In short
- Diabetes UK says diabetes leads to 184 amputations every week, and that most amputations can be prevented by knowing the signs to look for.
- NICE guideline NG19 says every adult with diabetes should have their feet assessed when diagnosed and at least once a year, and be told whether they are at low, moderate or high risk.
- People at moderate or high risk should be referred to the NHS foot protection service, which NICE says should see high-risk people within 2 to 4 weeks and provide their skin and nail care.
- Check your feet every day, test bath water with your wrist or elbow, avoid corn plasters and blades, and never warm your feet on a hot water bottle, fire or radiator.
- A red, hot or swollen foot, a new wound or blister, or a wound that smells or leaks needs your GP or foot protection team straight away (Diabetes UK says within 24 hours); signs of sepsis need 999 or A&E.
The short answer
If you have diabetes, look at your feet every day, go to your annual foot check and find out your risk level, keep your skin and nails in good order without corn plasters or sharp tools, wear shoes that fit, and act fast on any new wound, colour change, swelling or heat. If your feet are rated moderate or high risk, your foot care should be led by the NHS foot protection service, not by a private appointment.
The reason for the care is simple. Diabetes can reduce the feeling in your feet, so you may not notice a blister or cut, and it can reduce the blood supply, so that blister or cut heals slowly. That combination is how a small sore becomes an ulcer. Diabetes UK estimates that almost 6 million people in the UK are living with diabetes, and says that every week diabetes leads to 184 amputations. Its amputation awareness page adds that most amputations can be prevented by knowing the signs to look for.
Why diabetes affects your feet
Two things go wrong, often slowly and without pain.
Nerves
The NHS says diabetes is the most common cause of peripheral neuropathy in the UK, and that over time high blood sugar levels can damage the nerves. Early signs include pain, tingling or loss of sensation in the feet. Once feeling is reduced, it is easy to walk on a stone in your shoe or a rubbing seam all day without knowing.
Blood supply
Diabetes UK explains that high blood sugar over time can damage the small blood vessels that supply the nerves in your feet, and that reduced blood supply means wounds heal more slowly. The NHS page on neuropathy complications describes a diabetic foot ulcer as "an open wound or sore on the skin that's slow to heal", and says that if gangrene develops, surgery may be needed, and in severe cases a toe or foot may have to be amputated.
Diabetes UK lists warning signs to take to your GP or local foot protection team: tingling or pins and needles, burning pain, loss of feeling, swollen feet, feet that no longer sweat, cuts or sores that do not heal, calf cramps, shiny smooth skin and hair loss on the legs and feet.
Your annual foot check and your risk level
NICE guideline NG19 says adults with diabetes should have their risk of foot problems assessed when diabetes is diagnosed, at least once a year after that, whenever a foot problem arises, and on any admission to hospital. The check is done with your shoes and socks off. Diabetes UK says to expect the whole foot to be looked at, including between the toes, your pulses felt or checked with a handheld doppler, and your feeling tested with a tuning fork and a monofilament (a fine nylon thread).
You should then be told your risk level. NICE defines them like this, and sets how often you should be checked again:
| Risk level | What NICE means by it | Reassessed | Who leads your foot care |
|---|---|---|---|
| Low | No risk factors, except callus alone | Annually, at your diabetes review | You, with your GP practice |
| Moderate | Deformity, or reduced feeling (neuropathy), or peripheral arterial disease | Frequently, for example every 3 to 6 months | NHS foot protection service |
| High | A previous ulcer or amputation, kidney replacement therapy, or two problems together (for example neuropathy with callus or deformity) | Every 1 to 2 months, or every 1 to 2 weeks if there is immediate concern | NHS foot protection service |
| Active problem | An ulcer, infection, gangrene, suspected Charcot foot, or an unexplained hot, swollen foot with a change in colour | Referral within 1 working day | Specialist NHS foot team |
NICE says people at moderate or high risk should be referred to the foot protection service, which should see them within 2 to 4 weeks (high risk) or 6 to 8 weeks (moderate risk), and should give advice about, and provide, skin and nail care of the feet. It also says to consider more frequent checks for anyone who cannot check their own feet.
One difference to know about: NICE says low-risk feet should be checked annually, while Diabetes UK's page says people at low risk may have the check every other year. If you are unsure when your next check is due, ask your GP practice.
The Touch the Toes test you can do at home
Between checks, Diabetes UK's Touch the Toes test is a quick way to notice a change in feeling. You need someone to help.
- Take off your shoes and socks, lie down and close your eyes.
- Your helper lightly touches six toes with their index finger, in this order: right big toe, right little toe, left big toe, left little toe, right middle toe, left middle toe. Each touch is very light, no more than a second, and each toe is touched once.
- Say "right" or "left" each time you feel a touch, and your helper notes which ones you felt.
If you felt five or six, Diabetes UK says your sensation is fine, but keep going to your annual checks. If you felt four or fewer, you have reduced sensation: book a GP appointment for a full foot examination, and check your feet every day while you wait. It is a home check, not a diagnosis.
