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How Diabetes Causes Foot Problems

Overview

When you have diabetes, your feet need extra care and attention. Diabetes can damage the nerve endings and blood vessels in your feet, making you less likely to notice when your feet are injured. Diabetes also limits your body's ability to fight infection and get blood to areas that need it. If you get a minor foot injury, it could become an ulcer or a serious infection. With good foot care, you can prevent most of these problems.

Caring for your feet can be quick and easy. Most of the care can be done when you are bathing or getting ready for bed.

What increases your risk for problems?

Things that increase your risk for diabetic foot problems include:

Poor blood glucose control.

If your blood sugar levels are persistently above the target range, you are more likely to have foot problems.

Duration of diabetes.

The longer you have the disease, the greater your risk.

Other complications due to diabetes (small blood vessel disease, atherosclerosis of large vessels).

If you already have other diabetic complications, you are more likely to have foot problems.

Smoking.

Smoking contributes to circulatory problems in your extremities, increasing your likelihood of developing foot problems.

Peripheral neuropathy (damage to the nerves that control sensation and touch).

Peripheral neuropathy results in poor sensation in your extremities, increasing your likelihood of having foot problems.

How do problems start?

Foot problems in diabetes often begin with nerve disease (neuropathy). Neuropathy causes problems in your feet by damaging your nerves. This can make your feet numb and cause problems with the way you walk. These problems can harm your feet in the following ways:

  • Reduced feeling prevents you from sensing pain and realizing that your foot has been injured. If your vision has been affected by diabetic retinopathy or other eye problems, you may not see an injury or infection in your feet early. For example, you may have a blister and not know it because you don't feel any pain from it or don't see the blister. Without treatment, this injury can become infected.
  • Your feet are at risk for problems that arise from poor muscular control. If your nerves are no longer able to carry the correct motion signals to your feet and lower legs while you walk, your body may force your feet into unnatural positions as you move. Changing the way you walk increases your risk of getting foot ulcers and deformities. In fact, about half of all people with diabetes have a hammer toe or claw toe deformity or a Charcot foot deformity caused by an abnormal walk.

What can you do to help prevent problems?

Keeping your blood sugar under control and doing daily foot care can help you prevent foot problems from diabetes.

  • Keep your blood sugar close to normal by watching what you eat, monitoring your blood sugar, taking medicines if prescribed, and getting regular exercise.
  • Take care of your feet each day.
    • Wash your feet every day. Use warm (not hot) water.
    • Pat your feet dry, including between your toes. Do not rub the skin.
    • Check for blisters, cuts, cracks, or sores. If you have a foot problem, see your doctor. Don't try to treat a foot problem at home.
    • Use moisturizing skin cream to keep your feet soft. But don't put cream between your toes.
    • Change socks daily.
  • Have your doctor check your feet during each visit.

Credits

Current as of: March 1, 2023

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Karin M. Lindholm DO - Neurology