Number 

5 

in a 

Series 

of 7 

Large-print version 

Prevent diabetes problems:
 

Keep your feet and 

skin healthy 

U.S. Department 


of Health and
 

Human Services
 

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse

Prevent diabetes problems:

Keep your feet and 

skin healthy

U.S. Department 

of Health and 

Human Services

NATIONAL INSTITUTES OF HEALTH National Diabetes Information Clearinghouse
Contents 

What are diabetes problems? ............................................. 1
 

What should I do each day to stay healthy
 

with diabetes? ..................................................................... 2
 

How can diabetes hurt my feet?.......................................... 3
 

What can I do to take care of my feet?................................ 5
 

How can my doctor help me take care of my feet? ............. 7
 

What are common diabetes foot problems?........................ 8
 

How can special shoes help my feet? ............................... 11
 

How can diabetes hurt my skin? ....................................... 12
 

What can I do to take care of my skin? ............................. 13
 

Pronunciation Guide.......................................................... 14
 

For More Information......................................................... 15
 

More in the Series ............................................................. 17
 

Acknowledgments ............................................................. 18
 
 

 

 

What are diabetes problems? 

Too much glucose in the blood for a long time can cause 

diabetes problems. This high blood glucose, also called 

blood sugar, can damage many parts of the body, such 

as the heart, blood vessels, eyes, and kidneys. Heart and 

blood vessel disease can lead to heart attacks and strokes. 

You can do a lot to prevent or slow down diabetes problems. 

This booklet is about feet and skin problems caused by 

diabetes. You will learn the things you can do each day 

and during each year to stay healthy and prevent diabetes 

problems. 

Bone 

Blood 

vessel 

Nerve Skin 

High blood glucose can cause feet and skin problems. 

1 
What should I do each day to stay 

healthy with diabetes? 

Follow the healthy eating plan that you and your 

doctor or dietitian have worked out. 

Be active a total of 30 minutes most days. Ask 

your doctor what activities are best for you. 

Take your medicines as directed.
 

Check your blood glucose every day. Each time 

you check your blood glucose, write the number 

in your record book. 

Check your feet every day for cuts, blisters, 

sores, swelling, redness, or sore toenails. 

Brush and floss your teeth every day. 

Control your blood pressure and cholesterol. 

Don’t smoke.
 

2 
 

 

 

 

 

How can diabetes hurt my feet? 

High blood glucose from diabetes causes two problems that 

can hurt your feet: 

●	 Nerve damage. One problem is damage to nerves in 

your legs and feet. With damaged nerves, you might 

not feel pain, heat, or cold in your legs and feet. A sore 

or cut on your foot may get worse because you do not 

know it is there. This lack of feeling is caused by nerve 

damage, also called diabetic neuropathy.* Nerve 

damage can lead to a sore or an infection. 

●	 Poor blood flow. The second problem happens when 

not enough blood flows to your legs and feet. Poor 

blood flow makes it hard for a sore or infection to heal. 

This problem is called peripheral vascular disease, 

also called PVD. Smoking when you have diabetes 

makes blood flow problems much worse. 

These two problems can work together to cause a foot 

problem. 

*See page 14 for tips on how to say the words in 

bold type. 

3 
 

 

 

 

For example, you get a blister from shoes that do not fit. You 

do not feel the pain from the blister because you have nerve 

damage in your foot. Next, the blister gets infected. If blood 

glucose is high, the extra glucose feeds the germs. Germs 

grow and the infection gets worse. Poor blood flow to your 

legs and feet can slow down healing. Once in a while a bad 

infection never heals. The infection might cause gangrene. 

If a person has gangrene, the skin and tissue around the 

sore die. The area becomes black and smelly. 

To keep gangrene from spreading, a doctor may have to do 

surgery to cut off a toe, foot, or part of a leg. Cutting off a 

body part is called an amputation. 

Make sure you wear shoes that fit well. 

4 
 

 

What can I do to take care of my feet? 

●	 Wash your feet in warm water every day. Make sure 

the water is not too hot by testing the temperature with 

your elbow. Do not soak your feet. Dry your feet well, 

especially between your toes. 

●	 Look at your feet every day to check for cuts, sores, 

blisters, redness, calluses, or other problems. Checking 

every day is even more important if you have nerve 

damage or poor blood flow. If you cannot bend over 

or pull your feet up to check them, use a mirror. If you 

cannot see well, ask someone else to check your feet. 

