Diabetes can cause a number of changes and problems in your feet. High blood sugar levels over time can damage the nerves and blood vessels in your feet leading to various foot complications. Some of the common things you may notice with your feet if you have diabetes include dry skin, cracked heels, bunions and corns, ingrown toenails, fungal toenail infections, poor circulation, numbness, tingling and pain in the feet. Diabetes also increases your risk of foot ulcers and infections that can be severe. Knowing what diabetes does to your feet and getting regular foot exams and care can help prevent serious problems.
Dry, Flaky Skin
One of the first things you may notice is dry, flaky skin on your feet. High blood sugar causes dryness by damaging nerves that control oil and moisture. The skin on your feet can become very dry and peel or crack easily without enough moisture. Dryness leads to itching, flaking, cracking, and calluses on the heels and balls of the feet. Thick calluses under the foot are common with diabetes. Using moisturizing creams and lotions daily helps keep your feet from becoming too dry.
Cracked Heels
Extremely dry, cracked skin on the heels is also common with diabetes. The heels bear a lot of pressure and friction which causes the skin to thicken and split. Deep heel cracks that bleed or don’t heal can become infected easily. To prevent cracking, use a daily moisturizing foot cream and wear socks to keep your feet protected. If you get cracks, apply petroleum jelly and cover them before bed. See your doctor promptly for any heel cracks that won’t heal.
Bunions and Corns
People with diabetes often develop bunions, corns and calluses due to pressure points on the feet. Nerve damage can cause changes in the shape of your feet over time leading to bunions. Tight shoes rub against bunions causing pain and corns which are thick, hardened areas of skin. Calluses form as a response to friction. Wearing properly fitted shoes with enough room for your toes can help prevent bunions and corns from worsening.
Ingrown Toenails
Ingrown toenails are more common with diabetes. When the edges of the nail grow into the surrounding skin instead of over it, it causes pain, redness, swelling and infection. Poor circulation and nerve damage raise your risk. Prevent ingrown toenails by cutting your nails properly straight across and avoiding rounded edges. See a podiatrist for stubborn ingrown nails to remove the edge or part of the nail.
Fungal Nail Infections
Fungal infections under and around the nails are also more prevalent with diabetes. Yeast and fungi can more easily enter tissues when blood sugar is high. Signs include thickened, discolored, brittle nails that may separate from the nailbed. Oral and topical antifungal medications can treat fungal infections. Keeping your feet clean and dry helps prevent fungal growth.
Poor Circulation in the Feet
Over time, elevated blood sugar damages the nerves and blood vessels in the legs and feet. Nerves help control blood flow. Uncontrolled diabetes leads to peripheral arterial disease, causing poor circulation. Your feet may feel cold, numb, or tingly. Hair growth on the feet and legs can decrease and wounds heal slowly. Exercise improves circulation to the feet. Quitting smoking is also important.
Numbness and Tingling
Nerve damage in the feet can cause numbness, burning, or stabbing pains. Decreased sensation means you may not feel minor cuts, scrapes or irritation that could lead to infection. Numbness can cause changes in your walking pattern that result in calluses and ulcers. Check your feet regularly for any injuries if they are numb. Notify your doctor about any new numbness or odd sensations in the feet.
Foot Ulcers and Amputation
One of the most serious complications is foot ulcers. Ulcers are open sores that can occur due to cuts or scrapes that go unnoticed or untreated minor injuries that progress due to poor circulation and high blood sugar. If an ulcer on the foot becomes infected, it can lead to tissue death and require amputation of the foot or part of it. Prevent ulcers by checking your feet every day and getting prompt care for any cuts, cracks, red spots or skin changes.
Charcot Foot
Charcot foot is a condition caused by severe nerve damage that can occur with uncontrolled diabetes. It causes weakness and even fractures in the bones of the foot without any injury due to loss of sensation. The foot may have a dramatic change in shape due to flattening of the arch or collapsing joints. Surgery may be needed for severe cases to stabilize the foot and prevent deformity. Using custom orthotic inserts or casts, immobilization for several weeks and specialized footwear can help treat Charcot foot.
Table 1. Common Foot Problems with Diabetes
| Foot Problem | Symptoms | Prevention and Treatment |
|---|---|---|
| Dry, cracked skin | Flaking, peeling, itching, thick calluses | Use moisturizing creams daily, avoid very hot water, wear socks |
| Cracked heels | Deep painful cracks in heel skin | Moisturize feet, apply petroleum jelly on cracks at night, get prompt care if not healing |
| Bunions/corns | Bony bumps, hard thick areas of skin from pressure points in shoes | Wear proper fitting shoes with wide toe box, use padding and bunion splints |
| Ingrown toenails | Painful, red, swollen toenail edges digging into skin | Cut nails properly straight across, see podiatrist for removal of ingrown edge |
| Fungal infections | Thick, brittle, discolored nails, separation from nailbed | Use antifungal creams or oral medication, keep feet clean and dry |
| Poor circulation | Cold feet, numbness, tingling, decreased hair growth, slow wound healing | Exercise regularly, don’t smoke, keep blood sugar in control, avoid tight socks |
| Foot ulcers | Open sore on foot, may drain pus, redness, pain | Check feet daily, get prompt care for any skin injuries, offload feet, keep blood sugar controlled |
| Charcot foot | Joint deformity, flattening of arch, weak bones leading to fractures | Immobilize and offload foot, specialized footwear, surgery if severe |
Conclusion
Diabetes can affect your feet in many ways, from dry cracked skin to more serious bone and joint problems. Pay close attention to your feet each day for any cuts, changes or signs of abnormal pressure points. Keep your blood sugar controlled, stay active, don’t smoke, and work closely with your doctor to have your feet evaluated and catch problems early. Getting the right foot care and well-fitting shoes can help you avoid major complications like ulcers and amputations. Check your feet every day and see your podiatrist regularly to keep your feet healthy.