If you have diabetes, which is also called diabetes mellitus, it is important to be aware of early signs and symptoms as there are a few early-stage diabetes symptoms that can show up on the ankles and feet.
These can include swelling, redness, numbness, or pain in the legs, ankles, or feet.
If they are left untreated, these problems can lead to serious complications such as infection, gangrene, and even amputation.
In this article, we will discuss the early warning signs of diabetic foot and leg problems and what you can do to prevent them.
What is diabetes?
Diabetes is a chronic condition that affects the way your body metabolizes blood sugar also known as glucose. There are two main types of diabetes: type 1 and type 2, and each has unique causes.
Type 1 diabetes, also known as juvenile diabetes, is when your body does not produce enough insulin due to your immune system attacking the insulin-producing cells in your pancreas. Insulin is a vital hormone that helps your body convert blood glucose into energy.
Type 2 diabetes, which is the most common form of diabetes, occurs when your body does not produce enough insulin or is unable to properly use the insulin it does produce because your cells have developed insulin resistance.
The causes of insulin resistance can be due to genetics, being overweight, or having a sedentary lifestyle.
If either form of diabetes is left untreated, it can lead to serious complications such as heart disease (cardiovascular disease), kidney failure (renal failure), and stroke.
What are the symptoms of diabetes?
The early symptoms of diabetes can often go unnoticed.
Some early symptoms of diabetes include:
- Increased thirst
- Frequent urination
- Fatigue
- Blurred vision
- Increased hunger
- Slow healing wounds
- Mood swings or feeling more irritable
- Weakness
- Unexplained weight loss
- Increased risk of infections
If you experience any of these symptoms, it is important to contact your doctor for a correct diagnosis and treatment.
What causes diabetic legs, ankle, or foot problems?
Diabetic legs, ankle, or foot problems are normally caused by two different diabetic complications.
One common cause is diabetic neuropathy, also called peripheral neuropathy, which is damage to your nerves due to high blood sugar levels.
The damage can lead to numbness or pain in the extremities.
If you lose sensation in your legs or feet and you receive a cut or sore that turns into a foot ulcer, it may be difficult to notice and is at risk of becoming infected.
Poor circulation due to peripheral artery disease is another common cause of diabetic leg, ankle, and foot problems.
Peripheral artery disease, also known as peripheral vascular disease or peripheral arterial disease, is when plaque builds up in your blood vessels and narrows, causing poor blood flow to your extremities.
This can lead to pain, cramping, and also make it difficult for your wounds or sores to heal.
What are the warning signs of problems of diabetic foot or leg problems?
There are a few warning signs besides the symptoms listed above caused by peripheral artery disease and diabetic neuropathy that can indicate you are developing diabetic foot or leg problems.
These warning signs include:
- Foot or ankle swelling
- Ingrown toenails
- Fungal infections of your nails
- Foot odor
- Bunions
- Hair loss on your feet or legs
- Shiny skin that is smooth on your legs or feet
- Swollen feet
- Temperature changes in your feet such as cold feet or hot feet
- Lack of sweating in your feet
There are also numerous skin conditions that can signify diabetes too and they include:
- Diabetic blisters
- Calluses
- Corns
- A change in the color of your skin, especially on your feet, including dark, velvety skin patches caused by acanthosis nigricans
- Sores on your legs or feet that will not heal called diabetic ulcers or diabetic foot ulcers
- Hammertoes
- Dry skin
- Necrobiosis lipoidica is a disease that starts as small red pimple-like bumps that turn into brown, reddish, or yellow patches on your skin
- Hardening of the skin caused by digital sclerosis that normally happens on your fingers or hands, but can happen on your feet, legs, and ankles too in rare cases
- Skin infections such as the fungal infection athlete’s foot or bacterial infections
- Diabetic dermopathy which are shin spots that look like age spots but are harmless and go away on their own
- Eruptive xanthomatosis is a skin condition that starts as red bumps that look like pimples and then turn yellow and normally occur on the back of the knees, buttocks, thighs, and the crook of your elbows
- Red, pink, or bluish purple bumps caused by granuloma annulare
If you have any of these symptoms of skin conditions, please see your doctor or dermatologist for treatment.
