People with diabetes are more likely to be admitted to hospital with a foot ulcer than with any other complication of diabetes. This is because diabetes may lead to poor circulation and reduced feeling in the feet. It is important to understand how foot problems develop and how they can be prevented or detected early so that they can be treated successfully.

How can diabetes affect your feet?

If it is poorly controlled, diabetes can damage nerves and blood vessels. Nerve damage is called neuropathy. There are three types of neuropathy, and they can all affect your feet:

Sensory neuropathy:

This affects the nerves that carry messages from the skin, bones and muscles to the brain and affects how we feel temperature, pain and other sensations. It is the most common form of neuropathy, mainly occurring in nerves in the feet and legs, and can lead to a loss of feeling and a failure to sense pain. This could mean that you might develop a blister or minor burn without realising it, which, if not treated properly, could become infected or develop into an ulcer.

Motor neuropathy:

This affects the nerves responsible for sending messages to the muscles about movements, such as walking. If the nerves supplying your feet are affected it could cause your feet to alter shape. Your toes may become clawed (curled)as your arch/instep becomes more pronounced or the arch may ‘fall’ causing flat feet. This can cause the bones in your foot to fracture (break) when stressed.

Autonomic neuropathy:

This affects the nerves which control activities which our bodies carry out all the time, which we have no control over. Damage to these nerves may affect your sweat glands, reducing secretions and making your skin dry and inelastic. If not looked after the skin may crack and become sore and prone to infection.



Diabetes may also affect the circulation by causing the arteries to become 'furred up' (artherosclerosis). This can affect all the major blood vessels, especially those supplying the feet. Without a good blood supply, you will have problems with cuts and sores, which do not heal very well, and as a result of poor circulation, you may also suffer from cramp and pain in your legs and/or feet. If your diabetes is poorly controlled, you run greater risk of poor circulation and the problems associated with a poor blood supply to your feet. High blood pressure; a high fat content in your diet and, in particular, smoking, all increase the risk of poor circulation.