Not only do diabetics have to keep an eye on their diet, monitor their blood sugar levels and administer insulin shots, they must also ensure their feet are free from infection. With an estimated 120 million diabetics worldwide, podiatry has its work cut out treating the foot problems associated with diabetes. Foot ulcers, infections and even amputation are among the risks diabetics face from poor foot care. However, by following some simple guidelines, and regular visits to a podiatrist, diabetics can keep their feet clean, healthy and reduce the risk of disability.

People with diabetes have impaired nerve and circulatory function. Nerve damage can lead to a loss of sensation in the extremities, often the feet. An insensitivity to pain means the diabetic may not feel a blister, cut or sore on their foot. Poor circulation means that blood flow to the foot is reduced, impacting on the resistance to infection or the healing of an existing infection. An aggressive infection can potentially lead to the loss of a toe, foot or leg. Every year in the UK, nearly 5,000 diabetics need an amputation arising from a foot infection.

Half of all foot ulcers and amputations on people with diabetes could be prevented through improved foot care. Diabetics should develop a daily routine of inspection and cleaning along with periodic examination by a podiatrist. Diabetics should inspect their feet every morning and night checking for blisters, cuts and inflammation or toenail problems. It may be necessary to use a mirror to see the sole of the foot or ask someone else to take a look. Feet should be washed in warm water using a mild soap and dried carefully but thoroughly (paying particular attention to between the toes). Once dry, the feet should be moisturised. Podiatrists sell a specialist foot moisturiser that can prevent dry skin from cracking, however this shouldn't be used between the toes as this can cause a fungal infection.

Toenails should be cut straight and across but not too short as this can lead to an ingrowing nail. Also file down any edges to prevent snagging. Socks should be clean, dry, changed daily and not be too tight around the ankle as this can restrict circulation (remember, diabetics can have poor circulation to the extremities). Before putting on shoes, diabetics should check inside and shake them out; a small stone can easily cause a cut or irritation to the foot. When at home, avoid walking around the house in bare feet; wear slippers with a hard rubber sole. Diabetics are advised to avoid walking in bare feet on any occasion as the risk of a scratch or cut is possible on any surface. Heat should never be applied to the feet with hot water bottles or heat pads. If feet get cold in bed at night, wear a clean pair of socks instead.

Even following all these guidelines, diabetics are as prone to corns and calluses as non-diabetics. However, diabetics should not use corn plasters or chemical agents to treat the problem. Regular podiatry visits will clear up any skin problems and if creams or solutions are needed the podiatrist will recommend safe products. A podiatrist can also give advice on correctional devices like orthotics that can be placed in the sole of the shoe to ease pressure on the foot and prevent blisters forming.

Awareness, common sense, cleanliness and treatment from a trained podiatry practitioner can prevent diabetics from developing foot problems that can potentially lead to disastrous consequences.