Hygiene

Your teeth, skin and feet need special attention everyday. Caring for them properly plays a big part in keeping your diabetes under control by avoiding complications.

Teeth

To prevent periodontal disease, you need good diabetes control and oral care. Include the following things in your daily oral care:

• Use a soft-bristle toothbrush, because medium- or hard-bristle brushes can tear gum tissue.
• Brush twice a day.
• Floss daily to clean between teeth.
• Replace your toothbrush at least every 3 months.

Skin

You can do several things to avoid skin problems. Try these tips from the American Diabetes Association:

• Take warm baths and showers, because hot ones dry out your skin.
• Use mild shampoos and moisturizing soaps, which are unscented.
• Use an oil-in-water skin cream after bathing or showering.
• Keep your home more humid and bathe less during cold, dry weather.
• Prevent dry skin by not scratching when itchy and by moisturizing, especially in cold or windy weather.
• Use talcum powder in folds and places where skin touches skin, such as the armpits and groin.
• Take care of cuts right away by washing minor ones with soap and water. Avoid using alcohol, Mercurochrome antiseptic or iodine. Only use an antibiotic cream or ointment recommended by your doctor. Cover the cut with sterile gauze. See a doctor right away if you get a major cut, burn or infection.
• Avoid feminine hygiene sprays.
• See a dermatologist (skin doctor) if you cannot solve your skin problems. 

Feet

There are some simple steps you can take to avoid injury and reduce the risk of damage to your feet. Spending some time caring for your feet on a regular basis can help keep them healthy.

Inspecting Your Feet

Check your feet daily.

Look at the tops and bottoms of your feet and between each of your toes. If you have difficulty bending, use a mirror to check the bottoms or have someone help you. Look at your feet in a place with good lighting. A good time to look at your feet is after you take a bath or shower.

Look for changes.

Look for cuts, scratches, blisters, calluses, corns, ingrown toenails or signs of infection. Also look for white, moist, wrinkly skin, especially between the toes.

Feel for increased heat in the skin.

Hot spots may mean underlying infection or inflammation. If you have nerve damage in your feet, there may be little or no pain to alert you to these problems.
See your healthcare professional right away with any concerns.

Bathing

Keep your feet clean.

Wash them daily with a soft washcloth and mild soap in warm water. Remember to check the water temperature with your wrist or elbow to ensure that the water is not too hot to avoid burning your feet. Do not soak your feet in water or any other solution. Soaking will only cause your skin to dry out more.

Dry your feet.

Use a soft towel to completely dry your feet, remembering to dry between each and every one of your toes. Do not put lotion between your toes and never use a hair dryer to dry your feet.

Apply lotion.

Put lotion on the tops and bottoms of your feet after every wash. A mild 5 to 10% Urea-based lotion will help keep skin moisturized.

Corns and Calluses

Feet develop corns and calluses as a way of protecting your skin against pressure or friction, caused by poor-fitting shoes or an improper gait. And an improper gait can become even worse once calluses or corns develop.

Get rid of corns and calluses by reducing the pressure on your feet.

This may involve getting proper, well-fitting footwear and maybe using special insoles in your shoes. The insoles will help spread out your body weight evenly over the sole of your foot.

Take care of mild callus buildup.

When your foot is dry, gently file away any callused area with a pumice stone. Afterwards, apply lotion to all callused areas to keep the callus flexible and stop it from cracking.

Avoid using do-it-yourself corn or callus removers.

They can cause burns and may harm healthy skin around the problem area. Do not use corn pads.

Never cut your corns or calluses with a razor blade.

If you have thick calluses, you should ask your healthcare professional how to treat and prevent them.

Toenails

Keep your toenails properly trimmed and smooth.

Use blunt scissors to cut the nail straight across and then file the corners round with an emery board. Do not cut the nails too short; always leave about 1/16 to 1/8 of an inch of free nail beyond the end of your toe. The best time to cut your nails is after bathing when they are soft and easy to trim. If you have any problem reaching your nails easily or if your nails are thick and more difficult to cut, seek help from a healthcare professional trained to manage nails, such as a podiatrist or chiropodist.

Go the doctor for an ingrown toenail.

Do not try to treat it yourself.

Socks

Wear clean socks every day.

A sock that has at least 80% cotton or wool helps absorb sweat and lets the skin breathe. Avoid nylon in socks or stockings. Socks should fit well and have no tight elastic, especially at the top. Avoid socks with bulky seams.

Shoes

Never walk barefoot at home or outside.

Wear shoes and socks in the house and outside every day to protect and support your feet. Before you put on your shoes, always shake them out and then carefully feel inside for stones or rough spots that might hurt your feet.

Wear proper shoes.

Shoes should have a thick, flexible rubber sole with a closed toe and heel. The toe box should be wide and deep enough to accommodate your toes. Avoid shoes with a pointed toe. The inside lining of the shoes should not have ridges, wrinkles or seams. Lace-up shoes or ones with a Velcro®-brand closure are best. Try to avoid slip-on shoes.

Shop for shoes when your feet are largest.

Shopping for shoes in the afternoon is better than early morning. Avoid shoes that are too tight or pinch. If you are shopping for new shoes and you have numb feet, cut out an outline of each foot from stiff paper, and insert the outline into the pair of shoes you are thinking of buying to help you determine if they fit.

Wear new shoes for only short periods at first.

Break new shoes in by wearing them a maximum of 1 to 2 hours a day. After wearing new shoes, carefully inspect your feet and look for rubbed, red spots that might indicate a problem area.

Circulation

Quit smoking.

Smoking damages blood vessels and increases the risk of circulation problems in people with diabetes.

Exercise daily.

Also, don't sit in one position for too long. Move your legs and feet every few minutes, and avoid crossing your knees or ankles for long periods of time.

Wear warm socks, shoes or boots in the winter.

They help you avoid frostbite. Remember, the temperature sensation in your feet may not be reliable.

Avoid using heating pads or hot water bottles.

They can burn your skin. Instead, use wool socks to keep your feet warm.

Injuries

Stumbling or bumping into hard objects.

If you stumble or bump into a hard object, look at your feet to make sure they aren't hurt. If you have poor sensation in your feet, you may not feel the pain that normally warns you of a serious injury.

Foot injury.

If your foot is injured, refrain from walking on it even if it doesn't hurt, because that can cause more damage.

Blisters, cuts and scratches.

Treat blisters, cuts and scratches right away. Never use strong chemicals such as boric acid, hydrogen peroxide or any antiseptic. They can actually damage healing tissue. Do not open blisters yourself as it can lead to infections. Simply clean the wound with soap and water, and call your healthcare professional regarding further treatment. Cover all open injuries with a sterile dressing.

Open sores.

Call your doctor if there is any sign of heat, redness, swelling, pus or pain in or around an open sore.

Professional Care

Your feet need regular attention. Make sure that your doctor or diabetes educator checks your feet during your regular visits. Get help from a healthcare professional at the first sign of a problem. Podiatrists and chiropodists are healthcare professionals who specialize in the care and treatment of your feet. These specialists can treat your foot problems, or fit you with special shoes or inserts if you need them.

For more information about complications, please see Complications in the About Diabetes section.