Foot Problems and Diabetes: Causes, Signs and Care

If you want to learn about the common foot problems in diabetes and how to prevent them then you are in the right place. We will explore why diabetics are at high risk of foot problems, the signs to look for and the preventative strategies and treatment that are available.

Causes of diabetic foot problems

One of the long-term effects of raised blood glucose levels is that the small blood vessels in your feet can become damaged, preventing essential nutrients from reaching the nerves in your feet. When these nerves are damaged, you can lose sensation in your feet, suffer reduced blood supply and get cramps and pain in your legs and feet. If not addressed as a matter of urgency, the following conditions are likely:

Ulcers

Diabetics who have nerve damage in their feet are likely to experience foot injuries that, coupled with poor circulation, cause healing to slow and ulceration to become more likely. A foot ulcer is a painful condition that needs rapid intervention to prevent it from becoming infected. When diabetics begin to develop foot ulcers, rapid medical intervention is necessary as this is a prime indicator that they are also at greater risk of strokes and heart attacks as ulcers hint at vascular problems, such as plaque build-up in your arteries and blood clots.

Infections

For a diabetic, a minor skin irritation such as a rub from an ill-fitting shoe, a blister, cut or burn can quickly develop into a much more serious condition, especially as a loss of sensitivity may mean it is not identified and treated early enough to prevent an infection from setting in. Though many infections can be successfully treated with antibiotics, regular cleaning and dressing, there is a risk of amputation if the infection is deep set and cannot be controlled.

Toe problems

As the nerve damage progresses, your toes can be vulnerable to painful changes, including bunions and corns, but two other toe conditions frequently affect diabetics. These are hammer toe, where the toe joint begins to point upwards instead of lying flat, and claw toe, where the toes involuntarily clench into a claw shape.

Diabetic blisters

Diabetic blisters are usually painless but can be unsightly and uncomfortable, especially when they occur on the feet. They tend to affect diabetics with ongoing high blood glucose levels or who are already experiencing a level of nerve damage. Though they usually heal on their own, if they are popped, either intentionally or accidentally, there is a high risk of infection, so if the blister is particularly bothering you, you should speak to your GP about having it drained.

Early symptoms of diabetic foot problems

In order to understand the common foot problems in diabetes and how to prevent them, you must know what symptoms to look out for. The most common are:

1. A tingling sensation in your feet or cramps in your calves;
2. New foot pain, ranging from a dull ache to a burning pain;
3. A loss of feeling in your feet and legs;
4. Swollen feet;
5. Your feet stop sweating;
6. Minor wounds on the feet and legs won’t heal properly;
7. The skin on your legs and feet looks shiny and you experience hair loss.

If you are a diabetic and experience any of these symptoms, you should see your GP urgently to rule out diabetic foot problems and to begin treatment as quickly as possible.

Preventative strategies and treatment

Prevention is always better than cure, so it is important to take control of your diabetes and administer insulin as prescribed by your GP. You should also embrace a healthy diet and lifestyle, aiming to shed excess weight and increase your exercise. If you are a smoker, it is strongly recommended that you quit, as smoking increases your risk of many other medical conditions, as well as interfering with your diabetes treatment.

You should check your feet daily and take note of any changes in temperature and sensation, as well as making sure that any wounds heal as expected. Finally, you must attend your annual diabetic foot check as this is an important part of managing foot-related diabetic conditions.

##FAQs

Where can I find more information about common foot problems in diabetes and how to prevent them?

The Diabetes UK website is full of useful information about all aspects of diabetes and is a recommended source of impartial and up to date information.

Can I have a shower when I have a diabetic foot ulcer?

You must not get your dressing wet as this can slow down healing and potentially even aggravate the ulcer if bacteria get in. Your healthcare professional may be able to provide you with a waterproof dressing protector to use in the shower, or you could take a bath with your foot elevated out of the water. Rest and elevation are important to support healing, so unless you have been advised otherwise, take every opportunity to keep your foot up, even in the bath.

How often should I engage with a healthcare professional about my feet?

Diabetics who are at risk of developing a foot problem will be categorised as low, medium or high risk. Low risk individuals can usually self-monitor and attend their annual review with little to no other intervention necessary. Medium risk individuals will be referred to the foot protection service who will determine an appropriate monitoring schedule, usually being seen in person every 3 to 6 months. High risk individuals will be seen as often as weekly, depending on their specific needs.