Why do people with diabetes need to check their feet?

Pauline Shipley, MD
Endocrinology Diabetes & Metabolism
People with diabetes are at risk for diabetic neuropathy, a loss-of-pain sensation in their feet. The pain comes from damage to the nerves caused by diabetes. So a cut, sore, or ulcer can become a bigger problem quickly. People with diabetes are also at risk for decreased circulation. Their skin also tends to be drier. People with diabetes should examine their feet to look for blisters, dry skin, calluses and changes in the shape of the foot near pressure points. They should also see a podiatrist at least twice a year for general foot care.
People with diabetes need to check their feet often because cuts and other injuries to the foot could lead to infection and, in extreme cases, make it necessary to amputate. Neuropathy, which is nerve damage, can cause numbness, making it harder to feel pain or discomfort from minor wounds, such as a blister due to poor-fitting shoes or cracks in dry skin. Poor circulation resulting from diabetes can slow down healing, putting feet at high risk for ulcers that can become infected. If these aren't treated in time, gangrene may develop. That, too, can lead to amputation.

If you have diabetes, look at your feet every day. Check for blisters, cuts, swelling, calluses and red spots. Use a mirror to see the soles of your feet or ask someone else to help. Be sure your doctor examines your feet, too, at every appointment. If you notice problems, see your doctor or a foot specialist (a podiatrist).
People with diabetes are at greater risk for developing limb-threatening ulcers or wounds. The problem is often worsened by nerve damage (diabetic neuropathy), which occurs in half of all people with diabetes and diminishes their ability to feel pain. As a result, many people with diabetes sustain foot wounds or injuries without knowing it and wait too long to treat their condition.

“If you’re a diabetic, you should be checking your feet regularly to identify potentially serious problems” and also have regular evaluations by a specialist, says podiatrist Robert K. Lee, DPM, a member of the multidisciplinary team of experts at the UCLA Center for Wound Healing and Limb Preservation.

“In the last 10 to 20 years, we’ve seen an explosion of technology that enables us to better tailor wound care to the needs of each patient,” Dr. Lee says. Unfortunately, “sometimes patients seek help so late in the process, they already risk losing a foot or a toe,” says vascular specialist Peter Lawrence, MD, director of the Gonda (Goldschmied) Vascular Center. Any wound that fails to heal within 30 days should be evaluated by a multidisciplinary team of wound-care specialists, Dr. Lawrence says.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.