Diabetes Foot Care: Ulcer Prevention and Daily Inspection Checklist

alt Feb, 1 2026

Why Diabetic Foot Care Can Save Your Legs

Every year, over 82,000 people in the U.S. lose a foot or leg to diabetes-related amputation. Most of these aren’t caused by sudden accidents. They start with a tiny cut, a blister, or a red spot that goes unnoticed. For someone with diabetes, even a small injury can turn into a life-altering ulcer - and worse, an amputation. The good news? Almost all of these cases are preventable. The key isn’t fancy surgery or expensive gadgets. It’s a simple, daily habit: checking your feet.

Who’s at Risk? Know Your Foot Risk Level

Not everyone with diabetes has the same foot risk. The International Working Group on the Diabetic Foot (IWGDF) breaks it down into four clear levels:

  • Risk 0: No nerve damage, no past foot problems. You’re low risk, but not immune.
  • Risk 1: Nerve damage (neuropathy) but no foot deformities. You need to be more careful.
  • Risk 2: Nerve damage plus foot changes like bunions, hammertoes, or flat arches. Your feet are under more pressure.
  • Risk 3: You’ve had a foot ulcer or amputation before. This is high risk - every day matters.

If you’re Risk 2 or 3, you need to see a foot specialist every 1 to 3 months. Risk 1? Every 6 months. Risk 0? Once a year is enough - but don’t skip it. Many people think if they don’t feel pain, they’re fine. That’s exactly how ulcers sneak up.

The Daily Foot Inspection Checklist: Do This Every Single Day

There’s no magic tool. No app replaces your eyes. The most effective way to catch trouble early is a consistent, step-by-step inspection. Follow this routine every day, preferably between 10 a.m. and 2 p.m. when your body temperature is most stable.

  1. Wash your feet. Use lukewarm water - between 90°F and 95°F. Test it with your elbow or a thermometer. Hot water can burn you without you realizing it.
  2. Dry thoroughly. Pay special attention to the spaces between your toes. Moisture there breeds fungus and cracks.
  3. Look at every inch. Use a hand mirror or ask someone to help. You need to see the bottom of your feet, the sides, and between your toes. Don’t guess. Look closely.
  4. Check for these warning signs: Blisters larger than a pea, cuts deeper than a scratch, redness bigger than a coin, swelling that makes your shoe feel tight, or skin that’s warmer than the other foot.
  5. Moisturize. Use lotion on dry skin - but never between your toes. That’s a recipe for infection.
  6. Trim nails straight across. Cut them so they’re just short of the tip of your toe. Don’t round the corners. Don’t dig into the sides. Ingrown nails are a major cause of ulcers.
  7. Don’t ignore changes. If something looks off - even if it doesn’t hurt - write it down. Take a photo. Call your doctor the same day.

Studies show that 68% of ulcers start from injuries you never noticed. Why? Because nerve damage steals your sense of pain. You can step on a nail, walk on it for days, and feel nothing. That’s why inspection isn’t optional. It’s your first line of defense.

Side-by-side comparison of a healthy foot and a foot with warning signs like blisters and redness.

Footwear: The Silent Killer

Shoes are one of the biggest reasons people end up with ulcers. The IWGDF says 87% of forefoot ulcers and 79% of midfoot ulcers come from shoes that don’t fit right. Here’s what you need to know:

  • No barefoot walking. Not even in your house. Walking barefoot increases your ulcer risk by more than 11 times. That’s not a suggestion. That’s a fact.
  • Shoe fit matters. There should be at least half an inch (12.7 mm) between your longest toe and the end of the shoe. Your toes should be able to spread out naturally - no pinching.
  • Heel counter support. The back of your shoe should be stiff enough to hold your heel in place. Too soft, and your foot slides forward, putting pressure on the ball of your foot.
  • Therapeutic shoes aren’t optional for high-risk patients. If you’re Risk 2 or 3, custom shoes with pressure-reducing soles are medically necessary. They’re not luxury items. They’re medical equipment.
  • Avoid sandals and flip-flops. Even in summer. A study found people who wear sandals have a 4.3 times higher chance of developing ulcers. They offer no support, no protection.

Don’t wait until your feet hurt to change your shoes. By then, it’s too late. Get fitted by a podiatrist or certified pedorthist. Many insurance plans, including Medicaid, cover them now.

