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What Is Diabetes and How Does It Affect Your Feet?

Diabetes is a serious condition characterized by high blood sugar levels that can lead to blood flow and nerve issues.  The tiny nerves and blood vessels in our feet and toes are especially vulnerable to complications from diabetes.  

The two main complications affecting the feet (which can lead to a myriad of other issues) are: 

  1. Diabetic Neuropathy:  Diabetes causes nerve damage, which can lead to loss of sensation in the legs, feet and toes. This means if you injure your foot, you wouldn’t notice it right away.  The nerve damage can also affect the way we use the muscles in our feet, which can lead to misalignment, injury and other foot conditions.
  2. Peripheral Vascular Disease:  The accumulation of sugars in the bloodstream causes poor blood circulation.  Poor circulation makes it difficult for wounds in our feet to heal, and can lead to infection. 

As a result, common foot problems can lead to serious complications. In severe cases, infections in the feet may lead to gangrene and possibly amputation of the infected areas.  

Constant monitoring and specialized foot care from a foot specialist is essential for diabetes patients.  A chiropodist can help you keep your feet healthy:  they will check for adequate circulation, signs of neuropathy, risk for foot ulcers, and manage any nail and skin concerns.  


Signs and Symptoms

In people with diabetes, common foot problems can cause serious complications.  Even seemingly small and normal issues require the attention of a foot specialist.  

Diabetes can cause the following complications and symptoms in the feet:

  • Loss of sensation (Diabetic Neuropathy
  • Foot Infection
  • Foot Ulcers
  • Musculoskeletal Dysfunction
  • Gangrene
  • Amputation  

Contact your doctor or foot specialist immediately if you have diabetes and your feet display any of the following signs and symptoms: 

  • Skin or nail changes (i.e., a new callus, blister, or ingrown toenail)
  • Colour change
  • Temperature change
  • Swelling
  • Tingling or burning
  • An open or infected sore


How Does Diabetes Cause Foot Complications?

Diabetes is a disease of the pancreas.  The pancreas is responsible for producing insulin, a hormone that lets our body break down glucose (sugars) from food and convert it to energy.  In diabetic patients, the pancreas does not work properly.  This causes a chain reaction throughout the body, as our organs rely on the energy from glucose to function.  The chain reaction leads to poor circulation (Peripheral Vascular Disease) and nerve damage (diabetic neuropathy).  

Diabetic neuropathy can cause loss sensation to the limbs and feet.  This is problematic because pain is our body’s way of telling us something is wrong so that we can fix it: if we lose feeling in our feet from diabetic neuropathy, it means we may not notice if there’s something wrong that needs attention.  

On top of that, diabetes patients don’t have enough blood flow to their feet due to Peripheral Vascular Disease.  Good blood flow is required to stimulate our body’s healing process and immune response – without it, the feet’s ability to heal from wounds is compromised. That means otherwise benign issues that typically go away on their own, like a callus or sore, cannot heal properly and may become infected.  

The compromised immune system of diabetes patients has difficulty fighting off these infections.  If the infection grows, it can cause gangrene (tissue death) and foot ulcers (open sores on the feet).  If these get worse, it can lead to irreparable damage in the foot, which can lead to amputation and even death.  

In rare cases, nerve damage from diabetes can also change the feet (i.e.: Charcot’s foot). This occurs when the bones and toes in the feet shift and break as a result of compensating for nerve damage.  The shifting and breaking of the bones affects the shape of the feet.


How Do I Treat Diabetic Foot Complications?

Foot problems for diabetes patients can be a “double whammy”. This is because:  1) Diabetes makes you more vulnerable to developing complications from seemingly harmless foot issues (like a cut or scrape); and 2) You may not even notice these issues when they arise due to diabetes’ effect on your ability to feel sensation in your feet. 

Therefore, in order to manage and prevent complications in your feet, it’s important to be proactive and seek treatment from a foot specialist on a regular basis, ideally before issues arise.   

