✅ Medically reviewed by Dr. Thomas Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Diabetic Foot Care: The Complete 2026 Guide

Diabetes and Your Feet: Why This Is More Serious Than You Think

Every 30 seconds, someone in the world loses a leg to diabetes. I don’t say that to frighten you — I say it because the overwhelming majority of those amputations were preventable with proper foot care. As a podiatrist who works with diabetic patients daily, this is the area where my work has the most profound impact on lives. Here is everything you need to know to protect your feet.

How Diabetes Damages the Feet

Peripheral Neuropathy (Nerve Damage)

High blood sugar damages the small nerve fibers that provide sensation in the feet. The result: you lose the ability to feel pain, temperature, and pressure — your body’s primary early warning system. A pebble in your shoe, a blister from new shoes, a cut from a nail — these become invisible threats because you can’t feel them. By the time they’re noticed, they may already be infected.

Peripheral Artery Disease (Poor Circulation)

Diabetes accelerates the narrowing and hardening of blood vessels, reducing blood flow to the feet. Poor circulation means wounds heal more slowly or not at all. Infections can’t be fought effectively. Tissue dies. This combination — no sensation plus poor healing — is what turns a small foot wound into an amputation.

The Daily Diabetic Foot Exam

Every single day, examine your feet. This is non-negotiable. Use a mirror or ask a family member to check the bottom of your feet and between your toes. Look for: cuts, scrapes, or puncture wounds; blisters or sores; redness, warmth, or swelling; color changes (darker skin, blue tinges); any new growths; toenails that are ingrown, thickened, or infected. Catch problems early when they’re simple to treat.

Daily Foot Care Routine

Wash your feet daily with lukewarm water — always test temperature with your elbow or a thermometer, never with your feet. Dry completely, especially between toes (moisture causes fungus and skin breakdown). Apply a good moisturizing cream to the heel and top of the foot — not between the toes. Trim nails straight across, not curved, and not too short. Never use razors, corn plasters, or chemical callus removers on diabetic feet — always see a podiatrist for these.

Footwear for Diabetic Patients

Never walk barefoot — even at home. Wear well-fitting shoes with seamless interiors, adequate toe box depth, and no pressure points. Diabetic therapeutic shoes (Medicare Part B covers one pair annually for qualifying diabetic patients) provide extra depth, cushioned soles, and removable insoles for custom orthotics. Always inspect the inside of your shoes before putting them on — shake out any debris you can’t feel.

When to See Us Immediately

Don’t wait for scheduled appointments if you notice: any open wound that isn’t healing within a week, any signs of infection (increasing redness, warmth, swelling, drainage, fever), any area of skin that’s turning black or dark purple, or any new wound you don’t know how you got. These are medical emergencies in a diabetic patient.

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Frequently Asked Questions

How often should a diabetic see a podiatrist?

At minimum, once per year for a comprehensive diabetic foot exam. Patients with peripheral neuropathy, history of foot ulcers, or poor circulation should be seen every 1-3 months. Medicare covers this preventive care — use this benefit.

Can I cut my own toenails if I have diabetes?

If you have good sensation, good circulation, and good eyesight, careful home nail trimming is acceptable — cut straight across, file the edges. If you have neuropathy, poor circulation, or poor eyesight, professional toenail trimming by a podiatrist is strongly recommended to prevent accidental injury.

What do diabetic foot ulcers look like?

Diabetic foot ulcers typically appear as round or oval open wounds, often on the bottom of the foot at pressure points (ball of the foot, heel). They may be surrounded by callus and may drain clear, yellow, or bloody fluid. Some are initially painless due to neuropathy. Any open wound in a diabetic patient requires immediate professional evaluation.

Does Medicare cover podiatry for diabetics?

Yes. Medicare Part B covers an annual comprehensive diabetic foot exam, routine foot care for patients with documented peripheral neuropathy, and one pair of therapeutic shoes per year. We help patients access and document these benefits regularly.

Can foot pain be the first sign of diabetes?

Yes. Peripheral neuropathy — often presenting as burning, tingling, or numbness in the feet — is sometimes the first symptom that brings an undiagnosed diabetic to medical attention. If you have unexplained foot burning or numbness, ask your doctor about a blood glucose test.

About the Author: Dr. Tom Biernacki, DPM is a board-certified podiatric surgeon and founder of Balance Foot & Ankle Specialists, with locations in Howell and Bloomfield Hills, Michigan. He has treated over 5,000 patients.

Related Treatment Guides

• Diabetic Foot Care
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• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment

Medical References & Sources

• American Diabetes Association — Foot Complications
• PubMed Research — Diabetic Foot Care
• American Podiatric Medical Association — Diabetic Foot

Clinical References

1. American Diabetes Association. “Standards of Medical Care in Diabetes — 2024.” Diabetes Care. 2024;47(Supplement 1):S231-S243.
2. Bus SA, et al. “IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes.” Diabetes/Metabolism Research and Reviews. 2016;32(S1):16-24.
3. Singh N, et al. “Preventing foot ulcers in patients with diabetes.” JAMA. 2005;293(2):217-228.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.