The best way to help prevent osteomyelitis in diabetes is to prevent foot wounds and get any injury or infection checked early. Check your feet every day, wear well-fitting shoes and socks, wash and dry them carefully, and follow your diabetes care plan. Do not cut corns or calluses yourself. Contact a healthcare professional promptly about a wound, redness, warmth, swelling, drainage, or a sore that is not healing.
How can diabetes increase the risk of osteomyelitis?
Osteomyelitis is an infection in a bone. In people with diabetes, it can develop when germs spread from an infected wound or ulcer into the nearby bones, particularly those of the feet. Diabetes can damage nerves and reduce blood flow to the feet. Nerve damage may make it difficult to feel a blister, cut, or puncture, while poor circulation can slow healing and make infections harder to clear.
According to Mayo Clinic, people with diabetes who develop foot ulcers can develop osteomyelitis in the foot bones. Preventing skin injuries, recognizing wounds early, and obtaining timely care for possible infections are therefore important steps in reducing this risk.
What daily foot-care habits help prevent bone infections?
1. Check your feet every day
Examine both feet daily, including the soles, heels, spaces between the toes, and areas around the toenails. Use a hand mirror to see the bottom of each foot, or ask a family member or caregiver to help if you have difficulty seeing or reaching your feet. Check before going to bed or at another consistent time so that the habit becomes part of your daily routine.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recommends checking for foot problems every day because injuries may go unnoticed when diabetes has reduced sensation.
- Cuts, cracks, scratches, or puncture wounds.
- Blisters, open sores, or areas of broken skin.
- Redness, swelling, or skin that feels warmer than the surrounding area.
- Fluid or pus, an unusual smell, or changes in skin color.
- New calluses, bleeding under thickened skin, or changes around the toenails.
These changes do not necessarily mean that a bone infection is present. However, a new wound or concerning change deserves attention, even when there is little or no pain.
2. Wash and dry your feet carefully
Wash your feet daily using mild soap and lukewarm water. Check the water temperature before washing because nerve damage may prevent you from recognizing excessive heat. Dry your feet gently, paying particular attention to the spaces between the toes. Avoid soaking your feet, as prolonged soaking can dry the skin and increase the chance of damage.
If your skin is dry, apply a moisturizer to the tops and soles of your feet, but avoid putting cream between the toes, where excess moisture can encourage skin problems. Keep the skin clean and intact, and avoid rubbing or scrubbing areas that are sore, cracked, or fragile.
3. Wear protective, well-fitting footwear
Wear shoes and socks whenever you walk, including indoors. Walking barefoot or wearing only socks can expose your feet to sharp objects, friction, and injuries that you may not feel. Choose shoes with enough room for your toes, a comfortable fit, and protection from objects on the ground. Check the inside of every shoe before putting it on to remove pebbles, rough edges, or other objects that could injure your skin.
The Centers for Disease Control and Prevention (CDC) recommends wearing well-fitting shoes and socks, avoiding barefoot walking, inspecting the feet regularly, and seeking professional help with foot problems. If you have foot deformities, previous ulcers, or areas of high pressure, ask your healthcare professional whether specialized footwear or insoles would help protect your feet.
4. Care for your toenails and calluses safely
Trim your toenails straight across and gently smooth sharp edges with a nail file. Avoid cutting into the corners or cutting your skin. If your nails are thick, difficult to reach, or hard to see, seek help from a qualified foot-care professional.
Do not cut corns or calluses yourself, and avoid medicated corn plasters, chemical callus removers, blades, or other tools that could damage the skin. If thickened skin causes discomfort or repeatedly develops in the same area, have it assessed. Pressure-related skin damage can lead to an ulcer, particularly when sensation is reduced.
How can diabetes management lower the risk?
Follow your individualized diabetes management plan, including prescribed medicines, blood glucose monitoring, nutrition guidance, and physical activity recommendations. Keeping blood glucose within your agreed target range helps reduce the risk of diabetes-related complications. Good glucose management does not guarantee that an infection will never develop, but it is an important part of protecting your overall health and reducing foot-related risks.
The CDC explains that managing blood glucose through appropriate eating habits and physical activity, along with regular foot checks and medical foot screenings, can help prevent or delay diabetes-related foot complications. Take medicines as prescribed and discuss persistent high glucose readings or difficulties following your care plan with your healthcare professional.
Blood flow also matters because adequate circulation supports wound healing. Avoid smoking, and seek help to stop if you use tobacco. Stay physically active according to your healthcare professional's advice. If you have an existing foot ulcer or another condition that makes walking unsafe, ask which activities are appropriate rather than placing additional pressure on the affected area.
Who needs more frequent foot checks?
Everyone with diabetes should practise daily foot care, but some people need closer professional monitoring. The frequency of examinations depends on foot sensation, circulation, previous complications, and other individual risk factors.
- Nerve damage: Reduced sensation may allow cuts, blisters, or burns to go unnoticed.
- Poor circulation: Reduced blood flow can delay healing and make an infection more difficult to manage.
- Previous foot ulcers or amputation: A history of serious foot problems warrants careful ongoing assessment.
- Changes in foot shape: Deformities may increase pressure on particular areas and contribute to skin breakdown.
- Repeated corns or calluses: Thickened skin can develop over areas exposed to repeated pressure or friction.
Arrange a comprehensive foot examination at least once a year, and ask whether you need more frequent checks. Your healthcare professional can assess sensation and circulation, identify pressure areas, review your footwear, and recommend a personalized prevention plan. People who have already experienced a foot ulcer may need additional specialist support.
What should you do if a foot wound develops?
Do not wait for a wound to become painful before seeking help. Diabetes-related nerve damage can reduce pain sensation, and a wound may worsen without causing much discomfort. If you notice a cut, blister, ulcer, redness, warmth, swelling, drainage, or another unusual change, contact a healthcare professional promptly. An injury that does not begin to heal within a few days needs medical attention.
The NHS guidance on osteomyelitis highlights the importance of foot care in diabetes because an unnoticed cut can become infected, allowing infection to spread to the bone. Prompt assessment can help determine whether a wound needs professional cleaning, dressings, pressure reduction, or further testing.
While arranging care, gently protect the wound with a clean dressing and avoid unnecessary pressure on the injured area. Do not try to drain pus, remove dead tissue, cut away surrounding skin, or rely on home remedies instead of assessment. A foot wound that becomes increasingly swollen, red, warm, discoloured, or develops drainage or an unpleasant smell needs urgent medical attention. Seek emergency care if you have signs of a serious infection, such as fever with a worsening wound, rapidly spreading redness, or feeling severely unwell.
Can osteomyelitis be prevented completely?
No prevention plan can eliminate every possibility of osteomyelitis. However, daily foot inspections, appropriate footwear, careful skin and nail care, diabetes management, routine professional examinations, and early assessment of wounds can reduce avoidable risks. The most important habit is to treat changes in your feet seriously and seek help early rather than waiting for pain or obvious deterioration.
If you have previously had a foot ulcer, a bone infection, or an amputation, ask your healthcare team to review your individual risk and create a prevention plan tailored to your feet. Consistent care and timely attention to new problems can help protect foot health and reduce the chance that a skin wound will progress to a deeper infection.