Diabetic Foot Care & Podiatry Support

Why foot care matters if you have diabetes

High blood sugar can damage nerves and blood vessels, especially in your feet. That damage can reduce sensation, slow healing, and raise the risk of calluses, blisters, ulcers, infections, and in severe cases amputation. The good news is that daily foot care and steady diabetes management lower these risks, and most serious problems are preventable when caught early.

If you are managing neuropathy, you might not feel a cut, hot spot, or rubbing from a shoe. That is why a simple daily look at your feet and regular podiatry visits make such a difference. Consistent blood sugar control, blood pressure and cholesterol management, and tobacco cessation also protect your feet by improving circulation.

For more on managing nerve symptoms and medications, you can read our page on neuropathy support at Understood Care:
https://app.understoodcare.com/

What podiatrists do and how often to see one

A podiatrist specializes in diagnosing and treating foot and ankle problems. For people with diabetes, podiatrists:

• Check skin, nails, circulation, and sensation
• Screen for neuropathy using simple in-office tools
• Treat calluses, corns, thick toenails, and minor wounds
• Identify deformities that increase pressure points
• Prescribe offloading devices, inserts, and protective shoes
• Coordinate with your primary care clinician, endocrinologist, diabetes educator, and wound care team

How often to go:

• At least once a year if you have no current foot problems
• Every 3 to 6 months if you have neuropathy, poor circulation, foot deformities, prior ulcer, or prior amputation
• Immediately if you notice a new blister, open area, redness, drainage, warmth, swelling, foul odor, or black tissue

Many wound care centers include podiatrists on the team. If you already have a wound or high-risk changes, ask your clinician about referral to a wound clinic.

Daily foot care checklist

Use this short routine every day. It takes a few minutes and prevents most problems.

Look

• Check the tops, soles, heels, and between toes
• Use a mirror or ask someone to help if bending is hard
• Watch for cuts, cracks, blisters, redness, hot spots, swelling, or drainage

Wash and dry

• Wash with lukewarm water and mild soap
• Pat dry, especially between toes

Moisturize

• Apply a thin layer of lotion to tops and bottoms
• Keep lotion away from between toes to prevent excess moisture

Nails

• Trim straight across, then file edges
• If nails are thick, curved, or hard to reach, have a podiatrist trim them

Protect

• Always wear socks and shoes, even indoors
• Shake out shoes before putting them on
• Break in new shoes gradually

Position and activity

• Change positions often to encourage circulation
• Elevate feet when sitting if swelling occurs
• Choose activities that are easy on feet, like walking on even surfaces or stationary cycling, as advised by your clinician

Footwear, diabetic shoes, and inserts

Well-fitting shoes reduce pressure and friction so you avoid hot spots and sores. Features to look for:

• Roomy toe box that does not cramp your toes
• Seamless or soft linings to reduce rubbing
• Firm heel counter for stability
• Cushioned, supportive insoles that can be removed and replaced
• Low heels and slip-resistant soles

What are “extra-depth” or “therapeutic” shoes?
These shoes have additional internal space to fit your foot, socks, plus protective inserts without crowding. The goal is to spread pressure more evenly and minimize rubbing that can lead to calluses, blisters, or ulcers.

Medicare coverage in brief

• Many people with diabetes qualify for 1 pair of therapeutic shoes per calendar year
• Coverage typically includes extra pairs of heat-molded or custom inserts
• A certifying clinician and an eligible supplier are required, and documentation must show medical need

If you are unsure about your benefits, our advocates can review your plan and confirm which options are in network for you.

Warning signs and when to call right away

Contact your podiatrist or wound care center promptly if you notice:

• New blister, cut, crack, sore, or open wound
• Redness, warmth, swelling, or increasing pain
• Drainage, odor, or black or blue discoloration
• Fever or feeling unwell with any foot change
• Sudden change in foot shape, arch collapse, or a “rocker-bottom” appearance
• New numbness, tingling, or burning that is getting worse

Early evaluation prevents small issues from becoming serious infections. If you cannot get a same-day podiatry appointment and you see spreading redness, drainage, fever, or rapidly worsening symptoms, seek urgent care.

How Understood Care advocates support your foot health

This section incorporates guidance from our video to show exactly how we help you take the next steps.

Finding an in-network podiatrist

• We search your insurance directory for podiatrists and wound care centers near you
• We make the calls and confirm accepting new patients, locations, and wait times
• We share a short list of options and help you pick the best fit

Scheduling and reminders

• We can call for you or with you to book the visit
• We help you gather what the office needs, like referral notes or recent lab results
• We set up reminders so you do not miss preventive care

Transportation

• If your plan includes a ride benefit, we arrange it
• If not, we help locate local transportation resources in your area

Insurance and benefits review

• We verify whether podiatry visits are covered as part of your diabetes care
• We check if you qualify for Medicare-covered therapeutic shoes and inserts and confirm in-network suppliers
• We follow up with the provider if there is a question about coverage so you are not stuck in the middle

Care coordination

• If blood sugars are running high, we help you connect with a dietitian or diabetes educator
• If a wound is not improving, we facilitate a referral to a wound care center
• We keep your care team on the same page

You should not have to navigate directories, hold times, or paperwork alone. Our team does the heavy lifting so you can focus on healing and prevention.

