A diabetic foot is a foot that exhibits any pathology that results directly from diabetes mellitus or any long-term (or “chronic”) complication of diabetes mellitus.
Presence of several characteristic diabetic foot pathologies such as infection, diabetic foot ulcer and neuropathic osteoarthropathy is called diabetic foot syndrome.
Due to the peripheral nerve dysfunction associated with diabetes (diabetic neuropathy), patients have a reduced ability to feel pain. This means that minor injuries may remain undiscovered for a long while. People with diabetes are also at risk of developing a diabetic foot ulcer. Research estimates that the lifetime incidence of foot ulcers within the diabetic community is around 15% and may become as high as 25%.
In diabetes, peripheral nerve dysfunction can be combined with peripheral artery disease (PAD) causing poor blood circulation to the extremities (diabetic angiopathy). Around half of patients with a diabetic foot ulcer have co-existing PAD.
Where wounds take a long time to heal, infection may set in and lower limb amputation may be necessary. Foot infection is the most common cause of non-traumatic amputation in people with diabetes.
If you have diabetes, your blood glucose, or blood sugar, levels are too high. Over time, this can damage your nerves or blood vessels. Nerve damage from diabetes can cause you to lose feeling in your feet. You may not feel a cut, a blister or a sore. Foot injuries such as these can cause ulcers and infections. Serious cases may even lead to amputation.
Damage to the blood vessels can also mean that your feet do not get enough blood and oxygen. It is harder for your foot to heal, if you do get a sore or infection.
You can help avoid foot problems. First, control your blood sugar levels. Good foot hygiene is also crucial:
- Check your feet every day
- Wash your feet every day
- Keep the skin soft and smooth
- Smooth corns and calluses gently
- If you can see, reach, and feel your feet, trim your toenails regularly. If you cannot, ask a foot doctor (podiatrist) to trim them for you
- Wear shoes and socks at all times
- Protect your feet from hot and cold
- Keep the blood flowing to your feet
What can I do to keep my feet healthy?
Work with your health care team to make a diabetes self-care plan, which is an action plan for how you will manage your diabetes. Your plan should include foot care. A foot doctor, also called a podiatrist, and other specialists may be part of your health care team.
Include these steps in your foot care plan:
Tips to Take Care of Your Feet:
- Check your feet every day
- Wash your feet every day
- Smooth corns and calluses gently
- Trim your toenails straight across
- Wear shoes and socks at all times
- Protect your feet from hot and cold
- Keep the blood flowing to your feet
- Get a foot check at every health care visit
You may have foot problems, but feel no pain in your feet. Checking your feet each day will help you spot problems early before they get worse.
A good way to remember is to check your feet each evening when you take off your shoes. Also check between your toes. If you have trouble bending over to see your feet, try using a mirror to see them, or ask someone else to look at your feet.
Look for problems such as:
- Cuts, sores, or red spots
- Swelling or fluid-filled blisters
- Ingrown toenails, in which the edge of your nail grows into your skin
- Corns or calluses, which are spots of rough skin caused by too much rubbing or pressure on the same spot
- Plantar warts, which are flesh-colored growths on the bottom of the feet
- Athlete’s foot
- Warm spots
When should I see my health care provider about foot problems?
Call your health care provider right away if you have:
- A cut, blister, or bruise on your foot that does not start to heal after a few days
- Skin on your foot that becomes red, warm, or painful—signs of a possible infection
- A callus with dried blood inside of it,which often can be the first sign of a wound under the callus
- A foot infection that becomes black and smelly—signs you might have gangrene