Diabetes and Your Feet: Prevention and Management

We help decrease your risk of wounds and keep you active

If you have diabetes, you already know how much attention your health requires. But one area that’s easy to overlook—until it’s too late—is your feet.
Nerve damage, circulation problems, and infections can turn even a small cut into a serious wound.
Without proper care, these issues can lead to pain, ulcers, and even amputation.

At the Foot and Ankle Center of Seattle, we help you stay active, safe, and confident on your feet.

Don't delay foot care if you want to avoid these problems:

Loss of sensation (diabetic peripheral neuropathy) – making it hard to feel pain, heat, or injury
Poor blood flow – slowing your ability to heal
Increased risk of infection– small cuts can quickly become serious
Fungal nails or dry, cracked skin – can lead to ulcers or wounds

Ignoring these warning signs can lead to complications that threaten your independence and mobility.

Diabetic Foot Specialist in North Seattle

Let me help you!

I understand the frustration of having to constantly monitor your blood sugars and other aspects of your health when you have diabetes. I've helped thousands of patients over the years prevent life-altering medical consequences of this disease, including limb loss and falls. I encourage my diabetic patients to stay as active as possible.

Why Patients Get Diabetic Foot Care From Dr. Berg

More than 40 years of experience helping people with diabetes protect their feet and avoid complications.
Chief Podiatrist at the Wound Care Center at Northwest Hospital, now UW Medical Center-Northwest, for over 20 years.
Participates in the Medicare Therapeutic Shoe Program
Can alter orthotics in his own lab at the clinic to prevent ulcers
Conducts a Comprehensive Diabetes Foot Exam with all new patients and 1-2 times annually to catch problems early.
Uses Advanced Wound Care Products to heal difficult-to-treat ulcers.
His compassionate, preventive approach focuses on keeping you active and independent.

When you partner with us, you’re not just getting treatment—you’re getting peace of mind.

The Plan: How We Help You Protect Your Feet

We make diabetic foot care simple and stress-free with a clear plan:

1. Comprehensive Diabetic Foot Exam (CDFE)

We follow American Diabetes Association guidelines to evaluate your circulation, sensation, skin, and nails. This annual or bi-annual CDFE helps detect problems early—before they become serious.

2. Personalized Prevention Plan

You’ll receive guidance tailored to your needs, including:

Safe home foot care tips (see below)
Recommendations for diabetic socks, shoes, or orthotics
Trimming your nails and treating calluses on a regular basis
Detecting and treating Diabetic Peripheral Neuropathy, which occurs in 50% of people with diabetes
Smart ABI testing to detect and treat Peripheral Artery Disease, a common problem in people with diabetes
Encouraging foot hydration with moisturizers to prevent breakdown and cracks in the skin.

3. Advanced Treatment When You Need It

If you’re already experiencing pain, numbness, fungal nails, or a non-healing wound, we provide expert care:

Fungal nail treatments that are safe for diabetics
Advanced wound care
Custom orthotics and therapeutic shoes through Medicare’s Therapeutic Shoe Program

Diabetic Peripheral Neuropathy

About half of all people with diabetes develop Diabetic Peripheral Neuropathy, a condition which causes damage to the nervous system. With this condition, a person loses their ability to properly feel their feet. Minor injuries can go unnoticed leading to many foot problems including infections and diabetic foot ulcers. In addition, normal sweat secretion and oil production that lubricates the skin of the foot is impaired, which can lead to very dry skin which can break down and cause ulcers.

Factors Increasing Risk of Diabetic Foot Problems

Many of the factors that increase the risk of foot problems for people with diabetes can be resolved.

Poorly fitting shoes—this is one of the biggest culprits of diabetic foot complications. Fortunately, Medicare provides access to new diabetic shoes each year to help prevent these symptoms from occurring.
Common foot abnormalities such as bunions and hammertoes. These foot problems need to be resolved to prevent them from causing diabetic foot complications.
Poor circulation – quitting smoking, exercise, compression stockings, and stress reduction can help with poor circulation.
Trauma to the foot—dropping a heavy object on the foot or running into furniture, punctures to the skin by a foreign object, tight shoes, and toenails that are too long are some typical examples. These are all issues that can be prevented. Patients should avoid going barefoot, wear proper shoes that fit, and eliminate environmental factors that could lead to foot trauma.
Infections—resolving the first two problems will greatly reduce the chance of infection.
Smoking—people with diabetes who smoke increase their risk of diabetic foot complications. The best thing to do is quit.
Fungal toenails--see below

Fungal Toenails and Diabetes

Diabetic patients are at greater risk of developing a fungal nail infection due to a lack of sensation in the feet. For example, wearing shoes that are too tight (which may go unnoticed) can cause the nail to lift, allowing in fungus. Once the nails are infected, the fungus often spreads to the surrounding skin and can cause cracks and skin ulcers.

