Patient and Family Instructions for Care of the Diabetic Foot

Aug 21, 2019


    • Inspect feet daily watching for blisters, cracks, calluses, inflamed areas, fungus infection, signs of shoe pressure, and signs of injury such as cuts, bruises, and skin breakdown between the toes.
    • 􀀁Wash feet daily with mild soap in tepid water and a soft brush.
    • 􀀁Dry carefully, especially between the toes. Blot dry, do not rub.
    • 􀀁After drying skin, use lanolin or petroleum jelly to retain the absorbed moisture, which will aid in combating dryness. To prevent maceration, do not use between the toes.
    • 􀀁Avoid extremes of temperature, either hot or cold. Use a portion of the body not involved with neuropathy to test the bath temperature or have another member of the family perform the testing


  • 􀀁Tepid or warm soaks may be used at the direction of your doctor for aid in healing lesions of the skin. A thermometer should be used for actual testing of the temperature.
  • 􀀁If your feet are cold at night, wear wool socks or wool booties to conserve body heat.
  • 􀀁External sources of heat such as hot water bottles, warm flat irons, warmed bricks, heating pads, heat lamps, and stoves should not be used and are extremely dangerous.
  • 􀀁Do not place your feet on heat registers, car heaters, or other unregulated sources of heat.
  • 􀀁Do not cross your legs when sitting. The common peroneal nerve is especially prone to pressure at the fibular head.
  • 􀀁Do not use chemical agents for removal of corns and calluses. Check with your doctor first. Use pumice stone and other simple techniques for reducing calluses.
  • 􀀁Loosen the bed clothing at the bottom of the bed to reduce pressure on the toes and bony prominences at the toes, heels, and ankles.
  • 􀀁File the toenails straight across. Do not curve into the nail grooves. Do not dig into the corners or along the grooves. Do not use scissors. If nails are too thick for a straight pocket clipper, consult your doctor. Do not use a knife or razor blade.
  • 􀀁Soak and scrub with a soft brush to remove accumulation of tissue in the nail groove. Rubbing alcohol may be used as a rinse to help dry and toughen the nail groove.
  • 􀀁If the soft tissue around the toenail is injured, use 70% alcohol and a cotton swab, bandage the toe, and seek medical help.
  • 􀀁Calluses are signs of increased pressure. They occur about bony prominences. Pressure relief at home should be of the simplest type such as:
    • Small pads of lamb’s wool or cotton can be placed around the callus and held in place underneath the stocking.
    • Commercial pressure relief pads may be tried under the direction of your doctor.
    • If rapid relief is not obtained see your treating physician. Breakdown of callus is a major cause for ulcer formation.
    • Do not use chemical agents for the removal of corns or calluses. Phenol, bichloride of mercury, tincture of iodine, and similar chemicals are dangerous. Do not do bathroom surgery with knives, razor blades, or scissors. See your doctor for reduction of these calluses
  • 􀀁Shoes should be made of leather. They should be long enough, wide enough, and should have enough room in the toes for the clawing that is frequently present in diabetics.
  • 􀀁Let your shoe fitter know that you are diabetic. Inquire if the fitters are members of the Prescription Footwear Association. These professionals have had special training in fitting shoes for diabetics.
  • 􀀁Inspect the inside of the shoes daily for cracks in the soles, wrinkles in the linings, bunching up of the construction material, and even accumulation of foot powders.
  • 􀀁Each time the shoes are worn they should be turned over to be sure that no foreign objects have fallen inside.
  • 􀀁Avoid shoes with straps, cut-outs, and other open areas that might cause cuts, blisters, or pressure areas.
  • 􀀁Do not wear new shoes for more than an hour at a time for the first several days. Inspect the feet for any reddened areas. If necessary, have another family member inspect the feet after the new shoes are worn for the first several times. Gradually increase the time worn each day for about 2 weeks, when the shoes should be broken in.
  • 􀀁Change the shoes during the day. An extra pair taken to work and changed at lunch time can increase the longevity of both the feet and the shoes.
  • 􀀁Do not buy shoes with corrective pads and do not add inserts without medical advice. An insensitive foot can be broken down readily by abnormal pressures inside the shoe.
  • 􀀁Do not wear shoes without stockings.
  • 􀀁Wear properly fitted stockings. Do not wear mended stockings. Avoid stockings with seams. Change stockings daily. Be careful of pressure on the toes from stretch socks. Buy good quality heavy cotton, cotton and wool mixed, or all-wool stockings.
  • 􀀁Wash stockings daily and rinse well to remove soap.
  • 􀀁Avoid elastic garters and elastic tops in hoses. If garters are necessary, they should be attached to a garter belt.
  • 􀀁Have your physician examine your feet at each visit. Be sure that anyone caring for your feet knows that you are diabetic, including the shoe salesman. Recognize that as you get older, your feet will tend to spread and require a wider and longer shoe. Do not insist on the same size you wore at age 19.
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Louisville Orthopaedic Clinic

4130 Dutchman's Lane,
Suite 300,Louisville 40207
(502) 897-1794

Louisville Orthopaedic Clinic

1425 State St.,
,New Albany 47150
(812) 920-0408

Louisville Orthopaedic Clinic
4130 Dutchman's Lane
Suite 300
Louisville, KY 40207

Louisville Orthopaedic Clinic
1425 State St.
New Albany, IN 47150