The Complete Guide to Diabetes and Foot Health
- cmspodiatry
- 16 hours ago
- 6 min read
Living with diabetes means looking after your whole body, including your feet. Diabetes can affect the nerves, circulation and skin, making foot problems more likely to develop and slower to heal. However, with the right care, regular foot checks and early treatment, most serious complications can be prevented.
Whether you've recently been diagnosed with diabetes or have been managing it for years, understanding how diabetes affects your feet is one of the most important steps you can take to protect your long-term foot health.
This guide explains why diabetes increases the risk of foot problems, what warning signs to look out for, how to care for your feet every day, and when you should see a podiatrist.
What is diabetic foot disease?
Diabetic foot disease is a term used to describe the range of foot problems that can develop as a result of diabetes.
Not everyone with diabetes will experience foot complications, but diabetes increases the risk because it can damage the nerves and blood vessels that keep your feet healthy.
Over time, high blood sugar levels can affect sensation, reduce circulation and slow the body's natural healing process. This means even a small blister, cut or ingrown toenail has the potential to become a more serious problem if left untreated.
The good news is that most diabetic foot complications are preventable with good diabetes management, regular foot checks and prompt treatment when problems arise.
Why does diabetes affect the feet?
The feet are particularly vulnerable because they are the furthest part of the body from the heart and are subjected to constant pressure during standing and walking.
There are three main ways diabetes can affect foot health.
Diabetic neuropathy is nerve damage caused by prolonged high blood sugar levels.
When the nerves become damaged, you may experience:
Reduced sensation
Numbness
Tingling
Burning pain
Pins and needles
Difficulty detecting heat or cold
Some people lose feeling gradually without realising it.
This means you may not notice if you've developed a blister, stepped on something sharp or injured your foot.
Poor circulation
Diabetes increases the risk of peripheral arterial disease (PAD), where blood flow to the feet becomes reduced.
Poor circulation means:
Wounds heal more slowly
The skin becomes more fragile
The risk of infection increases
Serious complications become more likely
Signs of poor circulation may include cold feet, shiny skin, hair loss on the feet or lower legs, pain when walking and wounds that are slow to heal.
Changes to the skin
Diabetes can affect the skin's ability to retain moisture.
Dry skin is more likely to crack, particularly around the heels, creating an entry point for bacteria.
People with diabetes may also be more prone to fungal infections, including athlete's foot and fungal toenails.
What foot problems are common in people with diabetes?
People with diabetes can develop many of the same foot conditions as everyone else, but these problems often require earlier treatment because healing may be slower.
Common diabetic foot problems include:
Foot ulcers
A foot ulcer is an open wound that fails to heal normally.
Ulcers most commonly develop after repeated pressure, rubbing from footwear or unnoticed injuries.
Because sensation may be reduced, some ulcers are surprisingly painless.
Ulcers should always be assessed urgently by a healthcare professional.
Infection
Even small cuts or blisters can become infected more easily when diabetes affects circulation and healing.
Signs of infection include:
Increasing redness
Swelling
Warmth
Pus
Pain
An unpleasant smell
Prompt treatment is essential.
Areas of hard skin develop because of repeated pressure or friction.
Although corns and calluses are common, they should never be cut with blades or treated using over-the-counter corn removal acids if you have diabetes, as these can damage healthy skin.
Ingrown toenails
An ingrown toenail can become infected if left untreated.
Attempting to cut out the nail yourself may make the problem worse.
Athlete's foot and fungal nail infections are more common in people with diabetes.
Although they may seem minor, damaged skin caused by fungal infections increases the risk of bacteria entering the foot.
What are the warning signs to look out for?
You should inspect your feet every day.
Look for:
Cuts
Blisters
Cracks
Redness
Swelling
Changes in skin colour
Thickened nails
Ingrown toenails
Corns or calluses
Wounds that are not healing
Any fluid or discharge
If you cannot easily see the soles of your feet, use a mirror or ask someone you trust to help.
How often should you have a diabetic foot check?
Everyone with diabetes should receive a professional diabetic foot assessment at least once a year as part of their routine diabetes care.
Some people may require more frequent reviews depending on their level of risk.
During a diabetic foot assessment, a healthcare professional may:
Assess circulation
Test sensation using a monofilament
Check vibration sensation
Examine your skin and nails
Assess foot shape
Look for pressure areas
Identify your risk level
Offer advice about footwear and foot care
How should you care for your feet if you have diabetes?
Looking after your feet doesn't need to be complicated, but consistency is important.
Check your feet every day
Take a few moments each day to look for anything unusual.
Early detection allows treatment before small problems become larger ones.
Wash and dry your feet carefully
Wash your feet daily using warm water and mild soap.
Dry them thoroughly, especially between the toes, where moisture can encourage fungal infections.
Moisturise dry skin
Apply moisturiser to dry areas to help prevent cracks developing.
Avoid applying cream between the toes, as excess moisture may increase the risk of fungal infection.
Wear well-fitting footwear
Shoes should fit comfortably without rubbing.
Avoid tight shoes, narrow toe boxes and worn-out footwear that no longer provides adequate support.
Always check the inside of your shoes before putting them on to ensure there are no stones, rough seams or foreign objects.
Never walk barefoot
Walking barefoot increases the risk of cuts, splinters and burns.
Even inside the home, supportive slippers or shoes are usually the safest option.
Does good blood sugar control help your feet?
Yes.
Maintaining blood sugar levels within your target range helps reduce the risk of developing nerve damage and circulation problems.
Although good glucose control cannot reverse all existing complications, it plays a vital role in protecting long-term foot health.
Managing blood pressure, cholesterol, maintaining a healthy weight and avoiding smoking are also important.
When should you see a podiatrist?
Arrange an appointment with a podiatrist if you notice:
A new blister
A cut that isn't healing
A change in skin colour
Increasing swelling
Corns or calluses becoming painful
Thickened nails
Ingrown toenails
New numbness
Foot pain
Changes in the shape of your foot
You don't need to wait until your annual diabetic foot check if something changes.
When should you seek urgent medical advice?
Seek urgent medical attention immediately if you develop:
A foot ulcer
A wound that becomes infected
Increasing redness spreading across the foot
Significant swelling
Blackened skin
Fever with a foot wound
A wound that is producing pus
Sudden loss of circulation
Any injury that does not begin improving quickly
People with diabetes should never ignore foot wounds, even if they are painless.
How can you reduce your risk of diabetic foot problems?
Most diabetic foot complications are preventable.
Simple habits can make a significant difference:
Check your feet every day.
Attend all diabetic foot assessments.
Wear well-fitting footwear.
Moisturise dry skin.
Manage your blood sugar levels.
Never ignore wounds or blisters.
Seek professional advice early if something doesn't look right.
Final thoughts
Diabetes doesn't automatically mean you'll develop foot problems, but it does mean your feet deserve a little more attention.
Regular self-checks, good diabetes management and professional foot assessments are the best ways to protect your feet and reduce the risk of complications.
Many serious diabetic foot problems begin as something small, such as a blister, crack or ingrown toenail. Recognising these changes early and seeking prompt advice can often prevent them from becoming much more serious.
If you have diabetes and are concerned about your foot health, or you've noticed a new problem that isn't improving, arranging an assessment with a podiatrist is one of the best investments you can make in your long-term foot health.
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