Treatment for diabetes-related pain and complications affecting the feet may include:

  • Diabetic foot care by a foot specialist:  A licensed chiropodist will check for adequate circulation, any signs of neuropathy, risk for foot ulcers, and manage any nail and skin concerns. They will also properly trim your nails and treat any calluses or corns (just like a medical pedicure, but specially catered toward diabetes patients). Routine diabetic foot care will ensure your feet are on the right path to proper foot health by managing existing problems as well as detecting issues early on and treating them in their early stages.  It also reduces the risk of accidental cuts, nicks and irritation that can occur at a nail salon, or when you do it yourself – with diabetes, you can’t afford those risks.  
  • Advice on proper footwear:  Orthopaedic footwear is specially constructed for people with diabetes by having fewer seams and added cushioning. This alleviates pressure points on the feet, which reduces the risk of developing corns calluses and blisters. A foot specialist can help you find the solutions that work best for you. 
  • Custom orthoticsThese are constructed specifically for your feet and can accommodate any deformities resulting from diabetes.  They can also help correct the effects of diabetic neuropathy on the muscle function in your feet by adjusting your gait and encouraging biomechanically friendly movement.  
  • Wound care, including wound debridement and application of proper dressings to facilitate healing and manage or prevent infection:  This can be tended to with care by a chiropodist
  • Diabetic foot education:  A foot specialist can provide you with information about how to manage and prevent the effects of diabetes on your feet.  You can also check out this article on diabetic footcare. 
  • Prescribe medication if indicated

Putting your feet in the hands of a healthcare professional is one of the best ways to treat, manage and prevent the effects of diabetes on your feet.

To schedule a diabetes foot exam, click the “Book Appointment” button at the top of this page or call 416-769-FEET(3338). You do not need a physician’s referral.

Risk Factors

What Can Cause Diabetic Foot Complications?

Certain risk factors may increase your chances of diabetic foot complications:

  • Poor blood glucose control
  • Poor hygiene
  • Receiving nail care from nail salons that do not use sterilized instruments
  • Lack of routine foot care and maintenance
  • Foot injury
  • Wearing ill-fitting shoes, i.e.: shoes that are too tight
  • Lack of awareness or failure or seek diabetic foot education from a licensed chiropodist
  • Other foot and joint related disorders (i.e.: arthritis)


How Do I Prevent Complications?

Promptly identifying and treating skin and toenail problems is critical for preventing complications.  With routine and diligent footcare and foot monitoring, you can reduce your risk of serious complications or prevent them entirely. 

Prevention measures include:

  • Routine foot assessments by a foot care specialist that includes a thorough examination that checks for and treats:
  • Wash (not soak) your feet daily with warm, soapy water
  • Dry your feet thoroughly after bathing or taking a shower – do not forget in between the toes
  • Check your feet daily for injuries
  • Moisturize your feet if they become dry to prevent cracking
  • Trim your toenails once per month – if you cannot safely trim your nails, schedule a diabetes nail care appointment with one of our practitioners
  • Wear closed-toe orthopaedic shoes with a roomy toe-box, flexible fabric upper, and soft breathable lining to minimize rubbing and pressure against the skin of your feet.  This will reduce your risk for developing blisters, calluses, and corns
  • Avoid wearing sandals and walking barefoot:  Diabetes can turn a small cut into a big deal.
  • Wear moisture-wicking socks to control sweat levels that might exacerbate athlete’s foot or blister-causing friction
  • Wear white socks:  This makes it easier to notice blood or other signs of broken skin

Diabetic care products, including orthopedic shoes, creams, and foot device, are available in our Toronto foot clinic.

Prevention is paramount to managing the effects of diabetes on your feet.  Putting your feet in the hands of a healthcare professional is one of the best, proactive ways to prevent diabetic complications. To schedule a diabetic foot assessment with our licensed Chiropodists (foot specialists), click the “Book Appointment” button above or call 416-769-FEET(3338) – no referral needed!

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Carolina Charles

Patient Relation Coordinator (She/Her)

If you’ve been to the clinic before, chances are you had the pleasure of meeting Carolina! Carolina’s daily goal is going above and beyond to make sure patients are always completely satisfied. Having worked in the podiatry industry for 22 years, Carolina brings a wealth of knowledge pertaining to client service, insurance policies, and procedures.​ She steers the ship to make sure everything runs smoothly on the daily. Carolina is known for spicing up every outfit with her signature costume jewellery.