Diabetes is a chronic condition marked by high levels of blood sugar. It is common, affecting an estimated one in nine Americans. Diabetes impacts many areas of the body, including the feet. 

How does diabetes affect the feet?

Diabetes affects the feet in a few ways. First, it is important to note that not all diabetics have foot issues. It really differs from patient to patient and may depend on how long you have had diabetes and how well it has been controlled. Diabetes can affect the nerves, circulation, overall structure, and the skin of the foot.

Neuropathy signs and symptoms

Problems with the nerves are often referred to as neuropathy. The signs and symptoms of neuropathy are: 

  • loss of feeling or numbness
  • pins and needles
  • tingling
  • nerve pain 

Circulation problems caused by diabetes

Problems with circulation is often referred to as peripheral vascular disease or PVD. Signs and symptoms are:

  • cold feet
  • pain 
  • slow or non-healing wounds. 

Skin issues and diabetes

Skin issues associated with diabetes typically include cuts, blisters or wounds commonly referred to as ulcers. For individuals with increased risk factors and poorly controlled diabetes, wounds can be hard to heal. This can lead to infections of the skin and deeper tissues such as tendon and bone.

For individuals with poor circulation, a condition known as gangrene can also occur. In these more complex scenarios, patients may require hospitalization, antibiotics, and possibly surgery.

Foot structure issues

A foot deformity that can be seen in diabetics is called Charcot foot. This condition is characterized by an area of the foot and/or ankle that is red, warm, and swollen. Pain can also be present. This can mimic other conditions such as infection. Patients with diabetes can also have hammertoes and bunions which can lead to skin breakdown if shoes are not properly fitted for their specific foot type.

What is diabetic foot and what are the signs?

The term “diabetic foot” is typically used when patients develop one or more signs and symptoms of neuropathy, peripheral vascular disease, wounds, or poor foot structure. These can all be interrelated and need to be addressed individually. 

The causes of diabetic foot are typically poorly controlled diabetes and having had diabetes for a long period of time. Other factors, including smoking, can also worsen diabetic foot.

Diabetic foot pain

Diabetic foot pain can be debilitating. It can range from mild numbness and occasional tingling to severe burning pain, which is the most common type of diabetic foot pain. Pain can also come from poor circulation, which is typically associated with sharp pain and can cause loss of strength and ability to function. 

Unfortunately, some patients can experience both types of pain. Once again, diabetic foot pain needs to be evaluated to determine the cause so that it can be addressed. Treatment can be in the form of topical creams, medications and in some cases surgery if poor circulation is the causative factor.

Proper footcare for those with diabetes

Proper footcare for the diabetic starts with proper management of diabetes. That involves working closely with your provider who manages your diabetes and keeping your blood sugar levels as close to the target as your provider has set for you. 

Preventing foot issues is really the goal without a doubt. If you have diabetes, be sure to:

  • Check your feet daily looking for any open sores or deep cuts.
  • Wear proper fitting shoes as tight footwear can lead to skin breakdown. 
  • Avoid walking barefoot since this is a common way to get a cut or a wound. 
  • If a cut or a wound occurs, treat it promptly.
  • Trim toenails properly without going too deep.

If you have diabetes, it is important to have your feet checked by a podiatrist at least initially, so that you can be educated as to the current state of your feet. Education early on can help prevent many complications down the line.

Everyone’s foot is different. Individuals can have any number of problems with their feet including toe and foot deformities, gout, and arthritis, just to name a few. These conditions are not caused by diabetes but can make the feet uncomfortable. 

Learn more about podiatry and how we can help you here.

Edmund T. DosRemedios, DPM

Edmund T. DosRemedios, DPM

Dr. Edmund DosRemedios is a specialist in podiatry and foot surgery at the Lifespan Orthopedics Institute. He graduated from Temple University School of Podiatric Medicine in 1996. After graduating, he completed a three-year residency in foot surgery, with heavy emphasis in diabetic limb preservation, at Yale-New Haven Hospital.