What Doesn’t Work - And What Could Hurt You

There’s a lot of misinformation out there. Don’t fall for these traps:

  • Antibiotics won’t prevent ulcers. If you don’t have an infection, taking antibiotics won’t stop an ulcer. It’ll just make future infections harder to treat.
  • Foot exercises aren’t always safe. Some people think stretching your ankles helps. But without gait analysis, unsupervised exercises can actually increase pressure on weak spots. Stick to walking - and only if your doctor says it’s safe.
  • Nerve surgery doesn’t prevent ulcers. A recent review of 9 studies found nerve decompression procedures offer zero benefit for ulcer prevention. Skip it.
  • Don’t use heating pads or hot water bottles. You might not feel the heat, but your skin burns anyway.

Also, avoid cutting calluses yourself. Don’t use razors, corn removers, or chemical solutions. These can easily turn into open wounds. Let a professional handle it.

Barriers to Care - And How to Beat Them

Even if you know what to do, life gets in the way. Here’s what stops people:

  • Vision problems. If you can’t see your feet clearly, use a mirror or ask a family member to help. Many clinics offer free foot-checking training.
  • Cost. Therapeutic shoes and sensors can be expensive. But Medicaid now covers annual foot exams in 47 states. Ask your provider about coverage. Some nonprofits offer free or low-cost footwear.
  • Neuropathy severity. The worse your nerve damage, the harder it is to stay consistent. Set phone reminders. Put your mirror next to your toothbrush. Make it part of your morning routine.
  • Summer slip-ups. When it’s hot, people switch to sandals. Don’t. Keep your protective shoes on. Use breathable socks instead.

One study found that patients who had a family member help with foot checks were 52% more likely to stick with the routine. You don’t have to do this alone.

Family member helping someone with diabetes inspect their foot, using a mirror and smartphone photo.

New Tools - Helpful, But Not Required

There are new gadgets: smart socks that detect temperature changes, insoles that warn of pressure hotspots, apps that analyze photos of your feet. They’re promising. Some can predict ulcers days before they form.

But here’s the truth: none of them replace daily inspection. A $300 smart mat won’t help if you don’t look at your feet. The CDC found that even the best apps require fast internet - something 22 million Americans don’t have.

Use tech if it works for you. But don’t wait for it. Start today with a mirror, a towel, and a checklist.

What Happens If You Don’t?

Let’s be clear: skipping foot care doesn’t just mean discomfort. It means hospital visits. Long-term antibiotics. Surgery. Amputation. And death. One in five people with a diabetic foot ulcer die within five years - not from diabetes, but from complications of infection and immobility.

The CDC’s goal is to cut amputations by 25% by 2030. That’s possible - but only if people start checking their feet every day. It’s not about being perfect. It’s about being consistent. One day off can cost you your foot.

Start Today. No Excuses.

You don’t need to be an expert. You don’t need to buy anything. You just need to look. Every single day. Before you get dressed. After you shower. When you sit down to watch TV.

Put the mirror where you can’t ignore it. Set a reminder on your phone. Tell someone to check in with you. This isn’t about fear. It’s about control. You can’t control your diabetes completely - but you can control whether a tiny cut becomes a lost limb.

How often should I inspect my feet if I have diabetes?

You should inspect your feet every single day. This is non-negotiable if you have diabetes. Even if you feel no pain, nerve damage can hide injuries. Daily checks are the only way to catch problems early. If you’re at higher risk (history of ulcers, foot deformities, or poor circulation), your doctor may recommend additional professional exams every 1 to 3 months.

Can I use a mirror to check the bottom of my feet?

Yes, and you should. A handheld mirror is one of the most effective, low-cost tools for foot inspection. Place it on the floor and tilt your foot over it to see the sole. If you can’t bend over or reach, ask a family member or caregiver to help. Many clinics offer free training on how to use mirrors properly.

What should I do if I find a cut or blister on my foot?

Don’t wait. Don’t try to treat it yourself. Call your doctor or podiatrist immediately. Even a small cut can become infected quickly in people with diabetes. Avoid soaking it, applying ointments, or covering it with tape. Keep it clean and dry until you get professional advice. Early treatment can prevent a minor issue from becoming a major one.

Are over-the-counter foot creams safe for diabetics?

Yes - but only if you use them correctly. Use moisturizers on dry skin on the tops and sides of your feet. Never put cream between your toes. That area stays moist and becomes a breeding ground for fungus and bacteria. Look for fragrance-free, non-greasy lotions. Avoid products with alcohol or harsh chemicals.

