Preventing Diabetic Foot Ulcers: Foot Care &
Offloading Tips for South Texans
Foot ulcers are the most common cause of non-traumatic lower-limb amputations in the U.S. and they nearly always start small. In fact, according to the American Diabetes Association, over 85% of diabetes-related amputations begin with an ulcer. But here’s the truth: most diabetic foot ulcers (DFUs) are preventable with the right foot care, early intervention, and support.
At Hill Country Wound Care & Hyperbarics, we treat diabetic wounds every day, but we’d much rather help you avoid one altogether. If you’re living with diabetes in San Antonio or South Texas, this guide is for you.
Why Diabetic Foot Ulcers Happen
1. Start with a Daily Foot Check
If you have diabetes, especially if you’ve lost feeling in your feet, this is non-negotiable.
Every day, inspect your:
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Heels and soles
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Toes and toenails
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Sides and tops of the feet
Look for:
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Red spots, blisters, or scratches
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Cracks, calluses, or thickened skin
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Drainage, swelling, or odor
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Any area that’s unusually warm, cool, or discolored
Pro Tip: Can’t reach your feet? Use a hand mirror or ask a family member to help. Many patients we see at Hill Country caught early warning signs just by looking daily.
2. Never Go Barefoot, Even at Home
In warm climates like San Antonio, it’s common to go barefoot or wear flip-flops around the house, on patios, or at the beach. But this exposes your feet to:
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Burns from hot pavement or decks
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Cuts from glass, gravel, or thorns
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Punctures from splinters or nails
All it takes is one unnoticed injury to start a dangerous ulcer.
Instead:
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Wear closed-toe slippers or diabetic-safe shoes indoors
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Use protective sandals with toe shields at the pool
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Avoid walking barefoot on any outdoor surface
3. Choose Shoes That Protect, Not Just Fit
Poor footwear is one of the top contributors to DFUs. Tight shoes, high heels, or sandals with straps can create pressure points that lead to tissue damage.
What to Wear:
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Closed-toe shoes with plenty of room
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Soft inner linings without seams
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Rocker soles or cushioned insoles to reduce pressure
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Custom orthotics (when prescribed)
What to Avoid:
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Flip-flops or open sandals
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High heels or narrow toe boxes
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Stiff, unpadded interiors
4. Understand and Use Offloading Properly
“Offloading” means relieving pressure on high-risk areas of the foot, especially over bony spots like:
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The ball of the foot (metatarsal heads)
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The heel
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The big toe or lateral foot edge
Even standing or walking in your own home can cause repetitive stress injuries if the pressure isn’t redistributed.
Preventive Offloading Tools:
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Custom inserts or orthotics for daily shoes
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Wound shoes or pressure-relieving footwear
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Toe spacers or foam padding to prevent rubbing
For those with early-stage or healing ulcers, we may prescribe:
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Removable boots (CAM walkers)
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Total contact casts (TCCs)
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Custom braces
Our clinics also offer ultrasonic debridement, biologic dressings, and HBOT for patients with pre-ulcerative signs like calluses, redness, or fragile skin.
5. Keep Blood Sugar Under Control
No matter how meticulous your foot care routine is, it won’t be enough if blood glucose is consistently elevated.
High blood sugar:
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Impairs circulation
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Weakens immune defenses
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Slows new tissue growth
We recommend working with your endocrinologist or primary care provider to keep your A1C in target range and monitor blood sugar daily. This is your foundation.
6. Moisturize the Right Way
Dry, cracked skin is an open invitation for infection. Apply unscented moisturizer to the tops and bottoms of your feet daily, but avoid lotion between the toes, where moisture buildup can lead to fungal infections.
7. Know When to See a Specialist Before You Have an Ulcer
Many patients wait until an ulcer appears before seeking care. But at Hill Country, we help prevent DFUs by treating:
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Pre-ulcerative calluses
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Red pressure spots
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Early signs of skin breakdown
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Poor foot biomechanics
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Recurring “hot spots” from improper footwear
If you have neuropathy, a foot deformity, previous ulcers, or vascular disease, schedule a preventive foot evaluation with our team.