●	 If your skin is dry, rub lotion on your feet after you wash 

and dry them. Do not put lotion between your toes. 

Look at your feet every day to 

check for problems. 

5 
 

 

 

 

●	 File corns and calluses gently with an emery board or 

pumice stone. Do this after your bath or shower. 

●	 Cut your toenails once a week or when needed. Cut 

toenails when they are soft from washing. Cut them to 

the shape of the toe and not too short. File the edges 

with an emery board. 

●	 Always wear slippers or shoes to protect your feet from 

injuries. 

●	 Always wear socks or stockings to avoid blisters. 

Do not wear socks or knee-high stockings that are 

too tight below your knee. 

●	 Wear shoes that fit well. Shop for shoes at the end 

of the day when your feet are bigger. Break in shoes 

slowly. Wear them 1 to 2 hours each day for the first 

few weeks. 

●	 Before putting your shoes on, feel the insides to make 

sure they have no sharp edges or objects that might 

injure your feet. 

Always wear slippers or 

shoes to protect your feet. 

6 
 

 

 

How can my doctor help me take care of 

my feet? 

●	 Tell your doctor right away about any foot problems. 

●	 Your doctor should do a complete foot exam every year. 

●	 Ask your doctor to look at your feet at each diabetes 

checkup. To make sure your doctor checks your feet, 

take off your shoes and socks before your doctor comes 

into the room. 

●	 Ask your doctor to check how well the nerves in your 

feet sense feeling. 

●	 Ask your doctor to check how well blood is flowing to 

your legs and feet. 

●	 Ask your doctor to show you the best way to trim your 

toenails. Ask what lotion or cream to use on your legs 

and feet. 

●	 If you cannot cut your toenails or you have a foot 

problem, ask your doctor to send you to a foot doctor. A 

doctor who cares for feet is called a podiatrist. 

7 
 

 

 

 

 

What are common diabetes foot problems? 

Anyone can have corns, blisters, and other foot problems. If 

you have diabetes and your blood glucose stays high, these 

foot problems can lead to infections. 

Corns and calluses are thick layers of skin caused by too 

much rubbing or pressure on the same spot. Corns and 

calluses can become infected. 

Corn and callus. 

Blisters can form if shoes always rub the same spot. 

Wearing shoes that do not fit or wearing shoes without 

socks can cause blisters. Blisters can become infected. 

Blister. 

Ingrown toenails happen when an edge of the nail grows 

into the skin. The skin can get red and infected. Ingrown 

toenails can happen if you cut into the corners of your 

toenails when you trim them. You can also get an ingrown 

8 
 

 

 

toenail if your shoes are too tight. If toenail edges are sharp, 

smooth them with an emery board. 

Ingrown toenail.
 

A bunion forms when your big toe slants toward the small 

toes and the place between the bones near the base of your 

big toe grows big. This spot can get red, sore, and infected. 

Bunions can form on one or both feet. Pointed shoes may 

cause bunions. Bunions often run in the family. Surgery can 

remove bunions. 

Bunion.
 

Plantar warts are caused by a virus. The warts usually form 

on the bottoms of the feet. 

Plantar warts.
 

9 
 

 

 

 

Hammertoes form when a foot muscle gets weak. Diabetic 

nerve damage may cause the weakness. The weakened 

muscle makes the tendons in the foot shorter and makes the 

toes curl under the feet. You may get sores on the bottoms 

of your feet and on the tops of your toes. The feet can 

change their shape. Hammertoes can cause problems with 

walking and finding shoes that fit well. Hammertoes can 

run in the family. Wearing shoes that are too short can also 

cause hammertoes. 

Hammertoe.
 

Dry and cracked skin can happen because the nerves in 

your legs and feet do not get the message to keep your skin 

soft and moist. Dry skin can become cracked. Cracks allow 

germs to enter and cause infection. If your blood glucose is 

high, it feeds the germs and makes the infection worse. 

Dry and cracked skin. 

10 
 

 

 

 

Athlete’s foot is a fungus that causes itchiness, redness, 

and cracking of the skin. The cracks between the toes allow 

germs to get under the skin and cause infection. If your 

blood glucose is high, it feeds the germs and makes the 

infection worse. The infection can spread to the toenails and 

make them thick, yellow, and hard to cut. 

Athlete’s foot.
 

Tell your doctor about any foot problem as soon as you see it. 

How can special shoes help my feet? 

