Foot problems are associated with persistently high blood glucose levels. Therefore, it is important to keep blood glucose levels consistently within the normal range as this alone helps prevent many of the complications of diabetes, including foot problems.

1. Nerve damage
2. Blood vessel damage
3. foot shape
4. self-care

1. Nerve damage

Nerve damage in the legs causes:

• numbness
• coldness of the legs
• a tingling, pins and needles sensation in the feet
• burning pains in the legs and feet, usually more noticeable in bed at night.

This can lead to a loss of sensation in the feet, causing accidental damage because the person cannot feel any pain.

This can develop into ulcers on the bottom of the feet that can penetrate to the bone, leading to osteomyelitis and chronic infection in bones and joints.

This may necessitate amputation if not treated vigorously from the earliest time of infection, ulceration or the slightest discharge in the feet or toes.

Numbness or tingling plus a pins and needles sensation in the hand is more often due to compression of a nerve as it runs through a bony tunnel in the wrist, a condition relieved by a simple operation. This problem is relatively common in people with diabetes.

Nerve damage is detected by testing for different types of sensation in the feet and legs and by testing the knee and ankle reflexes.

Examine your feet at least every second or third day.

If you have nerve damage in the feet, do not walk barefooted and do wear properly-fitted shoes that rub neither feet nor toes.

Also known as clogging or narrowing of the arteries, this condition means that less blood is able to flow through the blood vessels.

If the feet lack a healthy supply, they are more prone to infection following any injury that breaks the skin. Avoid dryness and dry skin cracks with regular use of a moisturizing cream.

Signs of poor blood supply:

• sharp leg cramps after walking short distances or up stairs
• pain in the feet, even at rest (often in the early hours of the morning)
• feet feeling cold
• feet looking a reddish-blue colour
• cuts which are slow to heal

See your podiatrist, doctor or diabetes educator if you have any of these symptoms.

Some people’s feet do not work properly and become an odd shape; others inherit an unusual foot shape. People with diabetes with misshapen feet and nerve damage are the most likely to:

• develop ulcers from too much pressure over some areas of the feet
• develop more corns and calluses due to too much pressure on one area and can be avoided with some changes.

Seek your podiatrist’s help to get rid of calluses or corns before they become ulcers as these can become infected, risking the leg.

Do the following daily:

• wash your feet well and dry gently

• moisturise with a suitable cream

• check for trouble spots such as redness, swelling, cuts, pus discharge, splinters or blisters, being especially careful to look between toes, around heels and nail edges and at the soles of the feet – if you have difficulty with your vision you will need someone to check for you

• cover your feet with a clean sock or stocking without rough seams

• protect your feet in a shoe which fits well and has been checked for stones, pins, buttons or anything else which could cause damage.

• It is risky for anyone with poor blood circulation or limited sensation to cut their own nails. Thick or ingrown nails need special podiatry care.

• Nails need to be cut straight across, not too short and never down the sides. File rough edges with an emery board.

• If you find an injury

• wash and dry the area
• apply good antiseptic
• cover with a sterile dressing
• if it does not improve within 24 hours, seek help to avoid complications.