A daily routine for your feet
This routine combines Diabetes UK's foot care advice with an NHS community podiatry diabetes footcare leaflet from Kent Community Health.
- Look. Check your feet before you put your socks on in the morning and before bed: tops, soles, heels and between the toes. Look for breaks in the skin, blisters, redness, swelling and colour change, especially under hard skin. Use a mirror for the soles, or ask someone to look.
- Wash. Wash your feet every day in warm water with a mild soap. Check the temperature with your wrist or elbow first, because your feet may not feel heat properly. Do not soak them.
- Dry. Dry carefully, especially between the toes.
- Moisturise. Use an emollient cream every day (Diabetes UK says urea-based creams can help), but not between the toes, and do not use talc there either.
- Nails. Diabetes UK says to cut them often but not too short or down the sides, then file the corners with an emery board. The Kent leaflet adds that cutting your own nails may not be suitable for everyone, so ask at your foot check. Our guide to cutting toenails goes into technique.
- Socks and shoes. Wear socks without holes or thick seams, and shoes that are not too tight, too loose or rubbing. Feel inside your shoes for stones and rough patches before you put them on. Wear new shoes at home first and check for rubbing after half an hour.
- Keep shoes on. The Kent leaflet says to avoid walking barefoot at any time.
Two longer-term habits matter as well. Diabetes UK says keeping your blood sugar as close to your target range as you can helps prevent foot damage or stop it getting worse, and that smoking makes it harder for blood to reach your feet.
What not to do
| Avoid | Why | Source |
|---|---|---|
| Corn plasters, and creams or sprays for corns or verrucas | They can burn your skin and cause ulcers | Diabetes UK |
| Blades, razors or sharp tools on corns or hard skin | They can damage the skin | Diabetes UK; NHS Kent leaflet |
| Hot water bottles or heating pads in bed | They may burn your feet without you noticing | NHS Kent leaflet |
| Warming your feet in front of a fire or radiator | Listed with hot water bottles as something never to do | NHS Kent leaflet |
| Soaking your feet | It makes the skin more likely to get damaged | Diabetes UK |
| Cream or talc between the toes | Diabetes UK says both can cause problems there | Diabetes UK |
| Walking barefoot | The leaflet says to avoid it at any time | NHS Kent leaflet |
The NHS page on corns and calluses says that if you have diabetes you should not try to treat corns and calluses yourself, and should see a GP. Diabetes UK says to see a podiatrist for corns or other skin problems. Our guide to corns and calluses explains what they are and what helps.
The signs that need help straight away
Diabetes UK's page on serious foot problems says to see your foot team urgently, within 24 hours, if you notice:
- changes in the colour and shape of your feet, especially a red, hot, swollen toe, ankle or foot
- part or all of your foot feeling much colder or hotter than usual
- new blisters, cuts or wounds, especially if you can see them but don't feel them
- a cut or wound that smells bad or has started leaking fluid or pus
- new or unexplained pain in your foot.
Contact your GP or foot protection team straight away, and rest with your weight off the foot, raised on a cushion. If you cannot get through, Diabetes UK says to use your nearest out-of-hours service, and its main foot page says to call 111 for advice. The Kent NHS leaflet puts it plainly: do not wait until the next working day if your symptoms are getting worse. NICE says an active foot problem like these should be referred to a specialist foot service within 1 working day.
Call 999 or go to A&E if you have a foot wound or infection and signs of sepsis. The NHS sepsis page lists breathing very fast; being confused, having slurred speech or not making sense; blue, pale or blotchy skin; a very high or very low temperature, feeling hot or cold to the touch, or shivering; and a rash that does not fade when you press it.
For smaller changes, the NHS page on diabetes complications says to see a GP or diabetes nurse if you have blisters or cracked skin on your feet.
Who looks after what
| Your situation | Who to see |
|---|---|
| Annual foot check and risk rating | Your GP practice, as part of your diabetes review |
| Low risk, wanting help with routine nail and skin care | You can use a private Foot Health Practitioner or podiatrist, alongside your annual NHS check |
| Moderate or high risk | The NHS foot protection service, which NICE says should provide your skin and nail care |
| A new wound, blister, colour change, heat or swelling | Your GP or foot protection team the same day; 111 if you cannot get through |
| A foot wound with signs of sepsis | 999 or A&E |
| Corns, hard skin or verrucas with diabetes | A podiatrist or your GP before any home treatment |
If you are not sure of your risk level, ask your GP practice to tell you what it was at your last check. It is a useful thing to know before booking any foot care.
Where a private foot health appointment fits
A Foot Health Practitioner can help people with diabetes whose feet are at low risk keep on top of nails, thickened nails and hard skin, which many people find hard to manage themselves. The public site of the Alliance Register of Foot Health Practitioners describes this kind of routine maintenance for people with diabetes as part of the job, along with spotting signs such as potential ulceration and referring people on.
