Helping Patients with Diabetes CARE for Their Feet Protection Status
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By David Hite PhD

Diabetes, the leading cause of amputation of the lower limbs, places an enormous burden on both the individual and the health care system. It’s estimated that the annual cost for treating diabetic foot problems is over one billion dollars. During their lifetime, 15 percent of people with diabetes will experience a foot ulcer and about 20 percent of those will require amputation.

Many individuals with diabetes may not understand the importance of checking their feet on a daily basis or appreciate that as many as half of the 86,000 amputations each year could be prevented with simple foot care practices. Just as importantly as checking their own feet, patients also need to be aware that if they find changes in the color of the skin, skin breaks, swelling, or if they feel pain or numbness in their feet, they should make an appointment with their primary care physician to have them checked.

Encouraging patients with diabetes to undertake a basic foot care regimen should be a major point of emphasis for all Diabetes Educators. Basic foot care is simple, quick and empowers the patient to manage their diabetes more proactively, thus reducing the likelihood of complications. The key educational elements for diabetes patients can be described with the mnemonic CARE:

  • Control: control blood glucose levels.
  • Annual: have an annual foot screening examination with your healthcare professional.
  • Report: report any changes in your feet immediately to your healthcare provider.
  • Engage: engage in a simple daily foot care routine that includes washing and drying between the toes, moisturizing and checking for any changes, and by wearing shoes that support and protect the foot.

The educational CARE framework above should always be tailored to the individual and take into account their health beliefs, motivation, and personal circumstances. The importance of reinforcing the need for self-care on a regular basis will help our patients reduce their risk of diabetes complications.

Lipsky BA, et al. America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic Foot Infections [Online]. Clin Infect Dis. (2012) 54(12): 1679-1684. Available at: Accessed October 28, 2012.

McInnes A, Jeffcoate W, et al. Foot care education in patients with diabetes: Consensus statement [Online]. Diabet Med. 2011 February; 28(2): 162–167. Available at: Accessed October 28, 2012.

National Diabetes Education Program. Feet Can Last A Lifetime: A Health Care Provider’s Guide to Preventing Diabetes Foot Problems. Available at: Accessed October 28, 2012.

About The Author

David Hite PhD, is a lifelong educator, spending 20 years teaching biology, chemistry, and health education at the high school and community college levels, two years teaching science at Cairo American College in Egypt, and two years at Shanghai American School in China. Dr. Hite developed the patient-friendly "Take Control - Diabetes Basics", a diabetes educational DVD used by clinicians to encourage their patients to implement and maintain effective self-care strategies, and has spent the past 11 years working daily with diabetes patients as a Clinical Health Educator in the Chronic Conditions Management Department for a large non-profit healthcare provider in Sacramento, California. Dr. Hite is a member of the American Association of Diabetes Educators, and the American Diabetes Association.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of DiabetesProductSource, WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

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