Diabetic Foot Care

Learn more about your diabetic feet

What is a Comprehensive Diabetic Foot Evaluation (CDFE)?

A CDFE is a comprehensive diabetic foot evaluation performed on people with diabetes. Your podiatrist should perform a CDFE at least annually - and more often if you have foot problems. During this exam, your podiatrist will check your feet for signs of pressure or friction, calluses, nail problems, red spots, and signs of infection. They will also evaluate the condition of your skin. The exam will include non-invasive tests to see if you have lost any feeling in your feet, a simple examination of your circulation and if there is any change in the shape of your feet. The exam may turn up nothing, which means that your feet are in good condition. If changes are noted early, preventative measures can be taken.

What is a SudoScan?

A SudoScan is a 3 minutes screening test for early detection of small nerve peripheral neuropathy. The SudoScan is used for determining if you have neuropathy and the severity of your neuropathy. Peripheral Neuropathy refers to the conditions that result when nerves that connect to the brain and spinal cord from the rest of the body are damaged or diseased. Damage to these nerves interrupts communication between the brain and other parts of the body and can impair muscle movement, prevent normal sensation in the arms and legs, and cause pain.

What is Noninvasive Vascular Testing?

This screening test is designed to identify potential blockages in your arteries that lead to low blood flow to your feet and toes. This low blood flow can lead to a variety of problems including neuropathy, open wounds and difficulty with healing.

Diabetes and Your Feet

According to the American Diabetes Association, about 15.7 million people (5.9 percent of the United States population) have diabetes. Nervous system damage (also called neuropathy) affects about 60 to 70 percent of people with diabetes and is a major complication that may cause diabetics to lose feeling in their feet or hands.

Foot problems are a big risk in diabetics. Diabetics must constantly monitor their feet or face severe consequences, including amputation.

With a diabetic foot, a wound as small as a blister from wearing a shoe that's too tight can cause a lot of damage. Diabetes decreases blood flow, so injuries are slow to heal. When your wound is not healing, it's at risk for infection. As a diabetic, your infections spread quickly. If you have diabetes, you should inspect your feet every day. Look for puncture wounds, bruises, pressure areas, redness, warmth, blisters, ulcers, scratches, cuts and nail problems. Get someone to help you, or use a mirror.

Download the latest newsletter for diabetics and their feet to learn how best to care for your diabetic feet.

Here's some basic advice for taking care of your feet:

  • Always keep your feet warm.

  • Don't get your feet wet in snow or rain.

  • Don't put your feet on radiators or in front of the fireplace.

  • Don't smoke or sit cross-legged. Both decrease blood supply to your feet.

  • Don't soak your feet.

  • Don't use antiseptic solutions, drugstore medications, heating pads or sharp instruments on your feet.

  • Trim your toenails straight across. Avoid cutting the corners. Use a nail file or emery board. If you find an ingrown toenail, contact our office.

  • Use quality lotion to keep the skin of your feet soft and moist, but don't put any lotion between your toes.

  • Wash your feet every day with mild soap and warm water.

  • Wear loose socks to bed.

  • Wear warm socks and shoes in winter.

  • When drying your feet, pat each foot with a towel and be careful between your toes.

  • Buy shoes that are comfortable without a "breaking in" period. Check how your shoe fits in width, length, back, bottom of heel, and sole. Avoid pointed-toe styles and high heels. Try to get shoes made with leather upper material and deep toe boxes. Wear new shoes for only two hours or less at a time. Don't wear the same pair everyday. Inspect the inside of each shoe before putting it on. Don't lace your shoes too tightly or loosely.

  • Choose socks and stockings carefully. Wear clean, dry socks every day. Avoid socks with holes or wrinkles. Thin cotton socks are more absorbent for summer wear. Square-toes socks will not squeeze your toes. Avoid stockings with elastic tops.

When your feet become numb, they are at risk for becoming deformed. One way this happens is through ulcers. Open sores may become infected. Another way is the bone condition Charcot (pronounced "sharko") foot. This is one of the most serious foot problems you can face. It warps the shape of your foot when your bones fracture and disintegrate, and yet you continue to walk on it because it doesn't hurt. Diabetic foot ulcers and early phases of Charcot fractures can be treated with a total contact cast.

The shape of your foot molds the cast. It lets your ulcer heal by distributing weight and relieving pressure. If you have Charcot foot, the cast controls your foot's movement and supports its contours if you don't put any weight on it. To use a total contact cast, you need good blood flow in your foot. The cast is changed every week or two until your foot heals. A custom-walking boot is another way to treat your Charcot foot. It supports the foot until all the swelling goes down, which can take as long as a year. You should keep from putting your weight on the Charcot foot. Surgery is considered if your deformity is too severe for a brace or shoe.

For more information, please see our library of videos on foot and ankle conditions.