Diabetes and The Feet


Understanding the need to look after your feet when you have diabetes


What is diabetes?

The pancreas is no longer able to make insulin, or the body cannot make good use of the insulin it does produce.

Insulin enables glucose (sugar), from the food we eat to pass from the blood stream into the cells in the body to make energy.

Not being able to produce insulin or use it effectively can cause raised sugar levels (hyperglycaemia). Over the long-term high sugar levels can damage some tissues and organs in the body.

Type 1 diabetes is usually caused by an auto-immune reaction where the body’s defence system attacks cells that produce insulin. It can occur at any age, however it is more common in children or young adults. Injections of insulin to control sugar levels in the blood is required.

Type 2 diabetes occurs when the body is no longer using insulin efficiently. Sugar builds up in bloodstream and the cells are starved of energy. There may be a family history to developing type 2 diabetes or environmental triggers.

Diabetes and the feet come hand in hand (or foot in foot).


Every year, more than 4,400 amputations are carried out as a result of diabetes. (https://www.diabetesaustralia.com.au/national-diabetes-week). Foot complications with diabetes are becoming more prevalent. Prevention through education, understanding foot complications, signs and symptoms and regular assessment is required to prevent hospitalisation and risk of amputation.


Some foot concerns:

  • Nerve damage (peripheral neuropathy) and poor circulation in the feet (peripheral arterial disease).
  • Loss of feeling, tingling, burning sensation and numbness.
  • Poor healing, cramping.
  • Increase rate of infection.
  • Foot ulcers or sores that may have delayed healing.
  • Changes in shape which can cause an increase in pressure .
  • Hammer or claw toes, bunions, arthritis.
  • Charcot’s arthropathy.
  • A rare condition that occurs with good blood flow to the feet and numbness (peripheral neuropathy) – red, hot, swollen foot, rocker bottom foot.



Peripheral neuropathy explained

  • Insensitivity or loss of ability to feel; touch, pressure, vibration, pain, heat, cold or perception/position.
  • You may not realise you have a cut, blister, corn or footwear rubbing. The damage caused may not heal adequately, which may cause ulceration in some cases.
  • Check feet daily for cuts and redness and blisters etc.



Poor circulation explained

  • Reduced blood flow and nutrients to the feet
  • Swelling and dryness and impaired healing process
  • Cold feet
  • Painful calves when walking or at night in bed
  • Delayed or reduced healing rate in the feet
  • Improve – activity, avoid smoking, reduce caffeine
  • Control cholesterol and blood sugar levels



Regular podiatry and foot check-ups or assessments are an important part of preventative care for your feet to prevent serious complications. Diabetes assessment every 3-12 months and more regularly treatment for hard skin, corns and nail care is recommended. 



Quick and painless tests by your podiatrist include:

  • Vascular assessment with an ultrasound testing the amount of blood flow to the feet.
  • Neurological assessment testing sensation and your ability to feel.
  • Gait (Walking) assessment to assess any increase in pressure due to the change in foot shape.
  • Footwear assessment to ensure suitable footwear and fit.
  • Skin and nail care to prevent any ingrowing toenails, painful corns and pressure areas.



Preventing foot complications and self-managing tips

  • Control your blood sugar levels to reduce the risk of damage to your feet.
  • Keeping moving! Blood flow is important for healthy feet.
  • Stop smoking – smoking slows down blood flow to the extremities.
  • Check feet daily – with a mirror to observe for any cuts or red marks that require attention.
  • Good foot hygiene is important. Wash and dry your feet thoroughly daily.
  • Be careful with trimming toes nails and avoid cutting down the side.
  • Wear comfortable socks and shoes.
  • Get fitted professionally for shoes at the end of the day to reduce risk of poorly fitting shoes causing blisters.
  • Avoid uncomfortable or tight shoes that rub or cut into your feet.
  • Avoid high heels and pointed toes.
  • Look inside your shoes daily for any stones, or prominent lining to avoid rubbing against your feet causing blisters.
  • Avoid walking barefoot.
  • Wear comfortable socks that are a good fit and aren’t too tight.
  • Prevent dry skin by applying moisturise daily, avoid cream between the toes.
  • See a podiatrist regularly to trim off callous, remove corns and trim toenails.
  • Podiatry diabetes assessment.



In summary…

Of course not all foot problems will require a hospital visit, but they can vary from minor complications to wounds that won’t heal. Serious complications can be avoided through self-management and through regular check-ups.

Simple injuries such as corns, cuts, or callouses, when combined with loss of sensation in the feet can mean that these injuries go unnoticed. If untreated they may not heal due to lack of blood supply and infection can occur. Foot assessment by a podiatrist is recommended to establish your foot health status by determining the blood flow and sensation in your feet and identify any potential risk areas.


  • Look at your feet daily.