South Texas-Specific Risk Factors
Living in our region brings unique risks for diabetic feet:
- Heat & humidity: Increase sweat, fungus risk, and likelihood of barefoot exposure
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Outdoor culture: Yardwork, gardening, barbecues = more chances for unnoticed foot trauma
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Footwear choices: Flip-flops and sandals offer little protection but are worn year-round
We help patients across Bulverde, Live Oak, and Southwest San Antonio stay active while protecting their feet for the long haul.
Prevention Is Powerful But It Takes a Team
Preventing diabetic foot ulcers requires daily effort, smart decisions, and expert backup. At Hill Country Wound Care, we walk alongside high-risk patients to stop ulcers before they start.
What We Offer:
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✅ Preventive foot assessments
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✅ Access to offloading tools and footwear referrals
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✅ Guidance on proper foot hygiene and pressure relief
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✅ Full wound care services if problems arise
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✅ Board-certified wound care physicians and advanced technology at every location
Internal Resources You Can Explore
To learn more about Diabetic Foot Ulcer care, explore our core educational content:
Frequently Asked Questions
Smart foot care and the right offloading plan can stop small issues from becoming serious. Below are answers to the most common questions South Texans ask, daily foot checks, choosing shoes and inserts, how offloading works, and when to call our team at Hill Country Wound Care & Hyperbarics.
A diabetic foot ulcer (DFU) is an open sore, usually on the bottom of the foot, caused by a mix of nerve damage (neuropathy), poor circulation, and delayed healing. Small issues—like a blister or crack—can progress quickly when they’re not felt or treated early.
Inspect soles, heels, toes (including between toes), and around the nails. Look for redness, blisters, cracks, drainage, swelling, or areas that feel warmer or cooler. Use a hand mirror or ask a family member if you can’t see every area.
No. Hot pavement, deck boards, gravel, and thorns are common here and can cause burns or punctures you might not feel. Wear closed-toe slippers or supportive shoes indoors and protective footwear outdoors, always.
Choose closed-toe shoes with a roomy toe box, soft seamless interiors, and cushioned or rocker soles. Avoid flip-flops, high heels, narrow toe boxes, and stiff, unpadded interiors. Ask about diabetic shoes and custom orthotics if you have hotspots or deformities.
Offloading redistributes pressure away from high-risk areas (ball of foot, heel, toe). It’s used preventively for calluses or pressure spots and therapeutically for early or healing ulcers. Your provider will match the device to your risk and activity level.
Common tools include custom inserts/orthotics, wound shoes, toe spacers/padding, removable boots (CAM walkers), and total contact casts (TCC). At Hill Country, we fit and prescribe the right option and adjust as your foot changes.
Often, yes, with modifications. The goal is to reduce pressure and repetitive stress while you move safely. We’ll guide you on weight-bearing limits, break-in schedules, and when to switch devices as your risk improves.
They increase sweat and friction (blister risk) and raise the chance of fungal infections. Keep feet clean and dry, change socks during the day if damp, and use moisture-wicking socks. Never apply lotion between the toes.
Trim nails straight across (not too short) and smooth edges with a file. Don’t cut corns or calluses yourself and skip “bathroom surgery.” See a wound-care or foot-care professional for safe debridement.
New redness, warmth, swelling, drainage, odor, sudden pain (even with neuropathy), a blister or crack that’s not improving in 24–48 hours, or any dark/black tissue. If you notice these, contact Hill Country promptly.
Yes. Elevated glucose impairs circulation, weakens immune defenses, and slows tissue repair. Keeping A1C in target, plus daily foot care and the right footwear, dramatically lowers DFU risk.
Absolutely. We provide preventive assessments, footwear/orthotic referrals, and customized offloading plans, plus full wound care if needed, at our Live Oak, Bulverde, and Southwest San Antonio clinics. Call (210) 626-8201 to request a preventive foot consultation.