In one study, there was a 15% rate of secondary infections in diabetic patients with fungus toenails compared to a 6% rate in diabetic patients without fungus toenails. In addition, diabetic patients with toenail fungus, had three times greater risk of developing a foot ulceration (wound).

Patients with diabetes and thickened fungal toenails should obtain treatment to resolve this problem. Learn more about how we treat fungal toenails here.

Management of Diabetic Feet in Seattle

Comprehensive Diabetic Foot Exam (CDFE)

The American Diabetes Association now recommends that all patients with diabetes obtain an annual Comprehensive Diabetic Foot Exam (CDFE). This exam helps the podiatrist identify problems to prevent foot complications from diabetes.

Safe Home Foot Care Tips

Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems. Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything.
Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily. Use only lukewarm water – the temperature you would use on a newborn baby
Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting, and carefully dry between the toes.
Moisturize your feet – but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But DON’T moisturize between the toes – that could encourage a fungal infection.
Cut nails carefully. Cut them straight across and file the edges. Don’t cut nails too short, as this could lead to ingrown toenails. If you have concerns about your nails, consult your doctor.
Never treat corns or calluses yourself. No “bathroom surgery” or medicated pads. Visit your doctor for appropriate treatment.
Wear clean, dry socks. Change them daily.
Wear thick, soft socks without seams.
Avoid the wrong type of socks. Avoid tight elastic bands (they reduce circulation). Don’t wear thick or bulky socks (they can fit poorly and irritate the skin). Don't wear cotton socks. Ask your podiatrist about purchasing diabetic socks. Learn more about diabetic socks here!
Wear socks to bed. If your feet get cold at night, wear socks. NEVER use a heating pad or hot water bottle.
Shake out your shoes and feel the inside before wearing. Remember, your feet may not be able to feel a pebble or other foreign object, so always inspect your shoes before putting them on.
Keep your feet warm and dry. Don’t let your feet get wet in snow or rain. Wear warm socks and shoes in winter.
Never walk barefoot. Not even at home! Always wear shoes or slippers. You could step on something and get a scratch or cut.
Take care of your diabetes. Keep your blood sugar levels under control.
Don’t smoke. Smoking restricts blood flow in your feet.
Get periodic foot exams. Seeing your foot and ankle surgeon regularly can help prevent the foot complications of diabetes.
Exercise daily to improve your circulation and to manage weight. Make sure you choose an exercise you like to do and that you wear well-fitted shoes.
Obtain new shoes that fit properly - if you qualify you can obtain new shoes annually through your podiatrist's office.

Am I Eligible for Diabetic Shoes?

As a result of the CDFE, the podiatrist will determine if you need to obtain therapeutic shoes provided through a special Medicare Therapeutic Shoe Program. Sometimes your podiatrist will also recommend custom orthotics to help prevent protect your feet.

Are You Concerned About A Diabetic Wound That Isn't Healing?

Dr. Berg is a top expert in the Seattle area in healing diabetic wounds. He was the Chief Podiatrist at the UW Wound Care Center for over 20 years. Learn more about how we heal diabetic wounds here!

If you have diabetes, it is important to prevent foot problems before they occur, recognize problems early, and seek the right treatment when a problem does happen.

More Information About Management of Diabetes

A person with diabetes should have a podiatrist who specializes in evaluating and treating diabetic feet. Complete the contact form on this page or call our office at 206-368-7000 to schedule an appointment with Dr. Berg.

Most new patients are seen within 1-2 week's time. During your initial visit, Dr. Berg will spend up to 30 minutes getting to know you, your podiatry complaints, and your goals so that he can recommend the treatment best meets your needs. Don’t wait—contact us today.

North Seattle Foot & Ankle Specialist Dr. Rion Berg offers compassionate podiatry care for all foot and ankle problems to those living in Seattle Washington and the surrounding areas. Call us today at 206-368-7000 for an immediate appointment or request an appointment online.