Diabetic foot care: Moisturise here, not there and other tips every blood sugar patient should know

Imagine you are walking barefoot on a beach with the warm sand, sun and sea breeze feeling good. Now imagine forgetting the sunscreen and by evening your skin is blistered, painful and peeling. That is what untreated diabetes can do to your feet over time, slowly and subtly until one day a tiny cut becomes a major problem.

For someone living with diabetes, feet are not just an ignored body part, they are the first alarm system for deeper health issues. Think of them as your frontline soldiers where small cuts can become ulcers, mild redness can signal nerve damage and untreated blisters can escalate to infections and, in severe cases, amputation. That is why doctors call foot care as vital as insulin and diet but prevention does not mean expensive treatments or hospital visits. Often, simple daily foot habits, smart footwear and gentle activity can keep your feet safe, healthy and intact. Consistent attention to foot health can prevent complications and significantly improve overall quality of life.




In an interview with the Times of India, Dr Mahesh Babu, Senior Consultant Diabetologist at Meenakshi Super Speciality Hospital in Madurai, shared, “Foot hygiene and regular inspection is as vital as insulin and diet management. Washing feet with lukewarm water helps. Moisturising helps but excessive moisturising can lead to fungal infections. Custom made diabetic footwear or using of insoles helps in distributing pressure equally and does not create friction as much as open slippers or high heels do, that creates blisters.”

Each step of prevention is a step away from complications. Bringing his expertise to the same, Dr Nanda Kumar R, Senior Consultant - General Medicine at SRM Hospitals in Chennai, said, “Feet health is usually given the least attention despite being one of the first areas to show serious damage. High blood sugar damages small nerves, leading to loss of sensation and poor circulation — making tiny blisters progress into ulcers that can require hospitalisation or amputation. In India, 25% of diabetes-related hospital admissions are due to foot complications. Foot ulcers have a five-year mortality rate of 40–45%, comparable to several cancers.”

What the research says

Therapeutic footwear cuts ulcer risk by nearly half. Dr Mahesh Babu emphasised on custom-made footwear to reduce pressure and prevent blisters and ulcers. A 2022 study in Journal of Foot and Ankle Research, revealed, “Special therapeutic footwear with offloading properties significantly reduces the incidence of diabetic foot ulcers compared to conventional footwear.”

Custom insoles lower plantar pressure, which is a major cause of ulcers. Dr Mahesh Babu revealed that proper insoles prevent friction and pressure, unlike open sandals or heels. A 2024 study in Medicina (MDPI) found, “The use of foot insoles significantly reduced peak plantar pressure in the hallux, medial and lateral forefoot areas compared to controls.”

Footwear only works if you actually wear it. Dr Nanda Kumar warned that complications escalate fast if preventive steps (like proper shoes) are ignored. A 2013 Diabetes Care study found, “Among patients with high adherence, custom-made footwear reduced ulcer recurrence risk by 46% versus standard footwear.”

What causes diabetic foot damage?

Dr Nanda Kumar explained that prolonged high blood sugar damages the tiny nerves of the feet, a condition called peripheral neuropathy. This leads to:

• Loss of sensation (you don’t feel cuts)
• Poor circulation (wounds heal slowly)
• Altered skin texture (dry, cracked, flaky)
• High pressure points (which turn into ulcers)

When combined with wrong footwear or lack of inspection, these small issues turn into major medical emergencies.

Preventive steps: Expert-approved

1. Foot Hygiene and Inspection “As Vital as Insulin”: Wash feet in lukewarm water, dry between toes and inspect every day for cracks, redness, swelling, colour changes and tiny wounds.
2. Moisturise But Know Where to Stop: Use lotion on the heels and sole, not between toes. Excess moisture leads to fungal infections.
3. Wear Custom-Made Footwear or Insoles: Dr Babu emphasised, “They distribute pressure equally and prevent friction.” Open slippers, thin sandals and high heels cause blisters, calluses and pressure wounds.
4. Choose the Right Activity: Dr Babu recommended Yoga, mild walking and stretching. Avoid running, long hikes and high-impact sports because Neuropathy means you may not feel when shoes are injuring you.
5. Elevate the Feet Daily: Helps improve blood flow and reduce swelling.
6. Know the Red Flags and Seek Immediate Care: Dr Mahesh Babu highlighted that skin turning black, oozing wounds, persistent ulcers, foul odour or discharge may signal infection or tissue death. Dr Nanda Kumar pointed out consistent numbness in feet or tingling, flaky skin on feet, small wounds or cuts tend to heal slower than usual, healing slows down during constant swelling or redness on feet and changes in feet texture and skin colour as early warning signs that individuals must look out for.

Bottom line

Healthy feet are the cornerstone of personal independence. It is noteworthy that foot complications frequently serve as the first and most significant warning sign of people dealing with serious diabetes progression. The evidence is overwhelmingly clear, experts from various fields unanimously support this notion, and the message we need to convey is straightforward: it is essential to regularly check your feet, actively protect them, and make them a top priority in your daily care. This is particularly important because when you are living with diabetes, each step you take is not merely a form of movement but plays a vital role in your overall health and well-being, essentially serving as medicine for your body. If you are a diabetic individual, or perhaps you are familiar with someone who is, I encourage you to take a moment today to pay attention to your feet. Look closely at them. Examine the soles with care. Feel for any calluses that may have formed. Take note of any dryness, cracks, or signs of redness. Also, consider whether your shoes fit comfortably and adequately support your feet.

Prevention does not require amputation-level fear. It requires daily mindfulness, good habits and respectful care. Washing, moisturising sensibly, wearing proper insoles or therapeutic footwear, gentle walking, regular inspections and prompt medical attention may sound small but combined, these habits form a shield. Feet are the foundation of movement. In diabetes, that foundation is fragile. Protect it because every step you preserve is a step of independence, comfort and long-term health. Let that guide every step you take carefully, kindly and consistently.

Note: The information provided in this article is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before starting any new medication or treatment and before changing your diet or supplement regimen.