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Diabetes mellitus (DM) is a disease associated with increased glucose, or sugar, in blood vessels. High blood sugar can damage blood vessels, causing vascular disease, and can damage nerves, causing neuropathy. Individuals with vascular disease have re- duced blood flow that can impair healing. Individuals with neuropathy have difficulty sensing pain and pressure, which can lead to skin and subcutaneous (below the skin) damage where nerves are affected. Neuropathy and vascular disease often affect the feet and can lead to the following problems:

  • Corns and calluses, or areas of thickened rough skin
  • Blisters caused by friction and a collection of fluid
  • Ulcers, or open sores, that can extend to the deeper tissues of the foot
  • Cellulitis, or infection of the skin and subcutaneous tissue
  • Osteomyelitis, or infection of the bones
  • Amputation, or the surgical removal of toes, a foot or portions of the leg
  • Charcot foot, a condition associated with weak bones that can break

Individuals with DM types 1 and 2 should have a foot exam performed by their family doctor or a foot doctor, known as a podiatrist, at least once per year. During this visit, the doctor will examine the skin and bones, assess the function of the nerves using different tools, and feel for the strength of blood flow through arteries. In addition, they may help you trim your toenails and treat the problems listed above if found. In between visits, you can keep your feet healthy by:

  • Examining your feet daily for cuts, sores, blisters, warm spots, redness and thickened skin
  • Wearing shoes and socks, both outdoors and indoors
  • Wearing comfortable shoes that are supportive and “breathable”
  • Washing feet daily with soap and warm water not exceeding 95°F (35°C)
  • Smoothing corns and calluses as recommended by your doctor
  • Trimming toenails straight across, following the shape of the toe
  • Taking all medications and checking blood sugars as advised by your doctor
  • Not smoking
  • Exercising and eating healthy

Foot problems associated with DM can greatly impact your life and can cause further issues down the road. Following the advice of your doctor and the recommendations listed above can prevent or delay these problems. If you have concerns about DM or your feet, please contact your doctor.

RESOURCES

  1. Diabetes and foot problems. National Institute of Diabetes and Digestive Kidney Diseases. Updated January 2017. https://www.niddk.nih.gov/health-information/ diabetes/overview/preventing-problems/foot-problems

  2. Foot complications. American Diabetes Association. https://www.diabetes.org/diabetes/ complications/foot-complications

  3. Wexler DJ. Evaluation of the diabetic foot. Uptodate.com. Updated September 23, 2021. https://www.uptodate.com/contents/evaluation-of-the-diabetic-foot