Diabetes and Foot Health: Preventing Major Complications

Foot problems rarely make the top of the list when people think about managing diabetes. Blood sugar, diet, and medication tend to dominate those conversations. But diabetes does more damage to your feet than most people realize, and by the time that damage becomes visible, it’s often been building for a long time.

Narender Bharaj, MD, at Maryland Medical First P.A. in Parkville, Maryland, explains how diabetes affects your feet and what you can do before complications develop.

How diabetes damages your feet over time

Diabetes affects two systems your feet depend on: your nerves and your circulation. When blood sugar stays elevated over time, both take damage in ways that compound each other.

Nerve damage that hides injuries

Diabetic peripheral neuropathy develops when chronically high blood sugar damages the nerves that carry sensation to your feet and legs. The result is numbness, tingling, or a complete loss of feeling. 

A blister, cut, or area of irritation that a healthy person would notice immediately can go undetected for days, long enough for a minor problem to become an open wound.

Reduced circulation that slows healing

Diabetes accelerates the narrowing of blood vessels, reducing blood flow to your extremities. Poor circulation slows healing considerably. A wound that would resolve quickly in someone without diabetes can linger for weeks, creating a prolonged window for infection to take hold.

Losing sensation in your feet, along with the inability to heal efficiently, is what makes diabetic foot complications genuinely dangerous.

How small problems turn into foot ulcers

Foot ulcers are the most common serious complication of diabetic foot disease, affecting more than 15% of people with diabetes at some point in their lives. They don’t always start with a dramatic injury. 

A shoe that rubs in the wrong spot, a callus that breaks down under pressure, or a small cut that goes unnoticed can all develop into an open ulcer when neuropathy and poor circulation are present.

Ulcers on the bottom of the foot are especially common because pressure from walking concentrates in the same areas. Without sensation to signal that something is wrong, that pressure continues unchecked.

The link between foot ulcers and amputation

Diabetes is the leading cause of non-traumatic lower limb amputations in the United States, and a foot ulcer precedes the vast majority of those amputations. When an ulcer becomes infected and circulation is too poor to support healing, amputation may be the only way to prevent the infection from spreading.

Most amputations linked to diabetes are avoidable with early intervention and consistent monitoring.

Daily habits that protect your feet

Foot care doesn’t require much time, but it does require consistency. Patients with diabetes should:

• Inspect both feet every day, including the soles and between the toes
• Wash feet in lukewarm water and dry thoroughly, especially between the toes
• Moisturize dry skin, but avoid applying lotion between the toes
• Never walk barefoot, even indoors
• Wear properly fitting shoes with no seams or pressure points that could cause friction
• Trim toenails straight across to avoid ingrown edges

Any cut, blister, redness, swelling, or change in skin color warrants prompt attention rather than a wait-and-see approach.

Signs your diabetic foot problem needs a doctor’s attention

Patients with diabetes should have their feet examined at every primary care visit and receive a comprehensive foot evaluation at least once a year. Schedule an appointment sooner if you notice:

• A wound or sore that isn’t healing
• Numbness, burning, or tingling that’s new or worsening
• Skin that looks discolored or feels unusually cold
• Swelling in one foot that isn’t present in the other
• Any sign of infection, including warmth, odor, or discharge

Dr. Bharaj works with patients to manage blood sugar, monitor circulation, and address foot concerns before they become emergencies. If you have diabetes and haven’t had a recent foot evaluation, that’s a good place to start.

To schedule your appointment, call our office at 410-661-4670 or use our online booking tool.