How to Care for Your Feet and Legs When You Have Diabetes

Diabetes is perhaps best known for symptoms like high blood sugar and frequent urination. But the condition can also lead to complications that affect your feet and legs, which makes good diabetes foot care a must.

Here's why you should give your lower extremities extra TLC if you have diabetes and exactly how to care for your legs and feet to keep them healthy.

Good foot care is important for everyone but even more so for those with diabetes. People with the condition are at increased risk for complications that could lead to lower-limb amputations, per the Centers for Disease Control and Prevention.

Lifestyle changes, good blood sugar management and proper foot care can all reduce the likelihood of diabetes-related amputations of the feet and legs.

Diabetic neuropathy and peripheral arterial disease (PAD) are the two complications people with diabetes should be aware of, says Bruce Pinker, DPM, a podiatrist and board-certified foot and ankle surgeon in Nanuet, New York. Both are complications of diabetes that affect the lower legs and feet.

"Diabetic neuropathy, or nerve damage [caused by high blood sugar] in people with diabetes, can be painful and sometimes chronic," he explains. "It usually involves tingling, numbness or burning in the legs and feet."

This condition affects about half of all people with diabetes, according to the American Diabetes Association (ADA). It can occur throughout the whole body, including the lower extremities. When left untreated, the affected area could become infected or amputated, so prevention and management are key.

PAD is also common in those with diabetes — about seven times more common than in the general population, per June 2021 research in the ‌World Journal of Diabetes‌.

PAD is caused by narrowed arteries that make it harder for the heart to circulate blood to the legs. Telltale signs include pain in the legs when walking or moving along with coldness, numbness, weakness and cramping.

"The relationship between diabetes and PAD is well-documented, and it is also linked to obesity," Dr. Pinker says.

Because diabetic neuropathy most commonly occurs in the legs and feet, the right care can prevent it, according to the Mayo Clinic. Similarly, people with diabetes can also prevent PAD.

Once developed, neither condition is reversible. However, many people have great success managing their diabetes-related foot and leg symptoms with the right approach.

Foot care may not be your first thought when you have diabetes, but podiatrists want you to make it a priority.

"People with diabetes are prone to suffer from foot and leg problems because they are more likely to develop poor circulation and nerve damage," says Miguel Cunha, DPM, a New York City-based podiatrist.

Despite the importance of the feet, they're often the most neglected part of the body, he adds.

When you have diabetes, caring for your legs and feet isn't optional. It's one part of an overarching plan to manage your condition, but it's an important one, considering it could prevent amputations later on.

Follow these diabetes foot care guidelines:

One of the most important things you can do to prevent diabetes-related nerve damage is to keep your blood sugar levels within your target range, notes the CDC. In fact, this is Dr. Pinker's and Dr. Cunha's top tip.

High blood sugar can lead to diabetic neuropathy, so prevention starts with keeping your levels stable. When your blood sugar is high for a long time, nerve damage is more likely to occur.

Dr. Cunha recommends checking your blood sugar levels daily and sticking with the diabetes management plan laid out by your doctor or health care team.

This might include things like taking medication, getting regular exercise, sticking to a healthy diet and maintaining a healthy weight, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

When you have diabetes, podiatrists say to get into the habit of keeping your feet clean and moisturized. Here's how:

1. ‌Wash with warm, soapy water.‌ A hot-water soak may be tempting, but doctors warn against this: High temperatures from hot water can be dangerous for people with diabetes because nerve damage can make it difficult to tell just how hot a heat source is (meaning: you could easily burn yourself).
2. ‌Dry your feet well.‌ Extra moisture, especially between your toes, can lead to infections, Dr. Cunha says.
3. ‌Apply a gentle foot cream‌, per the ADA. Moisturizing helps prevent dry, cracked skin. Avoid getting any creams between your toes, though, as this could lead to infections, notes the ADA.

If you have diabetes, get used to giving yourself regular exams. In fact, you should be checking your feet daily.

What exactly are you looking for? Inspect your feet for cuts, scrapes or bruises — pretty much any abnormalities — says Dr. Pinker. That includes checking between your toes for things like corns, ulcers or athlete's foot.

And if you struggle to bend over to inspect your feet yourself, ask a loved one to help or get yourself a long-handled mirror to make the task easier.

This step may seem miniscule, but it's one of the most important parts of prevention. Even a small cut can lead to a serious infection when you have nerve damage or poor circulation from diabetes, notes the CDC.

Trimming your toenails on a regular basis is a small but effective way to preserve your foot health. Long nails could cut your skin, leading to an infection, or grow inwards, becoming ingrown toenails, per the NIDDK. Keeping them short prevents these problems.

Dr. Cunha recommends using a toenail clipper to trim the nails straight across and then filing the edges with an emery board.

You may be familiar with the benefits of going barefoot — or grounding, as some call it. While pressing your feet into the Earth may help you feel closer to nature, you should always wear footwear instead of going barefoot when you have diabetes, experts say.

This adds a layer of protection, because going barefoot leaves your feet vulnerable to the elements and could lead to scrapes and cuts.

The right shoes can also help alleviate symptoms like foot pain. The best shoes for people with diabetes are comfortable, supportive and have a wide toe box.

Custom orthotics can be beneficial for those with diabetes, too, because they keep your foot in the proper position, Dr. Cunha says.

He also recommends wearing socks and checking your shoes before you put them on to make sure there are no foreign objects that could become lodged in your toes or feet (you may not feel them if you have nerve damage, he warns).

If you find any corns or calluses when doing your daily foot check, it's important to address them right away. When left untreated, thick calluses can develop into ulcers or open sores, per the ADA.

You can use a pumice stone on wet skin to keep calluses at bay, but if they're persistent, you'll need to see a podiatrist.

Attempting to trim or cut corns or calluses yourself could lead to open wounds, which could become infected. Leave this to the professionals: A podiatrist can trim them for you and may recommend custom orthotics to reduce the pressure on your feet that causes them to form.

Physical exercise is beneficial for everyone. Regular movement is part of a healthy lifestyle, and it's associated with many health benefits.

Exercise is an important part of managing diabetes because it helps improve blood sugar control, insulin sensitivity and weight management, according to the CDC, all of which can reduce the risk of diabetes complications like neuropathy.

Just remember to check your feet for any injuries after exercise, the CDC notes.

The Physical Activity Guidelines for Americans recommend adults get at least 150 minutes of moderate-intensity exercise (think: walking, biking) or 75 minutes of vigorous-intensity exercise (like running or playing soccer) each week, along with two days of strength-training exercises. But if you're new to exercise, start slow and ask your doctor how much is right for you.

When you have diabetes, plan on seeing your team of doctors regularly. Specifically for your foot health, you should see your podiatrist at least once per year or more frequently.

At minimum, Dr. Pinker says anyone with diabetes should visit their podiatrist for a comprehensive annual foot exam. Those with severe cases of diabetic neuropathy or PAD may need to be seen every few months, though.

Other complications can also warrant a doctor's visit. For example, if you have any cuts, bruises or abnormalities that don't resolve on their own, you should get them checked out by a podiatrist. They will also want to see you for any unexplained foot pain.

Your podiatrist can also help you trim your corns, calluses and ingrown toenails.

If you suspect you have any of the symptoms of diabetic neuropathy or PAD, or you notice any unusual new symptoms in your feet or legs, it's always a good idea to be seen by a doctor.