Diabetic Foot Health

Diabetes may affect your feet in a number of ways. One of the early changes can be loss of sensation (peripheral neuropathy), often starting at the toes which may lead to complications such as diabetic foot ulceration and amputation

Diabetes & the foot

Diabetes is a disease that develops from high blood glucose levels which can cause damage to the nerve systems in your body by stopping important messages getting to and from your brain. The nerves most likely to be affected are the longest ones – those that reach all the way down to your legs and feet.

High blood glucose levels can also damage your blood vessels and thereby circulation to your feet and legs can become impaired so annual diabetic foot checks are essential along with other examinations such as eye and kidney tests which will be carried out by your GP.

Is it serious?

Ulcerated foot

Any injury or hard skin has the potential to develop into something more serious if you have diabetes. If you have lost feeling in your feet then it is possible that you may unknowingly injure your feet leading to ulceration and the risk of infection, by treading on a sharp objects like a nail. If not noticed and not treated appropriately this can have potentially serious consequences and could lead to an amputation. Such an outcome is less likely if you seek expert advice from your multidisciplinary foot care team.

How do I know I have it?

Diabetes may affect your feet in a number of ways. One of the early changes can be loss of sensation (peripheral neuropathy) in your feet, often starting at the toes. Your chances of losing feeling in your feet (neuropathy) increases with the number of years that you have diabetes and research suggests that up to one in three people with diabetes have some loss of sensation. The onset of neuropathy is gradual and often people who develop this complication are unaware of it at the start. Often it occurs between 7 and 10 years of having diabetes, although in some cases it can occur sooner where blood sugar levels have not been so well controlled. Very occasionally pain or a burning sensation may accompany loss of feeling (painful neuropathy).

Additionally when the nerves in your feet are affected other changes may follow, for example your toes may start to claw and the bones in your feet can become more susceptible to fractures.

Other changes that can occur is reduced blood flow to your feet. Diabetes may also affect your ability to heal and reduce your natural ability to fight infection. Consequently, you should take particular care of any scratches, cuts or blisters on your feet.

How do I prevent it?

Preventing foot problems involves managing your diabetes well, controlling blood glucose levels and leading a healthy active lifestyle. Your chances of doing this will be greatly increased if you do not smoke. By adopting these measures, you can prevent or slow down any changes to the nerves and blood vessels that supply your legs and feet.

In addition, regular foot care is important in preventing the build-up of hard skin. It is advisable to regularly moisturise your feet, preferably with a urea based emollient such as Flexitol heel balm. In order to keep the skin supple, always wear socks and shoes that fit you correctly.

Everyone who has diabetes should have their feet checked regularly by a podiatrist at the very least once a year at their annual review. However, if you are at increased risk of complications, these inspections may be done more frequently.

When should I see a podiatrist?

  • Walking becomes more difficult
  • Applying or wearing shoes becomes more difficult
  • Tingling sensation or pins and needles
  • Part or all of your foot becomes swollen
  • Breaks in the skin, opens sores/blisters or a discharge
  • Skin colour changes (redder, bluer, paler, blacker) over part or all of the foot
  • Swelling in your feet and/or an unusual odour
  • Part or all of your foot feels much hotter or colder than usual
  • Hard skin (callus)
  • Cramp in your calves
  • Shiny smooth skin and/or losing hair on your feet and legs