Diabetic Foot Care

Symptoms and questions to discuss

• Numbness, burning, or less feeling in one or both feet
• A blister, cut, or warm spot you did not feel at first
• Corns, thick nails, or a change in foot shape
• Red, swollen, or slow-healing skin on the foot
• A foot that feels cold, looks pale, or turns darker

What we check

• Soles, nails, and skin between the toes
• Feeling in the feet and ankle pulses
• Shoe fit, socks, and barefoot habits
• Prior ulcers, amputation, or a change in foot shape
• Whether an A1C would change today's plan

Treatment options by class

Your provider reviews appropriate options and follow-up based on your assessment.

• Daily inspection, careful washing, drying, and safer footwear
• Nail and callus guidance that avoids cutting skin or using corn removers
• Glucose review, with an A1C only when that result would change the plan
• Urgent specialist coordination for infection or poor circulation, not a clinic procedure

When we refer

This is primary-care education in the skin program, not a podiatry, vascular, or wound practice. An open sore, lost feeling, a warm swollen foot, or weak pulses is handed to foot and circulation specialists. That handoff is not an accepted appointment. A cold, pale, blue, or black foot, or infected tissue, needs emergency care now. No named provider has signed this draft.

How a foot check is organized

Shoes and socks come off so skin, nails, toe spaces, feeling, and ankle pulses can be checked. No device or reminder is promised. Feeling and pulses are reviewed at least yearly, and sooner after a shape change, less feeling, leg-artery disease, or a past ulcer or amputation. A 2023 guideline's shorter gaps are labeled expert opinion. This visit assigns no risk class.

Daily care, and procedures not done here

Look at both feet daily, including between the toes. Wash in warm water, about 90 to 95 degrees Fahrenheit, after you test it. Do not soak, and keep lotion out from between the toes. Do not cut corns or use corn pads or liquid removers. Trim nails straight across only if you can see and feel them. Wear shoes indoors, shake them out, and skip heating pads on numb feet. Dressings, removal of dead tissue, casts, and shoe fitting are not done here.

Who follows a sore or a result

A closed blister needs warning signs and a reassessment plan. An open area needs prompt outside foot assessment, without routine clinic dressings. Selected glucose testing may guide care, but a website laboratory listing does not verify diagnostic assay suitability. Confirm method, draw location, availability, and cost before nonurgent testing; outside coordination may be needed. Cultures, imaging, and circulation studies require appropriate outside assessment. Ask who reviews reports, how results reach you, and who remains responsible while awaiting referral acceptance.

Infection and circulation warnings

Seek prompt assessment for a cut that is not starting to heal or new red, warm, or painful skin. Go to emergency care now for black or foul tissue, spreading redness, streaks, pus with serious illness, fever, bleeding that will not stop, or a cold, pale, blue, or dark foot. Call 911 if severely ill or transport is unsafe. A warm, red, swollen foot can be infection or a bone-and-joint problem and must not wait for routine booking. Do not soak an open sore or start leftover antibiotics.

Frequently asked questions

Sources

• Diabetes and Foot Problems — National Institute of Diabetes and Digestive and Kidney Diseases
• IWGDF Practical Guidelines on the prevention and management of diabetes-related foot disease (2023 update) — International Working Group on the Diabetic Foot
• Foot Care Tips — American Diabetes Association
• Peripheral Artery Disease — Symptoms — National Heart, Lung, and Blood Institute