Diabetes can affect many parts of the body, including the feet. Over time, diabetes may contribute to nerve damage and changes in blood circulation, which can reduce sensation and make it harder for wounds to heal. As a result, a small cut, blister or pressure area may develop into a more serious foot problem if it is not identified and managed promptly.

For people living with diabetes, regular foot care, early detection and appropriate professional support are important parts of managing the risk of complications.

Some people can manage their daily foot care independently, while others may need additional assistance because of reduced mobility, reduced sensation, existing wounds, disability or difficulty managing their diabetes. In these situations, nursing support can provide assessment, monitoring, education and assistance as part of an individualised diabetes care plan.

Leah Bett Nursing Services provides home-based diabetes management support, including diabetic foot care, counselling and support, helping patients and participants manage their condition and reduce the risk of diabetes-related complications.

Why Is Diabetic Foot Care Important?

Diabetes can affect the nerves and blood vessels supplying the feet.

Nerve damage, also known as peripheral neuropathy, can reduce the ability to feel pain, temperature or other sensations. This means a person may not realise they have stepped on something sharp, developed a blister or sustained another injury.

Diabetes can also affect blood vessels and circulation. Reduced blood flow may make it more difficult for a wound to heal and can increase the risk of infection and other complications.

This is why diabetic foot care is not simply about keeping the feet clean. It involves:

• Regular observation and monitoring
• Early identification of changes
• Protecting the feet from injury
• Appropriate diabetes management
• Foot-care education
• Professional assessment when required
• Prompt attention to wounds and other concerning changes

For people who have difficulty managing these tasks themselves, appropriate nursing support can become an important part of their overall care.

How Diabetes Can Affect the Feet

There are several reasons people with diabetes may be more vulnerable to foot problems.

Reduced Sensation

Nerve damage can cause numbness, tingling or reduced sensation. A person may therefore have an injury without experiencing the pain that would normally alert them to a problem.

Changes in Circulation

Changes affecting blood vessels can reduce blood flow to the feet. This can affect the body's ability to heal injuries effectively.

Skin and Nail Problems

Dry or cracked skin, calluses, blisters and nail problems can create areas that require attention, particularly when sensation is reduced.

Increased Risk of Wounds and Ulcers

• When an injury goes unnoticed or does not heal properly, it can develop into an ulcer or become infected.
• This is why regular self-checks and professional foot assessments are important. Current Australian guidance recommends daily foot checks and regular professional assessment, with the frequency depending on a person's individual risk.

What Does Diabetic Foot Nursing Care Involve?

Diabetic foot nursing care can involve more than simply looking at a person's feet.

Depending on an individual's needs, care plan and scope of nursing practice, nursing support may involve assessment, monitoring, education, prevention, care coordination and support with broader diabetes management.

Assessment and Monitoring

A nurse may monitor the condition of a person's feet and look for changes such as:

• Cuts or breaks in the skin
• Blisters
• Redness
• Swelling
• Changes in skin colour
• Changes in temperature
• Pressure areas
• Calluses
• Skin breakdown
• Existing wounds or ulcers
• Changes that may require further clinical assessment

Monitoring can be particularly valuable for people who have difficulty inspecting their own feet or who are at increased risk of complications.

Supporting Early Detection

• Early detection can make it easier for healthcare professionals to respond appropriately to a developing problem.
• A nurse may identify a concerning change during routine support and recommend appropriate follow-up with the person's GP, podiatrist or other healthcare professional.
• Nursing support does not replace specialist medical or podiatry assessment. Instead, it can form part of a coordinated approach to helping a person manage their diabetes and foot health.

Diabetes Management Support

Foot health is closely connected with overall diabetes management.

Depending on the person's individual care requirements, nursing support may include:

• Blood glucose monitoring
• Insulin administration and management
• Diabetes education
• Monitoring for diabetes-related complications
• Support to follow an individualised diabetes care plan
• Diabetic foot care, counselling and support

The NDIS also recognises diabetes management as a potential disability-related health support where the person's disability affects their ability to manage their diabetes and the support meets the relevant NDIS requirements.

Diabetic Foot Assessment and Monitoring

Regular assessment can help identify foot problems before they become more serious.

