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.

Circulation

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.

Steps you can take to prevent problems happening include:

• give up smoking
• keep your blood glucose, blood pressure and cholesterol levels as near normal as possible
• eat a healthy diet which is low in fat, sugar and salt, and high in fruit and vegetables
• make sure that your feet are not exposed to extremes of heat or cold
• take regular physical activity, for example a brisk walk each day
• make sure that your socks and shoes are comfortable and fit well
• check your feet daily, including in between your toes
• attend your annual foot review (for those over 12 years old)
• know your risk of developing foot problems
• Many people only see a podiatrist (chiropodist)* on a referral, so make sure you keep any appointments you re given.

Reviewed: February 2012
Next review: August 2013