Diabetic foot care is a structured clinical process aimed at preserving limbs and preventing complications in individuals living with diabetes. It involves regular examination, risk assessment, early detection of problems, and timely intervention to reduce the risk of ulcers, infections, and amputations.¹ 

People with diabetes often develop changes in their nerves, blood vessels, and foot anatomy that impair sensation, blood flow, and pressure distribution on the feet. These changes make the foot more susceptible to injury and impair the body’s ability to heal once damage occurs.¹ 

Why Is Foot Care Important in Diabetes? 

Patients with diabetes have a markedly higher risk of foot ulceration and limb loss compared with people without diabetes. Neuropathy (nerve damage) reduces protective sensation, meaning patients may not feel minor cuts, blisters, or pressure injuries. Microvascular disease reduces blood flow, delaying healing and increasing infection risk. Structural deformities and pressure redistribution further predispose the foot to breakdown.¹ 

Because of these factors¹: 

Key Components of Diabetic Foot Assessment 

A thorough diabetic foot exam should be comprehensive and routine. Detailed assessments are often performed by a podiatrist, however, all wound management professionals should actively include these components in their examinations. Assessment includes four major domains: 

Dermatological Assessment 

Clinicians inspect the skin and nails, looking for signs such as¹: 

Temperature differences between feet > 3°C may indicate infection or acute complications like Charcot neuroarthropathy, which requires urgent attention.¹ 

Vascular Evaluation 

Assessing circulation is critical. Clinicians should palpate pedal pulses and consider additional tests if pulses are diminished. Poor blood flow significantly hinders wound healing and increases the risk of amputation.¹ 

Neurological Testing 

Loss of protective sensation is central to diabetic foot risk. Standard neurological tools include¹: 

If patients cannot feel these stimuli, they are at higher risk for injury and require more intensive monitoring. 

Musculoskeletal Evaluation 

Structural and biomechanical abnormalities like hammertoes, claw toes, ankle stiffness, or gait changes amplify pressure on the foot and contribute to ulcer development.¹ These changes should be documented and managed with appropriate referrals as necessary.  

Foot Care Best Practices 

Annual and Routine Foot Exams 

A complete diabetic foot examination should be performed¹: 

Daily Self-Inspection and Patient Education 

Empowering patients to inspect their feet daily helps detect early signs of problems. Education should cover¹: 

Appropriate Footwear and Offloading 

Footwear that reduces pressure — such as well-fitting shoes, orthotics, or protective inserts — can prevent breakdown and promote healing.¹ Recommendations may vary based on individual deformities and risk levels. 

Interprofessional Collaboration 

Effective diabetic foot care involves a team approach. This includes endocrinologists, podiatrists, vascular specialists, wound care nurses, and patient educators. Interprofessional care has demonstrated reduced rates of amputation, shorter hospital stays, and improved healing outcomes.¹ 

Common Complications to Watch For 

Foot Ulcers. Ulcers often result when pressure, nerve loss, and poor circulation converge. They require prompt evaluation and tailored wound care.¹ 

Infections. Diabetic foot infections can progress rapidly due to immune compromise and poor perfusion. Early signs require aggressive treatment, often with antibiotics and debridement.¹ 

Amputation. If complications are advanced — especially with infection or critical ischemia — amputation may be necessary. However, consistent and proactive foot care significantly reduces this risk.¹ 

Clinical Significance 

Diabetic foot care is essential for limb preservation in patients living with diabetes. By combining comprehensive clinical assessment with patient education and appropriate preventative strategies, wound care professionals can intervene early, reduce the incidence of ulcers and infections, and improve long-term outcomes.¹ 

For clinicians entering wound care, mastering diabetic foot assessment and preventive strategies will be a cornerstone of effective practice. 

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