What a private appointment should not do is replace your NHS care:
- It is not your annual diabetic foot check. Keep going to that.
- If you are rated moderate or high risk, or have had an ulcer or amputation, your foot care belongs with the NHS foot protection service.
- Any active problem goes to your GP, foot protection team or 111, not to a routine appointment.
- Tell any practitioner you see that you have diabetes, your latest risk level and your medicines, so they can decide whether you are right for them.
Our guide to the difference between a Foot Health Practitioner and a podiatrist explains who does what.
What this guide does not cover
This is general information for adults, based on NICE guidance for England and on Diabetes UK and NHS advice. It does not cover children and young people, who have their own NICE recommendations, or the treatment of ulcers, infection or Charcot foot, which is for specialist teams. Local NHS services organise foot protection differently, so the names and phone numbers in your area may differ. If anything in your own care plan differs from this guide, follow your diabetes team.
How we checked
On 10 November 2026 we read Diabetes UK's pages on foot problems, the annual foot check, taking care of your feet, serious foot problems, the Touch the Toes test, amputations and its statistics page; NHS pages on peripheral neuropathy and its complications, type 2 diabetes complications, sepsis and corns and calluses; and Kent Community Health NHS Foundation Trust's diabetes footcare leaflet. NICE's website refused automated reading, so we read guideline NG19's recommendations through the UK Government Web Archive's copy of the same page (captured May 2026) and link to NICE itself. Where Diabetes UK and NICE differ, on how often low-risk feet are checked, we say so. We did not contact any of the organisations.
Where Fairy Feet fits
Marianna Tapai FHP is a qualified Level 4 Foot Health Practitioner who has worked with nails and feet since 2006. Her Diabetic Foot Health Consultation is a careful foot health check with skin and nail care and advice, and it fits best for people whose NHS check rated their feet low risk and who want regular help with nails and hard skin, at her Doncaster studio or through a call-out home visit. A Foot Health Treatment / Medical Pedicure covers routine nail, corn and hard skin care.
Marianna is not a podiatrist, does not diagnose and does not replace your annual NHS foot check. If your feet are rated moderate or high risk, if you have had an ulcer or amputation, or if you have any of the urgent signs above, your GP, diabetes team or NHS foot protection service is the right place, and that is what she will tell you. For anything else, get in touch with your risk level and what is bothering you.
Questions people ask
How often should someone with diabetes have their feet checked?
NICE says at least once a year, and more often if your risk is higher: every 3 to 6 months at moderate risk and every 1 to 2 months at high risk. Diabetes UK says some people at low risk may be checked every other year. You should also check your own feet every day.
Can people with diabetes use corn plasters?
No. Diabetes UK says plasters, creams and sprays for removing corns or verrucas can burn your skin and cause ulcers. The NHS says people with diabetes should not treat corns and calluses themselves and should see a GP or podiatrist.
What is the foot protection service?
It is the NHS service for people whose feet are at moderate or high risk, and Diabetes UK says at these levels a podiatrist looks after your foot care. NICE says it should assess your feet, provide skin and nail care, look at footwear and insoles, and see high-risk people within 2 to 4 weeks of referral.
Can I see a foot health practitioner if I have diabetes?
Many people with diabetes whose feet are rated low risk see a Foot Health Practitioner for routine nail and skin care. Keep going to your annual NHS foot check, and tell the practitioner your risk level. If your feet are moderate or high risk, your care belongs with the NHS foot protection service.
What should I do if I find a blister and I have diabetes?
Rest with your weight off the foot and contact your GP or foot protection team the same day; if you cannot get through, call 111. Diabetes UK says new blisters, cuts or wounds, especially ones you cannot feel, need seeing within 24 hours.
Sources
- How many people in the UK have diabetes?. Diabetes UK, checked 10 November 2026.
- Be in the know about diabetes and amputations. Diabetes UK, checked 10 November 2026.
- Diabetes and foot problems. Diabetes UK, reviewed 28 November 2024.
- Your annual diabetes foot check. Diabetes UK, reviewed 22 November 2024.
- Testing for sensitivity in your feet (Touch the Toes test). Diabetes UK, reviewed 29 November 2024.
- How to look after your feet. Diabetes UK, reviewed 22 November 2024.
- Signs of a serious foot problem and foot infections. Diabetes UK, reviewed 24 December 2024.
- Diabetic foot problems: prevention and management (NG19), recommendations. NICE, August 2015, last updated October 2019.
- Peripheral neuropathy. NHS, reviewed 10 October 2022.
- Peripheral neuropathy: complications. NHS, reviewed 10 October 2022.
- Type 2 diabetes: complications. NHS, reviewed 10 February 2025.
- Sepsis. NHS, reviewed 14 May 2026.
- Corns and calluses. NHS, reviewed 28 July 2026.
- Diabetes footcare advice. Kent Community Health NHS Foundation Trust, February 2025, edited August 2026.
- The Alliance Register of Foot Health Practitioners. Alliance of Private Sector Practitioners, checked 10 November 2026.