Special shoes can be made to fit softly around your sore 

feet or feet that have changed shape. These special shoes 

help protect your feet. Medicare and other health insurance 

programs may pay for special shoes. Talk with your doctor 

about how and where to get them. 

11 
 

 

 

 

 

How can diabetes hurt my skin? 

Diabetes can hurt your skin in two ways: 

●	 If your blood glucose is high, your body loses fluid. With 

less fluid in your body, your skin can get dry. Dry skin 

can be itchy, causing you to scratch and make it sore. 

Also, dry skin can crack. Cracks allow germs to enter 

and cause infection. If your blood glucose is high, it 

feeds germs and makes infections worse. You may get 

dry skin on your legs, feet, elbows, and other places on 

your body. 

●	 Nerve damage can decrease the amount you sweat. 

Sweating helps keep your skin soft and moist. 

Decreased sweating in your feet and legs can cause 

dry skin. 

Drinking fluids helps keep your 

skin moist and healthy. 

12 
What can I do to take care of my skin? 

●	 After you wash with a mild soap, make sure you rinse 

and dry yourself well. Check places where water 

can hide, such as under the arms, under the breasts, 

between the legs, and between the toes. 

●	 Keep your skin moist by using a lotion or cream after 

you wash. Ask your doctor to suggest one. 

●	 Drink lots of fluids, such as water, to keep your skin 

moist and healthy. 

●	 Wear all-cotton underwear. Cotton allows air to move 

around your body better. 

●	 Check your skin after you wash. Make sure you have 

no dry, red, or sore spots that might lead to an infection. 

●	 Tell your doctor about any skin problems. 

Keep your skin moist by washing 

with a mild soap and using lotion 

or cream after you wash. 

13 
 

 

 

Pronunciation Guide
 

amputation (AM-pyoo-TAY-shuhn) 

gangrene (GANG-green) 

neuropathy (noo-ROP-uh-thee) 

peripheral (puh-RIF-ur-uhl) 

podiatrist (poh-DY-uh-trist) 

vascular (VASS-kyoo-lur) 

14
 
 

For More Information
 

Diabetes Teachers (nurses, dietitians, pharmacists, 

and other health professionals) 

To find a diabetes teacher near you, call the American 

Association of Diabetes Educators toll-free at 

1–800–TEAMUP4 (832–6874), or look on the Internet at 

www.diabeteseducator.org and click on “Find a Diabetes 

Educator.” 

Dietitians 

To find a dietitian near you, contact the American Dietetic 

Association at www.eatright.org and click on “Find a 

Nutrition Professional.” 

Government 

The National Institute of Arthritis and Musculoskeletal and 

Skin Diseases (NIAMS) is part of the National Institutes of 

Health. To learn more about feet and skin problems, write 

or call the National Institute of Arthritis and Musculoskeletal 

and Skin Diseases Information Clearinghouse, 1 AMS 

Circle, Bethesda, MD 20892–3675, 1–877–226–4267 

(toll-free); or see www.niams.nih.gov on the Internet. 

15 
To get more information about taking care of diabetes, 

contact 

National Diabetes Information Clearinghouse 

1 Information Way
 

Bethesda, MD 20892–3560
 

Phone: 1–800–860–8747
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndic@info.niddk.nih.gov
 

Internet: www.diabetes.niddk.nih.gov
 

National Diabetes Education Program 

1 Diabetes Way
 

Bethesda, MD 20814–9692
 

Phone: 1–888–693–NDEP (6337)
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndep@mail.nih.gov
 

Internet: www.ndep.nih.gov
 

American Diabetes Association 

1701 North Beauregard Street
 

Alexandria, VA 22311
 

Phone: 1–800–DIABETES (342–2383)
 

Internet: www.diabetes.org
 

Juvenile Diabetes Research Foundation International 

120 Wall Street
 

New York, NY 10005–4001
 

Phone: 1–800–533–CURE (2873)
 

Internet: www.jdrf.org
 

16 
More in the Series 

The “Prevent Diabetes Problems” Series has seven booklets 

that can help you learn more about how to prevent diabetes 

problems. 

For free single copies of these booklets, write, call, fax, or 

email the 

National Diabetes Information Clearinghouse
 

1 Information Way
 

Bethesda, MD 20892–3560
 

Phone: 1–800–860–8747
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndic@info.niddk.nih.gov
 

These booklets are also available at 

www.diabetes.niddk.nih.gov on the Internet. 