Preparing for your podiatry visit

Bring the following to your first or next appointment:

• A list of your medicines, including over-the-counter and supplements
• Your glucose logs or device reports if available
• Your current shoes, socks, and any inserts
• Questions you want answered, for example:
  • What is my foot risk level and how often should I follow up
  • Do I need therapeutic shoes, custom inserts, or offloading
  • Which daily care steps matter most for my feet
  • Should I see a wound care specialist, vascular specialist, or physical therapist

Practical tips if you have neuropathy

• Set a daily reminder to check your feet at the same time each day
• Keep a hand mirror near your chair to see your soles
• Keep socks by your bed so you do not walk barefoot at night
• Choose socks that are moisture-wicking with few seams
• Store a small first aid kit at home for minor skin care, and call your podiatrist for guidance before self-treating any open area

Video recap: what our advocates handle for you

• We confirm podiatry is covered under your plan as part of diabetes care
• We find in-network podiatrists and wound care centers, give you a clear list, and schedule the appointment for you if you like
• We arrange transportation if your plan offers it or help locate local options
• We check your benefits for diabetic shoes and inserts, then connect you with an in-network supplier
• We coordinate with your care team, including dietitians and diabetes educators, so your blood sugar plan, footwear, and wound care all work together
• We follow through so small trouble spots do not become open wounds

Frequently asked questions

Do I really need a podiatrist if I already see my primary care clinician

Yes. Podiatrists focus on foot and ankle health every day and can spot pressure points, nail problems, and early skin changes before they become serious. For many people with diabetes, especially with neuropathy, a podiatry visit is preventive care that saves time, pain, and cost later.

How often will Medicare cover diabetic shoes and inserts

Most eligible beneficiaries can receive one pair of therapeutic shoes per calendar year plus additional pairs of inserts when medically necessary. Documentation and supplier requirements apply. Our advocates can help verify your benefits and connect you with in-network suppliers.

What kind of shoes should I buy if I do not qualify for therapeutic shoes

Look for a roomy toe box, soft or seamless lining, removable cushioned insole, and a supportive, stable heel. Avoid high heels and narrow or pointed toe boxes. Break in new shoes slowly and check your feet after each wear.

When should I go to a wound care center

If you have an open sore, signs of infection, a foot that is suddenly warm, red, and swollen, or a wound that is not getting better after a few days, you may need advanced care. Wound centers can provide offloading, debridement, antibiotics when needed, and other treatments.

I have numbness and do not feel pain. How can I tell if something is wrong

Look for visual changes like redness, swelling, shiny or tight skin, drainage on socks, cracks, or a new callus or blister. Check the temperature by comparing one foot to the other with the back of your hand. Any difference or new change is a reason to call.

What is Charcot foot

Charcot neuro-osteoarthropathy is a condition where neuropathy leads to bone and joint changes in the foot. Early signs include warmth, redness, and swelling. It needs urgent evaluation and offloading to prevent deformity.

Can Understood Care help me schedule and get to appointments

Yes. We can search your insurance network, contact offices, schedule for you or with you, verify benefits, and arrange transportation if it is available through your plan. We also help coordinate referrals to wound care centers, dietitians, and other specialists.

References

1. National Institute of Diabetes and Digestive and Kidney Diseases. Diabetes and Foot Problems. Publicly accessible patient guidance.
   https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems
2. Centers for Disease Control and Prevention. Your Feet and Diabetes. Patient information on prevention, daily care, and when to call a clinician.
   https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-your-feet.html
3. Centers for Disease Control and Prevention. Promoting Foot Health, Clinical Guidance for Providers. Importance of annual foot exams and podiatry involvement.
   https://www.cdc.gov/diabetes/hcp/clinical-guidance/diabetes-podiatrist-health.html
4. American Diabetes Association. Standards of Care in Diabetes 2025, Retinopathy, Neuropathy, and Foot Care. Evidence-based care intervals and risk assessment.
   https://diabetesjournals.org/care/article/48/Supplement_1/S252/157552/12-Retinopathy-Neuropathy-and-Foot-Care-Standards
5. Cleveland Clinic. Diabetes-Related Foot Conditions: Symptoms and Treatment. Patient-friendly overview of risks, exams, and management.
   https://my.clevelandclinic.org/health/diseases/21510-diabetic-feet
6. Cleveland Clinic. Charcot Foot: Symptoms, Causes, and Treatment. Explanation of early signs and urgency of care.
   https://my.clevelandclinic.org/health/diseases/15836-charcot-foot
7. Mayo Clinic. Diabetic Neuropathy: Symptoms and Causes. Background on nerve damage that increases foot risk.
   https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/symptoms-causes/syc-20371580
8. Mayo Clinic. Amputation and Diabetes: How to Protect Your Feet. Prevention strategies and warning signs.
   https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/amputation-and-diabetes/art-20048262
9. International Working Group on the Diabetic Foot. 2023 Prevention Guideline. Evidence-based recommendations for ulcer prevention.
   https://iwgdfguidelines.org/wp-content/uploads/2023/07/IWGDF-2023-02-Prevention-Guideline.pdf
10. International Working Group on the Diabetic Foot. Practical Guidelines 2023. Screening, offloading, and care pathways.
    https://iwgdfguidelines.org/wp-content/uploads/2023/07/IWGDF-2023-01-Practical-Guidelines.pdf
11. Infectious Diseases Society of America with IWGDF. Guidelines on Diagnosis and Treatment of Diabetic Foot Infections.
    https://www.idsociety.org/practice-guideline/diabetic-foot-infections/
12. Medicare.gov. Therapeutic Shoes and Inserts. Benefit overview for beneficiaries.
    https://www.medicare.gov/coverage/therapeutic-shoes-inserts
13. Centers for Medicare & Medicaid Services. Therapeutic Shoes for Persons with Diabetes, Local Coverage Determination L33369.
    https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?DocID=L33369&LCDId=33369
14. CMS Policy Article A52501. Therapeutic Shoes for Persons with Diabetes, documentation and coverage details.
    https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52501‍

This content is educational and is not a substitute for medical advice. Always consult your healthcare provider for personalized care.