How Diabetes Can affect Your Feet: What Everyone Should Know

Diabetes affects millions of people worldwide and can have a significant impact on many parts of the body, including the feet. While many people associate diabetes with blood sugar levels, fewer realise how it can affect the nerves, circulation, skin and the body's ability to heal.

For many people, the feet are where the first signs of complications appear. Fortunately, many serious problems can be prevented through regular foot care, good diabetes management and early professional treatment.

WHY DOES DIABETES AFFECT THE FEET?  

Over time, high blood sugar levels can damage the small blood vessels and nerves throughout the body. The feet are particularly vulnerable because they are the furthest part of the body from the heart and are exposed to daily pressure, friction and minor injuries.  

The two main complications that affect the feet are:

 Peripheral neuropathy (nerve damage)

Poor circulation (peripheral arterial disease)

These conditions can occur separately or together, increasing the risk of infection and delayed healing.

PERIPHERAL NEUROPATHY - WHEN THE NERVES BECOME DAMAGED.

One of the most common complications of diabetes is peripheral neuropathy, a condition in which the nerves in the feet become damaged.

Healthy nerves allow us to feel pain, temperature, pressure and touch. When nerves are damaged, these sensations become altered or may disappear altogether.

Symptoms may include:

Tingling or "pins and needles"

Burning sensations

Sharp or shooting pains

Numbness

Reduced ability to feel heat or cold

Increased sensitivity to touch

A feeling of walking on cotton wool

Some people experience severe pain, while others lose sensation almost completely.

This loss of feeling can be dangerous because a person may not notice:

A small cut

A blister

A stone inside a shoe

A burn from hot water

An ingrowing toenail

Without treatment, these minor injuries can develop into more serious problems.

ITCHING AND DRY SKIN.

Many people with diabetes notice that their feet become unusually dry or itchy.

High blood sugar can reduce the skin's natural moisture, while nerve damage may affect the sweat glands. As a result, the skin becomes dry, rough and less flexible.

Persistent scratching can damage the skin, allowing bacteria or fungi to enter.

Applying an appropriate moisturising cream every day can help keep the skin healthy. However, cream should not be applied between the toes, where excess moisture may encourage fungal infections.

CHANGES IN SKIN COLOUR.

Changes in the colour of your feet should never be ignored.

You may notice:

Pale skin

Bluish or purple colouring

Redness

Darkened areas

Shiny skin

These changes may indicate reduced blood flow, pressure, inflammation or infection.

Any sudden or unexplained colour changes should be assessed by a healthcare professional.

POOR CIRCULATION.  

Diabetes increases the risk of narrowing and hardening of the arteries, reducing blood flow to the feet.

Signs of poor circulation may include:

Cold feet

Pale or bluish skin

Slow-growing toenails

Loss of hair on the feet or lower legs

Pain in the calves when walking

Slow healing of cuts or blisters

Good circulation is essential because it delivers oxygen, nutrients and infection-fighting cells needed for healing.

WHY WOUNDS HEAL MORE SLOWLY.  

Even a small cut may take much longer to heal in someone with diabetes.

This happens because:

Blood supply may be reduced.

White blood cells do not fight infection as effectively when blood sugar levels remain high.

Nerve damage means injuries may go unnoticed.

Pressure from walking continues to damage the area.

A wound that would heal within days in a healthy person may persist for weeks without proper care.

INFECTION.  

Because healing is slower, bacteria have more opportunity to enter damaged skin.

Signs of infection include:

Redness

Swelling

Warmth

Pain (although pain may be reduced if neuropathy is present)

Pus or discharge

An unpleasant smell

Fever or feeling generally unwell in more severe cases

Prompt treatment is essential, as infections can spread quickly.

DIABETIC FOOT ULCER.  

A foot ulcer is an open wound that develops when the skin breaks down.

Ulcers often develop because several factors occur together:

Loss of sensation

Poor circulation

Repeated pressure

Ill-fitting footwear

Delayed healing

Many ulcers begin as something very small—a blister, a cracked heel or a minor cut.

Because neuropathy reduces pain, people may continue walking on the injured area without realising the damage is worsening.

Early treatment greatly improves healing and reduces the risk of serious complications.

NAILS PROBLEMS.  

People with diabetes are more likely to develop nail problems, including:

Thickened nails

Fungal nail infections

Ingrowing toenails

Curved or distorted nails

These conditions may increase pressure on the surrounding skin and create opportunities for infection.

Professional nail care is often safer than attempting to manage thick or difficult nails at home.

LOOKING AFTER YOUR FEET EVERY DAY.  

Simple daily habits can make a significant difference.

Check your feet every day, including between the toes.

Wash your feet in warm (not hot) water.

Dry them carefully, especially between the toes.

Moisturise dry skin, avoiding the spaces between the toes.

Wear clean socks and well-fitting shoes.

Never walk barefoot, even indoors.

Cut your nails carefully or seek professional help if they become thick or difficult to manage.

Contact a healthcare professional promptly if you notice any wounds, blisters or signs of infection.

WHEN SHOULD YOU SEEK PROFESSIONAL ADVICE?  

Arrange an assessment as soon as possible if you notice:

Loss of feeling in your feet

Persistent tingling or burning

A blister, cut or wound that is not healing

Redness or swelling

Changes in skin colour

Thick or ingrowing toenails

Cracked heels that bleed

Any sign of infection

Early treatment can often prevent more serious complications.

Final Thoughts

Your feet carry you every day, so they deserve the same attention as the rest of your health. By recognising changes early and seeking advice when needed, you can reduce the risk of complications and help keep your feet healthy, comfortable and active for years to come.