If you have diabetes and do one thing for your feet, make it this. A daily inspection takes about two minutes and catches the problems that otherwise go unnoticed until they are serious.
The reason is simple and worth understanding. Diabetic nerve damage removes the warning system. A blister, a stone in the shoe, a burn from a hot bath — all of it can happen without pain. Your eyes have to do the job your nerves no longer do.
When
Same time every day, so it becomes automatic. Most people find the end of the day easiest, when shoes and socks come off anyway. Sit somewhere with good light.
What you are looking for
- Cuts, scratches, blisters or cracks — anywhere the skin is broken.
- Redness, especially over a knuckle, the heel, or the ball of the foot, which means something is rubbing.
- Swelling, or one foot looking different from the other.
- Colour changes — pale, blue, very red, or a dark patch.
- Warm areas. A patch warmer than the rest can precede a visible problem.
- Changes in the nails: thickening, discolouration, or a nail digging into the fold.
- Hard skin building up, which signals pressure and can hide an ulcer underneath.
Do not skip between the toes
This is where problems start and where people forget to look. Separate each toe and check the skin between. It should be dry and intact — not soggy, white, cracked or peeling.
The soles
You cannot see the bottom of your own foot comfortably, which is why most people skip it. Two solutions: put a mirror flat on the floor and hold your foot above it, or ask someone. A long-handled inspection mirror costs very little and makes this a five-second job.
If your eyesight is limited, have someone else do the check. It is too important to guess at.
Check the shoes too
Before you put them on, run a hand inside each shoe. Stones, a folded insole, a torn lining or a protruding stitch will happily wear a hole in a foot that cannot feel it.
What to do with what you find
Anything broken, spreading, discoloured, warm or smelling gets a call to your doctor or podiatrist. Not next month at your review — that week. Small diabetic foot problems are extremely treatable and large ones are not, and the distance between the two is often only a few weeks.
The full routine is in diabetic foot care, and foot care for seniors covers doing this with limited mobility or eyesight. This guide comes out of Dr. Maasi J. Smith's practice.
Building the habit so it survives
The check only works if it happens every day, and good intentions are not what makes that happen. Anchor it to something you already do without thinking — taking your shoes off when you get in, or brushing your teeth. A habit tied to an existing one survives; a habit relying on memory does not.
Keep the mirror where you will use it, next to the chair you actually sit in rather than in a drawer upstairs. Leave the light on. Remove friction wherever you can find it.
Some people photograph their feet weekly with a phone. It gives you something to compare against rather than relying on memory, and lets you show a clinician what a spot looked like a fortnight ago. Slow changes are exactly the ones the eye misses.
If you live with someone, ask them to check with you once a week. A second pair of eyes catches what yours have stopped noticing.