Diabetes can affect the foot in two ways that add up: it reduces sensation —so a wound, a rubbing spot or a stone in the shoe can go unnoticed— and it makes circulation harder, so anything that is injured takes longer to heal. That combination is what turns a blister or a badly cut nail into something worth watching closely.
A podiatric review in diabetes is not chiropody under another name: it includes assessing sensation in the foot and the state of the skin, looking at where footwear presses, caring for nails and hard skin with risk in mind, and agreeing how often to come back. Most of the work is prevention, and it works: regular checks and knowing what to look for at home is what prevents most complications.
What the review includes
- Assessment of sensation in the foot.
- Review of the skin, the heels and the spaces between the toes.
- Cutting and filing of nails and removal of hard skin, with risk in mind.
- Review of footwear and of the points where it presses or rubs.
- Guidance for checking your own feet at home, and how often to be seen.
Do you have diabetes and has it been a while since anyone checked your feet?
Book an appointmentFrequently asked questions
- I have diabetes. Can I cut my own nails?
- It depends on two things checked at the appointment: whether you still have sensation in the foot and whether you can see your nails properly. With normal sensation, good eyesight and a healthy nail, cutting it straight across without digging into the corners is reasonable. What should never be done at home is removing hard skin, touching an edge that is digging in, or using corn removers and aggressive metal files: in a foot with reduced sensation it is easy to go too far without noticing, and a wound there does not announce itself with pain. If you cannot see your feet well or cannot reach them comfortably, do not improvise: that is part of what the review is for.
- What should I be checking at home?
- Both feet in full, every day, and at the same time so it does not get forgotten — at bedtime, for instance. Look at the sole, the heels, the outer border and between the toes, which is the spot most often missed. What you are looking for is anything new: a wound or a blister even if it does not hurt, an area that is red or warmer than the rest, a change in colour, a crack, a bad smell, or a nail that has changed. If you cannot see the sole, use a mirror on the floor or ask someone to look for you. And feel inside the shoe with your hand before putting it on: a loose seam or a small stone can do damage without you noticing.
- I have diabetes but nothing feels wrong. Do I still need a review?
- Yes, and for that very reason. Loss of sensation is gradual and silent: you do not notice it being lost, you notice it once it is gone. So "nothing hurts" is not a measure of how the foot is doing — it is precisely what allows an injury to go unnoticed. Testing sensation is an objective check and is what tells you where you stand and how often you should be seen. If it comes out well, you are told so and the reviews are spaced further apart; and having a baseline from today is what will make a change visible later on.
