If you are diabetic, having problems with your toes and feet is common.
It is important to be aware of the potential for foot problems that can occur over time due to your diabetes as it can cause a wide variety of issues, including nerve damage, poor circulation, and infection.
Left untreated, diabetic foot problems can lead to serious complications which we will detail below.
In this article, we will discuss the causes and complications of diabetic foot problems and also give you some tips for prevention.
What is diabetes?
Diabetes is a condition that affects your body’s ability to use blood sugar, also called glucose, for energy.
If you have diabetes, your body either doesn’t make enough insulin, which is a hormone that helps your body use glucose for energy, or can not use the insulin it does make effectively.
Both of these conditions can lead to elevated blood sugar levels which can cause severe complications if left untreated.
There are several common forms of diabetes including type 1, type 2, and gestational diabetes.
Type 1 diabetes is characterized by your immune system attacking the insulin-making cells in your pancreas while type 2 diabetes is marked by your body’s resistance to insulin.
Gestational diabetes is a form of diabetes that can develop during pregnancy and usually goes away after your baby is born.
How can diabetes cause foot problems?
Diabetes can cause many different foot problems.
The loss of feeling can make it difficult to feel injuries or blisters on your feet, which can lead to infections. Diabetic neuropathy can also cause changes in the shape of your feet and toes, as well as foot ulcers which are open sores that can become infected.
Besides diabetic neuropathy, the other common cause of foot problems with diabetes is peripheral vascular disease, also called peripheral artery disease, which is the narrowing of blood vessels that can lead to reduced blood flow to your feet.
Poor blood circulation can make it difficult for wounds to heal and also increases the risk of infection of cuts or foot ulcers.
What foot problems can be caused by diabetes?
As explained above, diabetes due to damaged nerves and poor circulation can cause or exacerbate many foot ailments. The most common foot problems caused by diabetes include:
Athlete’s foot
Athlete’s foot is a common fungal infection that can cause itchiness, redness, and cracking skin usually on your foot or in between your toes.
To cure it, you will need an antifungal medication available in pill form and in a cream or lotion.
Blisters
Diabetic blisters, also called bullosis diabeticorum or diabetic bullae, are large, fluid-filled blisters that can occur on your feet and lower legs.
These blisters are caused by a diabetic condition called diabetic dermopathy and usually don’t require treatment unless they become infected. In that case, you will need antibiotics.
Corns and calluses
Corns and calluses are thickened areas of skin that usually develop on your hands, feet, or elbows in response to friction or pressure.
They can be painful and make it difficult to walk or wear shoes.
Treatment usually involves removing the thickened, dead skin with a scalpel or pumice stone and then using padded shoe inserts to prevent them from returning.
Ingrown toenails
An ingrown toenail is a condition in which your toenail grows into the flesh of your toe instead of growing straight which can happen if you wear shoes that are too tight or if you trim your toenails incorrectly.
To correct this, you will need to soak your feet in warm water and gently push the nail back into place although in rare cases surgery may be needed. If the ingrown toenail is infected, you will need antibiotics.
Plantar warts
Plantar warts are growths on the bottom of your feet that are caused by the human papillomavirus (HPV) that can be painful and make it difficult to walk.
Treatment involves removing the wart with a scalpel or freezing it with liquid nitrogen. You can also try over-the-counter wart treatments but they often do not work well on plantar warts.
Bunions
A bunion is a deformity of the big toe in which the toe points outward instead of pointing straight ahead which can cause pain and difficulty walking and is usually caused by narrow shoes.
To combat bunions you can wear shoes that fit well and do not put pressure on the bunions as well as use over-the-counter pain relievers. In some cases, surgery may be needed to correct the deformity.
Ulcers
Diabetic foot ulcers are open sores that can develop on your feet and are a common complication of diabetes.
The open sore can be very painful and prompt medical care is necessary to help avoid infection.
Cleaning the ulcer and applying a dressing to it is the most common treatment for foot ulcers although you may also need antibiotics if the ulcer is infected.
In some cases, surgery may be needed to remove dead tissue from the ulcer.
Fungal infections
Fungal infections of the nails, also called onychomycosis, can cause your toenails to become thick, yellow, or brittle, and antifungal creams and medications are used to treat infected toenails.
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Dry skin
Dry skin can cause the skin on your feet to crack and become irritated.
You can help treat and prevent dry skin by using a moisturizer on your feet every day.
Hammertoes
A hammertoe is a deformity of the toe in which the toe points downward instead of pointing straight ahead which can cause pain and difficulty walking.
Treatment for hammertoes involves wearing shoes that fit well and that do not put pressure on the hammertoe as well as using over-the-counter pain relievers.
In some cases, surgery may be needed to correct the deformity.
What complications are caused by these diabetic foot problems?
The most serious complication of diabetic foot problems is amputation.
Diabetes is the leading cause of nontraumatic lower extremity amputations in the United States and often occurs due to untreated ulcers or foot injuries that become infected.
Other major complications of diabetic foot problems include deformities, infections, abscesses, and gangrene. Foot deformities can occur from diabetic neuropathy or peripheral vascular disease and can lead to pain, difficulty walking, and decreased mobility.
Charcot foot is a deformity that can happen to diabetics where the bones in the foot break and collapse due to loss of sensation from diabetic neuropathy.
Both skin and bone infections are common complications of diabetes and can be difficult to treat. Abscesses are also a complication of diabetic foot problems and usually occur when there is an infection present.
Finally, gangrene can develop in diabetic foot problems when there is not enough blood flow to the area and tissue dies. Gangrene can lead to amputation if it is not treated quickly.
What are the best ways to prevent foot problems with diabetes?
The best way to prevent diabetic foot problems is to manage your blood sugar levels which can be done through diet, exercise, and medication.
You need to have regular checkups with your doctor to look for foot problems and seek medical treatment when there are signs of foot problems.
It is important to clean your feet every day and inspect them for cuts, sores, or redness, and to trim your toenails regularly by cutting or filing in a straight line using your nail clippers or nail file.
Wearing comfortable shoes that fit well, are closed-toed, and that do not put pressure on your feet will also help as will wearing comfortable, dry socks every time you wear shoes to help promote adequate blood flow.
Avoid walking barefoot if possible to avoid injury and also avoid walking barefoot on any hot or cold surfaces such as hot sand or hot pavement.
Quitting smoking will also help improve blood flow to your feet and reduce your risk of diabetic foot problems.
Finally, it is beneficial to also use a fragrance-free moisturizer after you wash your feet on any dry skin on your feet or body to help treat or prevent any dry skin.
Summary
Many of the complications are caused by nerve damage or poor blood flow and the treatment options will vary depending on your problem.
The best way to prevent diabetic foot problems is to manage your blood glucose levels and see your doctor regularly.
You can also follow our health tips for prevention measures and foot care above to help avoid any problems and keep your feet healthy.
If you have any more questions regarding diabetes and foot problems, please talk to your doctor, health care provider, or podiatrist for a diagnosis or to discuss treatment plans.
References and sources:
WebMD
CDC
NIH
Diabetes.org
Cleveland Clinic
Fact Checked and Editorial Process
Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Jacqueline Hensler and medically reviewed by Dr. Angel Rivera.
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