Problems affecting the feet are much more common in people with diabetes, due to the damage that raised blood sugars can cause to sensation and circulation.
Two specific complications of diabetes can be peripheral arterial disease, a common condition which can cause poor circulation to your feet; and peripheral neuropathy (nerve damage). These can result in a number of symptoms, including:
- Changes to the general condition of the skin on the feet. Look out for cracks or splits, which can increase the likelihood of infection.
- Impaired sensation, meaning you may not feel an injury to your foot, or if a shoe it rubbing.
- Changes to the shape of the feet, which can be caused by the skin’s ability to heal and to deal with infections. This can alter the areas experiencing pressure or rubbing, which may lead to thickened, hard skin forming. In turn, the pressure underneath these areas increases and can then cause damage to the underlying tissues.
It’s estimated that around 10% of diabetics may develop a foot ulcer at some point. This is a wound or sore on the skin that’s slow to heal and can extend to the deeper tissues, and can sometimes become infected. In extreme cases, the affected area may have to be surgically removed (which can include amputation of a toe, or more, depending on the extent of the tissue affected).
Steps you can take to prevent or minimise the risk of developing foot problems if you have diabetes, include:
- If you smoke, you should stop because smoking affects blood circulation - increasing your risk of developing serious foot problems.
- Keep your blood glucose under control, as well as keeping check on your blood pressure and cholesterol levels.
- Examine your feet every day to check for colour change, swelling, breaks in skin, pain or numbness.
- Clean both feet thoroughly with warm water and soap.
- Dry both feet, especially the space between the toes checking for cracks, swelling tenderness, inflammation or blisters.
- Moisturise dry rough skin, avoiding excess lotion in-between toes.
- Cut toe nails straight across keeping them at a comfortable length, using an emery board for sharp edges.
- Seek advice from a foot care specialist about treatment for any corns or calluses.
- Wear well-fitting shoes and socks, keeping your feet supported, protected, dry and warm.
- void walking barefoot.
If you have diabetes, you’ll be offered a yearly foot care check as part of your ongoing review by an appropriately trained healthcare professional (which may include your doctor, a nurse or your podiatrist).
What to expect at your yearly foot care check
Your feet will be examined to assess sensation and circulation, as well as your skin and toenail condition and any other problems, such as ulcers. Your footwear may also be reviewed.
Your healthcare professional will then calculate the level of risk of developing foot problems in future. If your risk is high you’ll be referred on to appropriate healthcare professionals, who’ll follow up with you more frequently.
Those involved in your ongoing foot care, could include:
- Diabetologists with expertise in lower limb complications
- Surgeons with expertise in diabetic foot problems
- Diabetes nurse specialists
- Tissue viability nurses
- Nurses trained in dressing diabetic foot wounds
If have diabetes and are concerns about your feet, see your GP immediately.
Visit the AXA PPP healthcare Diabetes Health Centre for more information.
Diabetes.org.uk – Taking care of your feet
NICE - Diabetic foot problems: prevention and management
Society of Chiropodists and Podiatrists