A daily foot check should look for changes such as:

• Cuts
• Bruising
• Blisters
• New calluses
• Skin breaks
• Redness
• Swelling
• Changes in temperature
• Changes in colour
• Numbness
• Tingling
• Pain
• Changes between the toes

The soles and areas between the toes can be easy to overlook. If a person cannot comfortably see or reach their feet, they may need assistance from a trusted person or member of their healthcare team.

The NDIS recommends daily self-checks and regular professional foot checks. The appropriate frequency of professional assessment depends on an individual's level of foot risk.

Nursing support may help people maintain consistent monitoring when disability, mobility limitations or other circumstances make independent foot care difficult.

Nursing Support for Diabetic Foot Wounds and Ulcers

A diabetic foot ulcer is an open wound that can develop on the foot. It may begin with a relatively small injury, pressure area, blister or break in the skin.

People with diabetes should take foot wounds seriously because reduced sensation may make an injury difficult to notice, while circulation problems can affect healing.

If someone already has a diabetic foot wound or ulcer, appropriate clinical care and monitoring may be required.

Depending on the individual's care plan and nursing scope, support may include:

• Observing changes in the wound
• Monitoring for concerning signs
• Supporting an existing wound-care plan
• Educating the person about foot protection
• Monitoring the person's broader diabetes management
• Communicating relevant changes to the appropriate healthcare professionals
• Supporting referrals or follow-up where required

A diabetic foot ulcer should not be treated as a minor skin problem. Appropriate medical or podiatry assessment may be required, particularly if there are signs of infection or deterioration.

The NDIS currently identifies wound and pressure care for slow-to-heal wounds, as well as podiatry assessment and foot care, among examples of disability-related health supports that may be funded where the relevant criteria are met.

Diabetic Foot Care Education: What Nurses Can Teach

Education is an important part of diabetes management.

A nurse can help a person understand the importance of protecting their feet and recognising changes that should not be ignored.

Depending on individual needs, education may cover:

Daily Foot Checks

People with diabetes should become familiar with how their feet normally look and feel so they can identify changes more easily.

Foot Hygiene

Feet should be washed regularly with warm water and dried carefully, particularly between the toes.

Skin Care

Moisturising can help with dry skin, but moisturiser should generally not be applied between the toes or over broken skin unless advised by an appropriate healthcare professional.

Footwear

Protective, well-fitting footwear can help reduce the risk of injuries. Shoes should be checked before they are worn to ensure there are no objects or rough areas inside.

Avoiding Barefoot Walking

Walking barefoot can increase exposure to cuts, burns and other injuries. Appropriate footwear provides protection.

Recognising Warning Signs

People should know what changes to look for and when they need to seek professional advice.

The NDIS recommends daily checking, washing and drying the feet, appropriate moisturising, nail care and protective footwear as part of routine foot care.

7 Ways to Protect Your Feet When Living With Diabetes

1. Check Your Feet Every Day

• Make foot checks part of your normal diabetes management routine.
• Look at the tops, soles, heels and spaces between your toes. Use a mirror or ask someone to assist if you cannot see your feet properly.

2. Keep Your Feet Clean and Dry

• Wash your feet with warm water and dry them thoroughly.
• Take particular care when drying between your toes.

3. Protect Your Skin

Dry or cracked skin can increase the risk of skin breakdown. Follow appropriate advice about moisturising and skin care.

4. Wear Suitable Footwear

Choose comfortable footwear that protects your feet and does not create unnecessary pressure or rubbing.

5. Avoid Walking Barefoot

Protect your feet indoors and outdoors by wearing appropriate footwear.

6. Follow Your Diabetes Care Plan

Blood glucose management, medication, nutrition, physical activity and regular health checks can all form part of an individual's diabetes care plan.

7. Act Quickly When Something Changes

• Do not ignore a new wound, swelling, redness, discharge or other unusual change.
• Early professional assessment can be important when managing diabetes-related foot problems. NDIS guidance recommends seeking medical attention promptly for foot injuries and concerning changes.

When Should a Diabetic Foot Problem Be Escalated?

Knowing when to seek additional professional help is an important part of diabetic foot care.

