Diabetes can, unfortunately, cause many foot problems that often lead to a great deal of pain and discomfort. For example, poor circulation of the feet is often an issue among those with diabetes because it damages the nerves. When this occurs, it’s likely for one to develop peripheral neuropathy. Peripheral neuropathy can make it feel like you have pins and needles in your feet. Others who have experienced this condition have also recalled a burning, tingling, or numbing sensation.

Since nerves are often damaged due to diabetes, the issue of not feeling when a wound has developed can lead to serious complications. Minor cuts or scrapes on the foot may run the risk of getting infected if the feet are not checked daily for wounds. Diabetes may also reduce blood flow to the feet, which in turn can make it harder for wounds to heal. With that being said, it’s important you seek professional help for treating any foot ailments. To prevent yourself from running the risk of developing a serious foot condition, it’s recommended that you wash and dry your feet daily, cut your toenails carefully, keep your feet moisturized, check them regularly for any abnormalities, and keep your feet warm and dry. 

For more advice on how to care for diabetic feet, we suggest you consult with a podiatrist for professional care and a recommended treatment plan for any existing conditions.

Diabetic Foot Care Q & A

What are Diabetes-related foot and leg problems?

Having diabetes puts you at risk for developing a wide range of foot problems:

• Infections and ulcers (sores) that don’t heal. Because of poor circulation in the feet, cuts or blisters can easily turn into ulcers that become infected and won’t heal. This is a common—and serious—complication of diabetes and can lead to a loss of your foot, your leg, or your life. An ulcer is a sore in the skin that may go all the way to the bone.
• Corns and calluses. When neuropathy is present, you can’t tell if your shoes are causing pressure and producing corns or calluses. Corns and calluses must be properly treated or they can develop into ulcers.
• Dry, cracked skin. Poor circulation can make your skin dry. This may seem harmless, but dry skin can result in cracks that may become sores.
• Nail disorders. Ingrown toenails (which curve into the skin on the sides of the nail) and fungal infections can go unnoticed because of loss of feeling. If they’re not professionally treated, they can lead to ulcers.
• Hammertoes and bunions. Motor neuropathy (nerve damage affecting muscles) can cause muscle weakness and loss of tone in the feet, resulting in hammertoes and bunions. If left untreated, these deformities can cause ulcers.
• Brittle bones. Neuropathy and circulation changes may lead to brittle bones (osteoporosis). This makes you susceptible to breaking a bone, even without a major blow or injury occurring.
• Charcot foot. This is a complex foot deformity. It develops as a result of loss of sensation and an undetected broken bone that leads to destruction of the soft tissue of the foot. Because of neuropathy, the pain of the fracture goes unnoticed and the patient continues to walk on the broken bone, making it worse. This disabling complications so severe that amputation may become necessary.
• Blocked artery in the calf. In diabetes, the blood vessels below the knee often become narrow and restrict blood flow.A severely blocked artery is a serious condition that may require intervention from a vascular surgeon. If vascular surgery fails and the wound does not heal, amputation may be necessary.

What can your foot and ankle surgeon do?

A major goal of the foot and ankle surgeon is to prevent amputation. There are many new surgical techniques available to save feet and legs, including joint reconstruction and wound healing technologies. Getting regular foot checkups and seeking immediate help when you notice something can keep small problems from worsening.Your foot and ankle surgeon works together with other health care providers to prevent and treat complications from diabetes.

When is Amputation necessary?

The goals of treatment of diabetic foot problems are not only to save the life and limb, but also to get the patient healed and moving about as soon as possible. If vascular surgery cannot improve blood flow and podiatric surgery cannot restore function, amputation may be the only solution that gets the patient walking again. Amputation may involve one or two toes, part of the foot, or part of the leg. It is selected on the basis of the patient’s condition and level of predicted healing. A return to normal life is especially possible today because of advances in prosthetics.

What are proactive measure you can take?

You play a vital role in reducing complications. Follow these guidelines and contact your foot and ankle surgeon if you notice any problems:

• Inspect your feet daily. If your eyesight is poor, have someone else do it for you. Inspect for: Skin or nail problems--look for cuts, scrapes, redness, drainage, swelling, bad odor, rash, discoloration, loss of hair on toes, injuries, or nail changes (deformed, striped, yellowed or discolored, thickened, or not growing). Signs of fracture—If your foot is swollen, red, hot, or has changed in size, shape, or direction, see your foot and ankle surgeon immediately.
• Observe for changes in circulation. Pay attention to the color of your toes. If they turn red, pink, or purplish when your legs hang down while sitting, poor circulation may be a problem.
• Don’t ignore leg pain. Pain in the leg that occurs at night or with a little activity could mean you have a blocked artery. Seek care immediately.
• Nail cutting. If you have any nail problems, hard nails, or reduced feeling in your feet, your toenails should be trimmed professionally.
• No “bathroom surgery.” Never trim calluses or corns yourself, and don’t use over-the-counter medicated pads.
• Keep floors free of sharp objects. Make sure there are no needles, insulin syringes, or other sharp objects on the floor.
• Don’t go barefoot. Wear shoes, indoors and outdoors.
• Check shoes and socks. Shake out your shoes before putting them on. Make sure your socks aren’t bunched up.
• Have your sense of feeling tested.Your foot and ankle surgeon will perform various tests to see if you’ve lost any feeling.

Diabetes can be dangerous to your feet—even a small cut could have serious consequences. Diabetes may cause nerve damage that takes away the feeling in your feet. Diabetes may also reduce blood flow to the feet, making it harder to heal an injury or resist infection. Because of these problems, you might not notice a pebble in your shoe—so you could develop a blister, then a sore, then a stubborn infection that might cause amputation of your foot or leg. To avoid serious foot problems that could result in losing a toe, foot, or leg, be sure to follow these guidelines:

• Inspect your feet daily. Check for cuts, blisters, redness, swelling, or nail problems.Use a magnifying hand mirror to look at the bottom of your feet. Call your doctor if you notice anything.
• Wash your feet in lukewarm (not hot!) water. Keep your feet clean by washing them daily. But only use lukewarm water—the temperature you’d use on a newborn baby.
• Be gentle when bathing your feet. Wash them using a soft washcloth or sponge. Dry by blotting or patting—and make sure to carefully dry between the toes.
• Moisturize your feet—but not between your toes. Use a moisturizer daily to keep dry skin from itching or cracking. But DON’T moisturize between the toes—this could encourage a fungal infection.
• Cut nails carefully—and straight across. Also, file the edges. Don’t cut them too short, since this could lead to ingrown toe nails.
• Never trim corns or calluses. No “bathroom surgery”—let your doctor do the job.
• Wear clean, dry socks. Change them daily.
• Avoid the wrong type of socks. Avoid tight elastic bands (they reduce circulation). Don’t wear thick or bulky socks (they can fit poorly and irritate the skin).
• Wear socks to bed. If your feet get cold at night, wear socks. NEVER use a heating pad or hot water bottle.