Sensation · Skin · Pressure · Footwear
Protecting feet when diabetes changes risk
Diabetes can affect sensation, circulation, skin and healing. That means pain alone is not a reliable warning system. Daily checks, appropriate footwear and timely interprofessional care matter.
Get prompt medical help for a new wound or infection concern
Contact your physician, diabetes team, wound-care service or urgent-care provider promptly for an ulcer, blister that is not settling, drainage, spreading redness, warmth, swelling, blackened tissue, fever or another sign of infection—even if it does not hurt. A cold, pale or blue foot, sudden colour change or rapidly worsening symptoms also need urgent assessment.
Ashfield Orthotics does not treat active ulcers or infections. Pedorthic services may be considered as part of the wider plan when the appropriate medical team has addressed the immediate risk.
Why feet need attention
Risk can increase quietly
Reduced sensation
Peripheral neuropathy can make pressure, friction, heat or injury harder to notice. Daily visual inspection becomes more important.
Pressure and structure
Deformity, limited motion, callus and footwear fit can concentrate pressure in a small area and increase tissue risk.
Circulation and healing
Peripheral arterial disease and other health factors can affect healing and change how quickly a concern should be escalated.
Daily protection
Small, repeatable checks are more useful than occasional alarm
- Look at the tops, soles, heels and between the toes every day; use a mirror or ask for help if needed.
- Check for cuts, cracks, blisters, redness, swelling, callus, drainage, temperature or colour change.
- Wash and dry carefully, especially between the toes. Follow your clinician’s advice about skin care.
- Check inside shoes before putting them on and use clean socks that do not create pressure.
- Avoid walking barefoot and avoid direct heat sources that could burn skin without being noticed.
- Do not cut corns or calluses yourself or use medicated corn or wart treatments without professional guidance.
Footwear and pressure
Fit should be checked, not assumed
Enough width and depth
The shoe should accommodate the foot and toes without rubbing, crowding or relying on the upper to stretch around a pressure point.
Smooth and inspectable
Seams, foreign objects, folded liners and worn interior surfaces can create pressure that reduced sensation may not reveal.
Stable for the activity
The shoe should suit the person’s walking, balance, swelling, orthotic needs and daily environment.
New shoes or orthotics: Follow the wear-in and skin-check plan provided by your clinician. Stop and seek advice if you see persistent redness, blistering, rubbing or skin breakdown.
The pedorthic role
One part of an interprofessional foot-care team
A Certified Pedorthist can assess footwear, fit, pressure-related concerns and relevant foot and lower-limb function; recommend or modify footwear; and design or fit an orthotic when appropriate.
That role does not replace diabetes management, vascular assessment, wound care, infection treatment or the medical evaluation of new neurological or circulatory changes. Good care depends on involving the right professional at the right time.
Medical and diabetes care
Risk screening, circulation, glucose management, infection and systemic concerns.
Wound and foot-care expertise
Prompt treatment and off-loading decisions for active wounds or high-risk tissue.
Pedorthic care
Footwear, pressure, fit, orthotic design and follow-up within scope.
Before a pedorthic appointment
Bring the care context with you
- your regularly worn shoes and any orthotics;
- a current medication and medical-history list if relevant;
- information from your physician, diabetes team or wound-care team;
- the prescription and plan requirements if you are seeking coverage;
- questions about pressure areas, fit, skin checks and follow-up.
Sources and review
Evidence-aware foot protection
- Diabetes Canada: Foot Care Clinical Practice Guideline
- Diabetes Canada: Diabetes and Foot Care Checklist
- Diabetes Canada: Neuropathy Clinical Practice Guideline
This information supports—but does not replace—individual advice from your diabetes and foot-care team.
Protection begins before pain