Diabetic foot

For people with diabetes, having too much sugar in their blood for a long time can cause serious complications, including foot and skin problems, as well as heart disease, nerve injury, kidney disease, eye damage, and other problems.

How can diabetes affect my feet?

Diabetes can cause problems that can affect your feet:

Diabetic neuropathy — Uncontrolled diabetes can damage your nerves. If you have damaged nerves in your legs and feet, you might not feel heat or pain. This lack of feeling is called diabetic neuropathy. If you do not feel a cut or sore on your foot, the cut could get worse and become infected.
Peripheral vascular disease — Diabetes also affects the flow of blood. Without good blood flow, it takes longer for a sore or cut to heal. Poor blood flow in the arms and legs is called peripheral vascular disease.
Foot ulcers — A foot ulcer is a break in the skin or a deep sore, which can become infected. Foot ulcers can result from minor scrapes, cuts that heal slowly or from the rubbing of shoes that do not fit well. Early intervention is important in treating foot ulcers. Ask your health care provider for advice on how to best care for your wound.

If you have an infection that will not heal, you are at risk for developing gangrene, which is the death of tissue due to a lack of blood. If the infection is not treated quickly, it can spread into the bone. These can be prevented through proper foot care.

Can these foot problems be prevented?

Proper foot care can help prevent these common foot problems and/or treat them before they cause serious complications. Here are some tips for good foot care:

Take care of yourself and your diabetes. Follow your doctor’s advice regarding nutrition, exercise, and medication. Keep your blood glucose level within the range recommended by your doctor.
Wash your feet in warm water every day, using a mild soap. Do not soak your feet. Dry your feet well, especially between the toes.
Check your feet every day for sores, blisters, redness, calluses or any of the other problems listed above. If you have poor blood flow, it is especially important to do a daily foot check.
If the skin on your feet is dry, keep it moist by applying lotion after you wash and dry your feet. Do not put lotion between your toes. Your doctor can tell you which type of lotion is best to use.
Gently smooth corns and calluses with an emery board or pumice stone. Do this after your bath or shower, when your skin is soft. Move the emery board in only one direction.
Check your toenails once a week. Trim your toenails with a nail clipper straight across. Do not round off the corners of toenails or cut down on the sides of the nails. After clipping, smooth the toenails with an emery board.
Always wear closed-toed shoes or slippers. Do not wear sandals. Do not walk barefoot, even around the house.
Always wear socks or stockings. Wear socks or stockings that fit your feet well and have soft elastic.
Wear shoes that fit well. Buy shoes made of canvas or leather, and break them in slowly.
Protect your feet from heat and cold. Wear shoes at the beach or on hot pavement. Wear socks at night if your feet get cold.

Maintain good blood flow to your feet. Put your feet up when sitting, wiggle your toes and move your ankles several times a day.
Stop smoking. Smoking makes blood flow problems worse.
If you have a foot problem that gets worse or won’t heal, contact your doctor for advice and
treatment.
Make sure your diabetes doctor examines your feet during each check-up.
See your podiatrist (foot doctor) every two to three months for check-ups, even if you don’t have any foot problems.

When should I contact my doctor?

If you experience any of the following problems:

Changes in skin colour
Changes in skin temperature
Swelling in the foot or ankle
Pain in the legs
Open sores on the feet
Ingrown toenails or toenails infected with fungus
Corns or calluses
Dry cracks in the skin, especially around the heel
Unusual and/or persistent foot odour