in corn pads or the physical abrasion from exfoliants can further slow down the healing process. For example, a patient of mine once used an exfoliant to try and remove a thick callus. The abrasion from the exfoliant caused a tear in the skin, and healing took much longer than it should have. The area became infected, and it took weeks to get it under control.
- Aggravating Existing Conditions: If you already have blisters or cuts, using these products can make things worse, leading to more pain, infection, and complications. Even when a corn or callus seems harmless, it can lead to bigger issues when treated incorrectly.
- Loss of Protective Skin Layer: Your skin is meant to protect the underlying tissues from the outside world. Overusing abrasive products can strip away that protective barrier. For diabetics, this is a serious concern. Without that layer of protection, bacteria have easy access to deeper tissues, leading to infections that are much harder to treat.
Prevention: Instead of using harsh products, opt for moisturising creams and gentle foot care routines. If you have corns or calluses that need attention, seek professional treatment from a podiatrist who can manage them safely without risking further damage.
3. Never Soak Your Feet for Long Periods
I know many people love a good foot soak, but if you have diabetes, prolonged soaking can cause more harm than good. Here’s why:
- Loss of Natural Oils: Soaking your feet for long periods can strip away the natural oils that keep your skin hydrated. The skin on diabetic feet is already more prone to cracking and drying out. When you soak for too long, you accelerate this process, which leads to an increased risk of infections.
- Skin Maceration: Prolonged exposure to water can soften the skin to the point of maceration, where the skin breaks down and becomes more fragile. This makes it easier for bacteria to invade and cause infections. I’ve treated many patients whose feet became macerated after soaking, which led to cracks, sores, and ulcers.
- Aggravation of Existing Conditions: If you have open cuts or blisters, soaking can worsen these injuries. The excessive moisture can cause them to become more tender and slower to heal. I’ve had patients come to me with wounds that were significantly worsened by long soaking periods. The skin simply couldn’t handle the constant moisture.
- Increased Risk of Burns: Because diabetics often suffer from neuropathy, they can’t feel temperature extremes. Soaking your feet in water that’s too hot can lead to burns without the individual even noticing. It’s a risk that many people overlook.
Prevention: Keep your foot soaks short—no longer than 10-15 minutes—and always use lukewarm water. After soaking, make sure to dry your feet thoroughly, especially between the toes, to prevent fungal infections. Always moisturise afterward to lock in hydration.
Keep Your Feet Healthy, Keep Moving Forward
When managing diabetes, it’s not just about controlling blood sugar levels—foot health is just as important. By understanding what to avoid, like walking barefoot, using harsh exfoliating products, and soaking your feet for too long, you can protect your feet from complications that could lead to serious health issues, including ulcers and amputations.
Remember: preventive care is the key to healthy feet. Regular foot exams, proper footwear, daily inspections, and good hygiene habits go a long way in preventing long-term complications. If you notice anything unusual or experience pain, don’t wait—seek professional care immediately. Your feet—and your future—will thank you.
Frequently Asked Questions
Why Should People With Diabetes Never Walk Barefoot?
Diabetic individuals should avoid walking barefoot because they are more susceptible to foot injuries, which may go unnoticed due to nerve damage (neuropathy). Even a small cut, scrape, or puncture can become a serious problem if left untreated, potentially leading to infection, ulcers, or more severe complications like amputations. Wearing protective footwear at all times, even indoors, helps safeguard the feet from external injuries and reduces the risk of infection.
Why Is It Dangerous For Diabetics To Ignore Foot Pain?
Foot pain should never be ignored, especially for those with diabetes. Due to nerve damage, many diabetic individuals may not feel pain as acutely, which can delay the identification of potential issues. Ignoring pain can lead to untreated injuries or infections that could worsen over time, potentially leading to complications like ulcers, deformities, or even amputation. If you experience persistent foot pain, it’s crucial to seek prompt medical attention to avoid further damage.
Why Shouldn’t Diabetics Use Sharp Objects To Treat Corns Or Calluses?
Using sharp objects, such as razors or scissors, to remove corns or calluses is risky for diabetics. The skin of someone with diabetes may already be fragile and prone to infection, and using these tools can cause cuts or open wounds. These small injuries can quickly become infected, especially in those with poor circulation or weakened immune systems. It’s best to consult a podiatrist for safe, professional treatment rather than attempting to remove corns or calluses on your own.
Why Should Diabetics Avoid Soaking Their Feet For Long Periods?
Soaking the feet for extended periods can be harmful to diabetics, as it can cause the skin to lose its natural oils, leading to dryness and cracking. Prolonged soaking may also soften the skin too much, making it more susceptible to tears and infections. Additionally, people with diabetes often have reduced sensation in their feet, so they may not feel if the water is too hot, leading to burns. Limiting foot soaking to brief sessions and moisturising afterward is a safer approach for those with diabetes.
Why Should Diabetics Never Wear Tight Or Ill-Fitting Shoes?
Tight or poorly fitting shoes can cause a range of foot problems, including blisters, calluses, and ulcers, all of which can become serious for someone with diabetes. These issues can quickly lead to infections, especially if unnoticed due to nerve damage. Additionally, tight shoes can worsen circulation problems, further increasing the risk of complications. It’s essential for diabetics to wear properly fitting shoes with adequate cushioning and support to prevent unnecessary pressure and protect their feet.
