Diabetic Neuropathy: How It Affects Your Feet

Foot problems are common in people with diabetes. Here’s what you need to know.

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If you have diabetes, you’re probably aware that foot problems can be a common complication of the disease. While it’s scary to think about the most serious foot complications, such as amputation, it may ease your mind to know that by managing your blood sugar and taking good care of your feet, you can dramatically lower your risk of diabetes-related foot problems.

How Diabetes Affects Your Feet

“Foot problems are common in people with diabetes because it boils down [to] elevated blood sugar. Blood sugar elevations prevent nerves from transmitting signals in the manner in which they should,” says Minisha Sood, MD, an endocrinologist in New York City.

Over time, this causes nerve damage, also known as diabetic neuropathy. “If nerves don’t function well, people with diabetes can’t feel pain [and] they can’t feel when their feet are being damaged, says Dr. Sood. “If they can’t feel when their feet are being damaged, they can get a cut that might get infected, or an ulcer that might get infected, and they only know about it when it’s too late.”

Diabetes can also cause decreased blood flow to the feet. Not having enough blood flow to your legs or feet can make it hard for a sore or an infection to heal, which may lead further complications, including gangrene, or the death of body tissue due to lack of blood flow. People with diabetes also have an increased chance of developing foot sores, called diabetic ulcers. Gangrene and foot ulcers that do not get better with treatment can ultimately lead to amputation.

Signs of Diabetic Nerve Damage

Patients who have diabetic neuropathy may feel a pins-and-needles sensation, burning, or numbness in the legs or feet. “Some patients are severely numb and some patients just start to lose just a little bit of sensation in their feet,” says podiatrist William Spielfogel, DPM, chief of the division of podiatry at Lenox Hill Hospital.

“You could live a very long time with neuropathy, but the problem is, if you’re walking and you have a lack of sensation, you’re not feeling what’s going on at the bottom of your foot, and you can wind up with a serious condition which can leave to an amputation,” says Dr. Spielfogel.

How to Lower the Risk of Diabetes Foot Problems

If you have diabetes, managing your blood sugar levels is the most important thing you can do to prevent foot problems, says Dr. Sood. It’s also essential to pay attention to and care for your feet. “Address little cuts, scrapes, and cracked skin areas early, and don’t let them fester and collect bacteria, because that can turn into infection,” she says. To care for your feet properly, follow these foot care tips for people with diabetes and take care to avoid blisters and soothe cracked heels.

People with diabetes should see a podiatrist at least once a year, even if they don’t show signs of foot problems. “If you have complications, if you have peripheral neuropathy, or if you have peripheral vascular disease, you should be seeing a podiatrist on a more regular basis,” says Dr. Spielfogel. “It’s really just as a preventative measure because we want to avoid the complications of diabetes, such as ulceration of these non-healing wounds and amputations.”