Do I need special shoes if I have diabetes?

If you’re at moderate or high risk - meaning you have nerve damage, foot deformities, or a past ulcer - then yes, therapeutic footwear is essential. These shoes are designed to reduce pressure on vulnerable areas. For low-risk patients, well-fitting, closed-toe shoes with good support are enough. Never wear sandals, flip-flops, or barefoot shoes. Check with your doctor or podiatrist about insurance coverage - many plans, including Medicaid, cover them.

Can exercise cause foot ulcers?

Exercise itself doesn’t cause ulcers - but the wrong kind of exercise can. Walking is generally safe and encouraged. But unsupervised ankle stretches or high-impact activities without proper footwear can increase pressure on weak spots. Always get your feet checked before starting a new routine. Your doctor may recommend a gait analysis to make sure your walking pattern isn’t putting extra stress on your feet.

Is it safe to trim my own toenails?

Yes - if you do it right. Cut them straight across, not rounded or too short. Leave about 1-2 mm of nail beyond the tip of your toe. Don’t dig into the corners. If you have thick nails, poor vision, or numbness, ask a podiatrist to trim them. Many clinics offer free nail care for diabetic patients. Never use sharp tools like razors or clippers meant for calluses.

What’s the biggest mistake people make with diabetic foot care?

The biggest mistake is assuming no pain means no problem. Nerve damage hides pain, so a cut, blister, or infection can be growing without you noticing. Many people wait until their foot swells or smells bad before acting. By then, it’s often too late. Daily inspection is the only reliable way to catch problems early. Make it a habit - like brushing your teeth.

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8 Comments

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    Bob Hynes

    February 3, 2026 AT 07:37
    bro i just started checkin my feet daily after my cousin lost his toe 😭 i used to think "no pain = no gain" but now i keep a mirror by my toothbrush. also i spell everything wrong but i look at my toes right lmao
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    Eli Kiseop

    February 5, 2026 AT 03:48
    I never realized how dangerous barefoot walking is even at home i always thought it was just for old people now i wear slippers inside and its crazy how fast a blister can turn into a hospital trip
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    larry keenan

    February 5, 2026 AT 14:58
    The IWGDF risk stratification model is clinically robust and supported by longitudinal cohort data. Compliance with daily inspection protocols correlates strongly with reduced amputation rates (p<0.001). Therapeutic footwear is not a luxury but a biomechanical intervention that redistributes plantar pressure. Adherence remains suboptimal in primary care settings due to patient education gaps and systemic access barriers.
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    Nick Flake

    February 5, 2026 AT 21:31
    This post literally changed my life 🙏 I used to think my feet were fine because I didn't feel anything... until I saw a tiny red spot that turned into a blister in 3 days. Now I do my checklist every morning like brushing my teeth. I even got my wife to help me with the mirror. If you're reading this and you have diabetes... please just LOOK. Your feet are begging you. đŸ«¶
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    Akhona Myeki

    February 6, 2026 AT 02:19
    In South Africa we have no access to therapeutic shoes or podiatrists. But we still inspect our feet daily with a broken mirror and boiled water. You think this is about technology? No. This is about discipline. You do not need a $300 smart sock. You need a towel. You need a mirror. You need to care. This is not a Western problem. This is a human problem.
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    Chinmoy Kumar

    February 7, 2026 AT 09:36
    i was just diagnosed last month and this post made me cry in a good way 😅 i used to think i could ignore my feet since i dont feel pain but now i check them after every shower. also i typed this with one hand cause my other hand is holding the mirror lol. thank you for this
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    Brett MacDonald

    February 7, 2026 AT 20:30
    The real issue isn't the checklist. It's the metaphysical disconnection between body and self. We live in a world that treats the body as a machine to be optimized, but when the machine fails, we blame the user. Diabetic neuropathy doesn't just steal sensation-it steals agency. The mirror isn't a tool. It's a mirror of the soul's neglect. You don't inspect your feet because you're told to. You inspect them because you finally remember you're still alive.
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    Sandeep Kumar

    February 8, 2026 AT 00:31
    All this talk about mirrors and socks is basic. In India we have better ways. Ayurvedic oil massage + neem leaf wash = no ulcers. Why are you wasting money on shoes? Your body heals itself if you respect it. Modern medicine is just profit-driven fear. Look at your feet. Then forget about it. Trust the process.

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