Having diabetes can feel overwhelming. There’s a lot to pay attention to – like checking your blood sugar, taking medication, getting regular check-ups, and keeping active.

But did you know you should pay attention to your feet too? It’s true. With diabetes, high blood sugar levels can cause nerve damage, and the feet and legs are most often affected.

It’s important to keep your feet healthy, catch any problems before they become serious, and promptly seek medical help if you notice any issues that aren’t getting better.

We caught up with Dr. Craig Herman, the Director of Podiatry at Community Healthcare Network, to learn more about the connection between diabetes and foot health, and for some tips on steps you can take to stay healthy and avoid serious complications.

Feeling no pain? That’s a problem

About half of people with diabetes will develop some type of nerve damage because high blood sugar levels can cause the nerves in your body to not work properly.

“When you have diabetes for a long time, such as greater than 10 years, or if your diabetes is out of control, your feet may start to lose the ability to feel pain and temperature,” says Dr. Herman. “This is called diabetic peripheral neuropathy.”

Imagine not noticing you’ve been cut because you can’t feel it. Avoiding pain might sound nice, but pain is there for a reason. It’s telling you that something’s wrong and that you should pay attention.

• Pay close attention to the health of your feet so you can catch any issues before they turn serious.
• A serious foot problem might begin as something small – like a little cut or sore. If the wound doesn’t heal properly and an infection sets in, part of the foot, the whole foot, or even part of the leg, might eventually need to be amputated (removed with surgery).
• If an area appears red, swollen, warm, if you feel pressure in the area, or if it’s giving off a bad odor, seek attention urgently – usually within one to three days.
• If you have deep a wound or open sore on the foot, it may be a foot ulcer. If it gets infected, the infection can spread to other areas of the foot and even infect the bone or get into the blood system.

“It’s important to identify an ulcer as early as possible,” says Dr. Herman. “If you have good circulation and the problem is found in its early stages, it can usually be cured quickly. However, the longer you wait, the more severe the ulcer is, and if your circulation is poor, the ulcer can take a long time to heal and lead to amputation.”

Build a daily foot care routine

Practicing good self-care can go a long way to avoiding serious foot problems that diabetes can cause.

• Check your feet daily, even if don’t feel there’s anything wrong. Remember, nerve damage might cause you to lose feeling. You might have a problem and not know it.
• Look carefully for cuts, bruises, sores, redness, swelling – anything out of the ordinary – including changes to the skin or nails. A small cut might not look like much, but it could turn into something serious if untreated, so don’t ignore it.

Dr. Herman says it’s most important to keep the damaged area clean and covered.

“Don’t let the air dry it out,” he says. “The wound should be cleaned with water and antibacterial soap, then dried, treated with an over-the-counter antibiotic ointment, and kept covered.”

• Be thorough. Use a hand-held mirror to check those hard-to-see spots – or ask someone, such as family member, for help.
• If a wound doesn’t show signs of infection – such as redness, swelling, and increased pain – but it isn’t healing, see a doctor within one to two weeks. You should ideally see a podiatrist, but your primary care provider, an urgent care clinic, or an emergency department is ok if you’re concerned.

Know your risk factors

Anyone with diabetes can develop nerve damage, but these factors increase your risk:

• Blood sugar levels that are hard to manage
• Having diabetes for a long time, especially if your blood sugar is often higher than your target levels
• Being overweight
• Being older than 40 years
• Having high blood pressure
• Having high cholesterol

Steps you can take to stay healthy

There are several simple, yet effective things you can do to protect your feet.

• Don’t go barefoot – even when indoors. There’s a much greater chance of injury.
• Wear shoes that fit well. If they feel too loose or too tight, there’s more risk they’ll damage your feet. Wear socks too.
• Wash your feet daily. But avoid soaking your feet or scrubbing them with soap. Dry your feet well – including between your toes – immediately after washing.
• Trim your toenails regularly. Smooth out any sharp edges and create a straight line along the top of the nail.
• Stay active. This will help to keep blood flowing to your feet.
• Have your feet checked as part of your regular physical exams. Your doctor or healthcare provider will notice any issues and act if needed. The frequency of how often you should have them checked depends on your risk level.
  • Low risk. If you have no physical problems, good circulation, no loss of feeling, and your blood sugar is in control, you should be seen once a year for an evaluation.
  • Moderate risk. If you have good circulation, your diabetes is controlled, and you have feeling in your feet, but you have medical problems that require more attention, more frequent visits – such as once every three to six months – may be needed.
  • High risk. You should be seen at least every three months, possibly more often if you have any or all the following problems:
    – uncontrolled diabetes
    – loss of feeling in your toes or feet
    – poor circulation in your feet
    – a history of amputation or foot ulcers
    – other health problems

Remember, having diabetes doesn’t mean you’ll develop foot problems – or that you’ll lose your feet. By practicing good self-care, knowing what to look for, and staying in close contact with your doctor or healthcare provider, you can do your part to keep your feet healthy.