Are there any complications caused by diabetes that affect the feet, ankles, or legs?
The problems caused by diabetes can also lead to some serious complications if left untreated.
The most frequent complications of diabetes are:
Charcot foot
Also called neuropathic arthropathy or Charcot arthropathy, Charcot foot is a diabetic foot complication that causes the progressive destruction of the joints and bones in the feet and ankles due to diabetic neuropathy.
As the condition progresses, the joints start to break down which leads to joint destruction while your bones can break causing deformities to develop.
Charcot foot also leads to a higher risk for ulcers and infections.
Infections
Skin and bone infections are common complications of diabetes due to the numbness that can develop in your extremities from diabetic neuropathy.
If the infections are left untreated, they can lead to gangrene and amputation.
Gangrene
Gangrene is the death of tissue due to a lack of blood flow.
If you have diabetes you are at a higher risk for developing gangrene because of the peripheral artery disease that can narrow your blood vessels and reduce blood flow to your extremities.
Gangrene usually starts as a wound, sore, or infection that does not heal.
The tissue then starts to die and can turn black or green. If gangrene is left untreated it can lead to amputation.
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Amputations
The most common type of amputation is the partial or total removal of a toe, foot, or leg.
Amputations are usually caused by gangrene or severe infections that do not heal.
Abscesses
An abscess is a pus-filled pocket that forms under the skin.
They are usually caused by an infection, but can also be caused by an injury or foreign object.
Abscesses are normally drained by your doctor or health care provider but sometimes they need to be removed along with bone or soft tissue.
Deformities
Besides bunions, hammertoes, and Charcot foot, there are other foot deformities that can be caused by diabetes.
Claw feet, when the joint on a toe closest to your ankle is bent upwards, and mallet toes, which is when the joint closest to your nail on your toes is bent, are all deformities caused by diabetes.
Prominent metatarsal heads which are the bones on the balls of your feet can also happen.
Finally, you may also suffer from pes cavus which is a condition where the arch of your feet will not flatten even when you put weight on it.
What are the best ways to control your diabetic foot, ankle, and leg problems?
The best way to prevent diabetic foot and leg problems is to monitor and manage your blood glucose levels.
Besides this, other preventative measures you can take to keep your legs and feet healthy are:
- Quit smoking
- Exercise regularly
- Eat a healthy diet
- Check your feet every day for cuts, sores, blisters, redness, or swelling
- Wash your feet every day with warm water and mild soap
- Dry your feet well, especially between your toes
- Apply moisturizing cream daily to your feet and any dry skin after washing and drying
- Trim your toenails regularly straight across and file down any sharp edges to avoid ingrown toenails
- Wear shoes that fit well and protect your feet
- Never go barefoot, even inside your house
- See your doctor or podiatrist regularly and schedule foot exams, especially if you have any foot problems
- Do not expose your feet to very high or very low temperatures
- Wear socks or stockings always
- Smooth corns or calluses with a pumice stone
If you are experiencing any diabetic foot, ankle, or leg problems, the best thing to do is to see your doctor right away as early treatment can help prevent serious complications from developing.
Summary
Diabetes can lead to a number of problems in the feet, legs, and ankles with diabetic neuropathy and peripheral artery disease being the main causes for most of them.
If left untreated, high blood sugar levels can lead to serious complications including amputation making it important to see your doctor at the first sign of any problems.
The best way to prevent these problems is to monitor and manage your blood glucose levels as well as take other preventive measures that we list above.
If you have any more questions regarding diabetes and the problems it causes with your legs and feet, please talk to your doctor, health care provider, or podiatrist.
References and sources:
Mayo Clinic
American Academy of Dermatology Association
WebMD
Cleveland Clinic
CDC
Healthline
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.
Erik Rivera is a co-founder of Diabetic.org and has been an e-commerce Entrepreneur for over 10 years since he retired from Special Forces after graduating from the Naval Academy. He also is the founder of Health Ramp Services, a company that brings new medical device companies to market. He has founded several digital businesses and has had a number of successful exits in e-commerce as well as software. His OnePet business is a leader in the online Pet Care space by creating and delivering high quality products and services for pet owners.