Diabetes is an incurable disease that is caused by high levels of sugar in the blood. There are two main types of diabetes – type 1 diabetes and type 2 diabetes.
Type 1 diabetes can develop at any age, but usually appears before the age of 40, particularly in childhood. Around 10% of all diabetes is type 1, but it's the most common type of childhood diabetes. In type 2 diabetes, the body either doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. Around 90% of adults with diabetes have type 2, and it tends to develop later in life than type 1.
People with diabetes are at much greater risk of developing problems with their feet, due to the damage the condition can cause to sensation and circulation. If left untreated, these problems can cause foot ulcers and infections and, at worst, may lead to amputations. However, most foot problems are preventable with good, regular foot care. You should make sure that you get a quality foot check from a properly trained person at least once a year.
There are two principal ways that diabetes can affect feet:
When diabetes causes nerve damage, doctors call it diabetic neuropathy. You can lose all feeling in your feet to the extent that you can damage them without knowing. For example, you may not feel a stone inside your shoe or pain from a blister on your foot. Since you won't feel cuts and sores, you might not notice them and they could get infected or develop into an ulcer.
Nerve damage can affect your sweat glands too and make your skin dry and tight. This can make your skin crack, which can feel sore and it may get infected.
Poor glucose control can also affect the circulation in your feet. This is called peripheral vascular disease and is when the arteries that supply your feet with blood get narrower. If your feet don't get a good supply of blood, cuts and sores don't heal very well. You can also get cramp and pain.
If you have both diabetic neuropathy and peripheral vascular disease, you can be at particular risk of foot infections. This is because you can injure your feet without knowing and these cuts and sores then don't heal. If hard skin builds up from putting pressure on it, a wound may form under the hard skin. Some people with diabetes get such bad infections that they need to have their toe, foot, or even a leg amputated.
The good news is that most problems can be prevented with regular care for your feet. The following are some tips on how to do this.
- Check your feet every day for any problems such as cuts, blisters or sores
- Wash your feet every day and dry them well, particularly between your toes. If you have dry skin, use lotion on your feet afterwards.
- Gently file corns and calluses (areas of thickened hard skin).
- Cut your toenails regularly.
- Wear slippers or shoes to protect your feet from getting injured – remember you might not feel any pain if you step on something sharp.
- Wear socks or tights to prevent blisters.
- Wear shoes that fit your feet well. If you have neuropathy or poor circulation, problems with your feet can get worse if you wear unsuitable shoes.