Managing diabetes and keeping your blood sugar within a healthy range doesn’t only protect against heart attacks and stroke, it can also keep your feet healthy.
Diabetes is a condition where the body doesn’t produce enough insulin or use insulin properly, causing sugar levels in the blood to rise above normal. Uncontrolled high blood sugar can reduce blood flow in your feet, leading to serious complications.
Paying attention to your foot health—which includes recognizing early signs of problems—and maintaining a healthy blood sugar lowers the risk for complications.
Prolonged high blood sugar can gradually damage your blood vessels, restricting blood flow to your organs and other parts of your body. Lack of blood flow can lead to heart disease, stroke, kidney problems, and even vision problems.
Blood vessel damage also affects blood flow to your feet, causing a number of foot health issues.
1. Diabetic neuropathy
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Nerve damage can cause a tingling sensation and pain in your feet. As your condition worsens, you might lose all feeling in your feet. This is when diabetic neuropathy becomes dangerous.
Pain is a warning that something isn’t right in the body. It can alert you to cuts, sores, and blisters on your feet. But if you have diabetic neuropathy and lose feeling in your feet, a cut or blister could go unnoticed for an extended length of time. If you don’t receive prompt treatment for these types of injuries, you could develop an infection.
Diabetic neuropathy can lead to other complications. Reduced blood flow to your feet means that sores or infections might not heal as easily. Infections that don’t heal can progress to gangrene, which is death of tissue due to lack of blood flow.
If gangrene starts to affect other parts of your body, your doctor might have to amputate a toe, foot, or leg to stop its spread.
3. Peripheral vascular disease
Diabetes can also cause a circulation disorder known as peripheral vascular disease. This cardiovascular disease results from limited blood flow to the legs and feet. A blockage or narrowing of blood vessels also restricts blood flow.
This condition can occur in anyone, but the risk is higher in people with diabetes, because blood vessel changes often prevent the smooth flow of blood. Plus, high blood sugar can thicken blood to the point where it doesn’t flow easily.
4. Charcot foot
Nerve damage from diabetes can also trigger a rare condition known as Charcot foot. This typically occurs when a person has an injury, such as a sprain or fracture, that goes unnoticed due to lack of sensation caused by peripheral neuropathy. As the person continues to walk on the injured foot, it causes trauma to the bone.
Deformity occurs when joints become dislocated and collapse. The arch of the foot will often collapse, too, causing a roundness on the bottom of feet.
Along with foot deformity, other signs of Charcot foot include swelling, and your feet might appear red and warm to the touch.
A round bottom on feet also raises the risk of sores due to friction. If you have diabetic neuropathy and lose feeling in your feet, an open sore can become infected. This puts you at risk for amputation.
Poor blood circulation and blood flow can slow the healing process of sores on your feet, putting you at risk for serious life-threatening complications.
Even if you haven’t lost feeling in your feet, bring the following symptoms to your doctor’s attention. Signs of feet issues include:
- swelling in your legs or feet
- tingling, pins and needles sensation in your feet
- loss of feeling in your feet or legs
- numbness in your toes
- sores that don’t heal
- blisters on your feet
- cracks between your toes
- corns or calluses
- developing hammer toe or bunions
- ingrown toenail
- changes in skin color on feet
- peeling or cracking on soles of feet
You can avoid serious diabetes complications by seeing your doctor and getting treatment early for conditions that affect your feet.
Unfortunately, there’s no cure for diabetic neuropathy. But you can take steps to slow the progression of this disease. Your doctor will likely recommend pain medication to help alleviate nerve pain.
For mild nerve pain, you can take over-the-counter medications like acetaminophen or ibuprofen. For moderate or severe pain, prescription medications like anti-seizure drugs and antidepressants can help ease nerve pain and improve the quality of your life, too.
Maintaining a healthy weight and regular physical activity can also slow the progression of diabetic neuropathy.
Peripheral vascular disease
If you develop peripheral vascular disease your doctor will also recommend treatment to slow disease progression and improve blood flow.
Treatment might also involve medication to reduce blood clotting, lower your cholesterol, or reduce your blood pressure depending on the underlying cause of a blockage.
Good diabetes management—medication, regular exercise, and a healthy diet—can also reduce symptoms of peripheral vascular disease.
In severe cases, you may need angioplasty for peripheral vascular disease. This is a surgical procedure to open up a blocked artery and restore blood flow.
Gangrene and charcot foot
Gangrene treatment involves antibiotics to kill bacteria and stop an infection, as well as surgery to remove damaged tissue. Treatment for Charcot foot involves preventing further deformity.
Wearing a cast to immobilize the foot and ankle can gradually strengthen these bones, as does wearing custom shoes or a brace. In severe cases, surgery can help correct a deformity.
One way to prevent foot issues with diabetes is to keep your blood sugar within a healthy range, so check your blood sugar on a regular basis. Also, take your diabetes medication as instructed. If you’re unable to control your blood sugar, see your doctor.
Other tips to prevent foot issues include:
- Stay physically active, at least 30 minutes most days of the week.
- Consult a nutritionist or certified diabetes educator (CDE) for meal planning advice.
- Quit smoking.
- Keep your blood pressure and cholesterol within a healthy range.
- Maintain a healthy weight.
Not only should you take steps to keep your blood sugar within a healthy range, you should also take steps to keep your feet healthy. Here’s how to protect your feet with diabetes:
- Examine your feet daily and look for signs of injury, such as scrapes, cuts, blisters, etc.
- Wear appropriate fitting shoes to avoid injury and blisters.
- Don’t walk barefoot.
- Moisturize your feet daily.
- Wash and dry your feet daily.
- Trim your toenails straight across to avoid ingrown nails.
- See a doctor to remove corns or calluses (don’t do it yourself).
- Treat cuts immediately to avoid infection (clean wounds daily and apply antibiotic ointment).
Some diabetes foot complications are life-threatening, or they put you at risk for amputation. See a doctor if you have any concerns or notice unusual changes with your feet.
A seemingly minor issue like cracked skin on your feet, yellow toenails, athlete’s foot, or an ingrown nail can become a serious problem if left untreated. Also, see your doctor for any cuts or scrapes that don’t heal to avoid an infection on your feet.
Although there’s no cure for diabetes, a healthy diet, regular exercise, and taking your medication as instructed can lower your risk for complications.
It’s very important to keep your feet healthy when you have diabetes. Check your feet daily for signs of injury or infection, and see your doctor right away if you notice any unusual symptoms.
- Diabetes and foot problems. (2017). https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems
- Diabetes and your feet. (2019).
- What is diabetic neuropathy? (2018). https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/nerve-damage-diabetic-neuropathies/what-is-diabetic-neuropathy