Diabetes and foot problems

Diabetes mellitus is a chronic disease affecting nearly 16 million Americans. Diabetes is caused by the body’s inability to regulate blood sugar. Diabetes mellitus can have a variety of serious impacts on a person’s vascular health. Diabetes puts people at higher risk for cardiovascular disease. It often leads to serious problems in the feet through the development of nerve damage (neuropathy) and/or poor circulation (peripheral arterial disease, or PAD).

People with diabetes should check their feet daily and have their feet examined regularly by a physician. The following are symptoms that may indicate developing neuropathy or peripheral arterial disease (PAD):

• Dry skin and thickened nails
• Loss of sensation in the feet
• Hammer toes
• Bunions
• Weak or absent pulses in the lower legs or feet
• Blister or pressure spot that the person does not feel
• Sores or ulcers that do not heal

To prevent foot problems, patients with diabetes should:

• Check feet daily
• Have feet examined by a physician at least once a year
• Wear shoes with a wide toe box
• Wash feet daily
• Wear socks and shoes at all times
• Keep skin soft and smooth with emollients
• Control blood sugar levels
• Protect feet from exposure to cold and heat
• Exercise regularly

The treatment of diabetic neuropathy of the feet focuses on controlling blood sugar to prevent progression of the nerve damage, treating any existing sores to prevent infection and preventing the recurrence of sores through the use of special shoes. Nerve damage cannot be reversed.

See peripheral arterial disease (PAD) for treatments for poor circulation.