Seek prompt professional assessment if you notice:

• A new wound or ulcer
• Redness or swelling
• Increasing warmth
• Pus or other discharge
• An unpleasant smell from a wound
• Skin breakdown
• Significant changes in skin colour
• New or increasing pain
• A wound that is not healing
• New changes in sensation
• A sudden change in the appearance or condition of the foot

NDIS guidance advises people with diabetes to seek urgent professional attention for foot injuries, including ulcers, skin breakdown, swelling, redness, temperature changes and signs of infection.

Nursing support can help with monitoring and ongoing care, but urgent or deteriorating foot problems require appropriate medical assessment.

When Might Someone Need Nursing Support for Diabetes?

Not everyone with diabetes needs nursing assistance. However, additional support may be useful when a person has difficulty managing aspects of their condition because of disability or other care needs.

Someone may require nursing support if they:

• Have difficulty checking their feet
• Have reduced sensation
• Have limited mobility
• Have difficulty monitoring blood glucose
• Require assistance with insulin management
• Have an existing diabetic foot wound
• Have a history of diabetic foot complications
• Need additional diabetes education
• Have difficulty following their diabetes care plan
• Require monitoring for diabetes-related complications
• Have complex disability support needs affecting diabetes management

The NDIS states that diabetes management supports may include a nurse helping identify disability-related support needs, supporting a Diabetes Care Plan or, in certain circumstances, providing more complex diabetes management support. Eligibility depends on the participant's individual circumstances and NDIS requirements.

What Does Home-Based Diabetes Nursing Support Involve?

For some people, receiving diabetes management support at home can make ongoing care more practical.

A home-based nursing service can provide support within the person's normal environment and help address individual care needs.

Leah Bett Nursing Services' diabetes management program includes:

• Individual assessment
• Development of a comprehensive care plan
• Blood glucose monitoring
• Weight and blood pressure monitoring
• Insulin administration and management
• Personalised diabetes education
• Diet counselling and monitoring
• Healthy lifestyle education and counselling
• Monitoring for diabetes-related complications
• Diabetic foot care, counselling and support

This approach recognises that diabetes management involves more than one aspect of care. Foot health, blood glucose management, lifestyle and early recognition of complications can all form part of a person's broader diabetes-care needs.

NDIS Diabetes Management and Nursing Support

• For eligible NDIS participants, diabetes management supports may be available where the person's disability affects their ability to manage their diabetes.
• The NDIS distinguishes between ordinary healthcare and disability-related health supports. Diabetes management supports may be considered where they relate to a person's disability and meet the relevant funding criteria.
• The NDIS also explains that a nurse may be involved in developing disability-related diabetes management support or training support workers in a person's specific diabetes-care requirements. In more complex circumstances, nursing support may be considered where the participant has complex disability support needs.
• If you are an NDIS participant, your eligibility and support requirements should be discussed with your healthcare and NDIS support team.

How Leah Bett Nursing Services Supports Diabetes Management

Managing diabetes can be challenging, particularly when a person needs assistance with daily care, monitoring or understanding how to manage their condition.

Leah Bett Nursing Services provides personalised, home-based diabetes management support for patients and participants who need additional assistance.

Our diabetes management service can support people who are:

• Worried about starting insulin
• Unsure how to respond when blood glucose is high or low
• Finding it difficult to manage lifestyle changes
• Looking for personalised dietary guidance
• Unsure how to check their feet
• Already experiencing diabetic foot ulcers
• Looking for support with diabetes-related complications
• Finding frequent hospital visits difficult to manage

Our scope of diabetes management includes assessment and care planning, blood glucose monitoring, insulin management, diabetes education, diet and lifestyle counselling, monitoring for diabetes-related complications, and diabetic foot care, counselling and support.

Support is tailored to individual needs and forms part of an appropriate care plan.

Protecting Your Feet Starts With Consistent Care

Diabetic foot care is an important part of managing diabetes and reducing the risk of serious complications. Daily foot checks, appropriate protection, regular professional assessments and early attention to changes can all play an important role.

For people who need additional assistance, nursing support can provide personalised education, monitoring and practical assistance as part of a broader diabetes management plan.

Leah Bett Nursing Services provides home-based diabetes management support, including diabetic foot care, counselling and support for people who need assistance managing their condition.

If you or someone you support needs assistance with diabetes management or diabetic foot care, contact Leah Bett Nursing Services to discuss your individual care needs.