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The science behind how diabetes affects your feet

The high blood sugar levels associated with diabetes can affect your circulation and damage the sensory, motor or autonomic nerves in the body. Nerve damage is known as neuropathy, and the feet are often the first part of the body to be affected.  

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 that control activities that 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.

Poor circulation

Diabetes may also affect your 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 may have problems with cuts and sores, as your feet will be less able to heal well. You may also suffer from cramp and pain in your legs and/or feet as a result of poor circulation. 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.

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