Diabetic Foot Disease

Diabetic foot disease is a group of foot problems that can happen in people with diabetes.

High blood sugar levels over time can damage nerves and blood vessels in the feet. This can lead to loss of feeling, poor circulation, infections, and foot ulcers. If not treated early, diabetic foot disease can become serious.

Diabetic foot disease develops slowly due to long-term effects of diabetes.

It usually happens because of:

• Nerve damage (peripheral neuropathy), which reduces feeling in the feet
• Poor blood flow (peripheral arterial disease), which slows healing
• Foot injuries or pressure, such as cuts, blisters, or rubbing from shoes

Because feeling is reduced, small injuries may go unnoticed and can worsen over time.

The risk of diabetic foot disease is higher if you:

• Have had diabetes for a long time
• Have poor blood sugar control
• Have nerve damage or poor circulation
• Have had previous foot ulcers or amputations
• Smoke
• Have foot deformities or poorly fitting footwear
• Do not check your feet regularly

People with both diabetes and kidney disease or heart disease are also at higher risk.

Symptoms may be mild at first and can be easy to miss.

Common symptoms include:

• Numbness, tingling, or burning in the feet
• Loss of feeling or reduced sensation
• Dry or cracked skin
• Calluses or thickened skin
• Changes in foot shape

More serious signs include:

• Open sores or foot ulcers
• Redness, swelling, or warmth
• Infection or discharge
• Blackened skin (a medical emergency)
• Pain in the legs or feet when walking or at rest

If any of the above symptoms are present, it is important to check the circulation in your legs and feet.

Poor blood flow can delay healing and increase the risk of serious complications. If circulation problems are suspected, screening with a vascular specialist is recommended.

Specialist tests such as:

• Arterial duplex ultrasound, and
• Toe pressure studies

can help assess blood flow and identify circulation problems that may need treatment. These tests are available through Circulation Health Imaging.

Many foot problems can be prevented with regular care.

Steps to reduce risk include:

• Keep blood sugar levels within your target range
• Check your feet every day for cuts, blisters, or colour changes
• Wash and dry feet well, especially between the toes
• Moisturise dry skin (avoid between toes)
• Wear well-fitting shoes and clean socks
• Do not walk barefoot
• Have regular foot checks with a podiatrist
• Stop smoking

Treatment depends on how severe the problem is. Treatment may include:

• Wound care for foot ulcers
• Treatment of infection with medicines
• Special footwear or dressings to reduce pressure
• Improving blood flow with medication or procedures
• Regular care from a podiatrist and diabetes care team

In severe cases, surgery or hospital treatment may be needed.

See your GP, podiatrist, or diabetes specialist urgently if you notice:

• An open sore or ulcer
• Signs of infection
• Sudden colour changes in the foot
• Increasing pain, swelling, or redness

Early assessment and treatment can prevent serious complications.