17 
 

 

 

 

 

 

 

 

 

Acknowledgments 

The National Diabetes Information Clearinghouse thanks the 

people who helped review or field-test this publication: 

For the American 

Association of 

Diabetes Educators 

Lynn Grieger, R.D., C.D.E.
 

Arlington, VT
 

Celia Levesque, R.N.,
 

C.D.E. 

Montgomery, AL 

Teresa McMahon, 

Pharm.D., C.D.E. 

Seattle, WA 

Barbara Schreiner, R.N., 

M.N., C.D.E. 

Galveston, TX 

For the American 

Diabetes Association 

Phyllis Barrier, M.S., R.D., 

C.D.E. 

Alexandria, VA 

Linda Haas, Ph.C., R.N., 

C.D.E. 

Seattle, WA 

Kathleen Mahoney, 

M.S.N., R.N., C.D.E. 

Drexel Hill, PA 

Randi Kington, M.S., R.N., 

C.S., C.D.E. 

Hartford, CT 

For the Centers for 

Medicare & Medicaid 

Services 

Baltimore, MD
 

Jan Drass, R.N., C.D.E.
 

For the Diabetes Research 

and Training Centers 

Albert Einstein School 

of Medicine 

Norwalk Hospital 

Norwalk, CT 

Jill Ely, R.N., C.D.E. 

Sam Engel, M.D. 

Pam Howard, A.P.R.N., 

C.D.E. 

Indiana University 

School of Medicine 

Indianapolis, IN 

Madelyn Wheeler, M.S., 

R.D., F.A.D.A., C.D.E. 

VA/JDF Diabetes 

Research Center 

Vanderbilt School of 

Medicine 

Nashville, TN 

Ok Chon Allison, M.S.N., 

R.N.C.S., A.N.P., C.D.E. 

Barbara Backer, B.S. 

James W. Pichert, Ph.D. 

Alvin Powers, M.D. 

Melissa E. Schweikhart 

Michael B. Smith 

Kathleen Wolffe, R.N. 

For the Grady Health 

System Diabetes Clinic 

Atlanta, GA
 

Ernestine Baker, R.N.,
 

F.N.P., C.D.E. 

Kris Ernst, R.N., C.D.E. 

Margaret Fowke, R.D., L.D. 

Kay Mann, R.N., C.D.E. 

For the Indian Health 

Service 

Albuquerque, NM
 

Ruth Bear, R.D., C.D.E.
 

Dorinda Bradley, R.N.,
 

C.D.E. 

Terry Fisher, R.N. 

Lorraine Valdez, R.N., 

C.D.E. 

Red Lake, MN 

Charmaine Branchaud, 

B.S.N., R.N., C.D.E. 

For the Medlantic 

Research Center 

Washington, DC 

Resa Levetan, M.D. 

For the Texas Diabetes 

Council 

Texas Department of 

Health 

Austin, TX 

Luby Garza-Abijaoude, 

M.S., R.D., L.D. 

18 
 

 

 

 

 

 

 

 

National Diabetes 

Information Clearinghouse 

1 Information Way
 

Bethesda, MD 20892–3560
 

Phone: 1–800–860–8747
 

TTY: 1–866–569–1162
 

Fax: 703–738–4929
 

Email: ndic@info.niddk.nih.gov
 

Internet: www.diabetes.niddk.nih.gov
 

The National Diabetes Information Clearinghouse (NDIC) is a service 

of the National Institute of Diabetes and Digestive and Kidney Diseases 

(NIDDK). The NIDDK is part of the National Institutes of Health of the 

U.S. Department of Health and Human Services. Established in 1978, the 

Clearinghouse provides information about diabetes to people with diabetes 

and to their families, health care professionals, and the public. The NDIC 

answers inquiries, develops and distributes publications, and works closely 

with professional and patient organizations and Government agencies to 

coordinate resources about diabetes. 

Publications produced by the Clearinghouse are carefully reviewed by both 

NIDDK scientists and outside experts. 

This publication is not copyrighted. The Clearinghouse encourages users 

of this booklet to duplicate and distribute as many copies as desired. 

This booklet is also available at www.diabetes.niddk.nih.gov. 

This publication may contain information about medications. When 

prepared, this publication included the most current information available. 

For updates or for questions about any medications, contact the U.S. Food 

and Drug Administration toll-free at 1–888–INFO–FDA (463–6332) or visit 

www.fda.gov. Consult your doctor for more information. 
U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

NIH Publication No. 08–4282L 

May 2008