The Foot  Care-team

• Chief Consultant Diabetologist                            

• Clinical coordinator Diabetes foot care clinic,

• Senior Consultant Surgeons

• Vascular Surgeons

• Orthopedic Surgeons

• Plastic Surgeons

• Physiotherapists

• Junior Residents in Diabetes

• Diabetes foot care nurse

• Nutritionists, Clinical Dieticians and Diabetes Educator

How can diabetes hurt my feet?

High blood sugar from diabetes causes two problems that can hurt your feet:

1. Nerve damage. One problem is damage to nerves in your legs and feet. With damaged nerves, you might not feel pain, heat, or cold in your legs and feet. You might let a sore or cut on your foot get worse because you do not know it is there. This lack of feeling is called diabetic neuropathy (ne-ROP-uh-thee). It can lead to a large sore or infection.

2. Poor blood flow. The second problem happens when not enough healthy blood flows to your legs and feet. Poor blood flow makes it hard for a sore or infection to heal. This problem is called peripheral (puh-RIF-uh-rul) vascular disease. Smoking when you have diabetes makes blood flow problems much worse.

These two problems can work together to cause a foot problem.

For example, you get a blister from shoes that do not fit. You do not feel the pain from the blister because you have nerve damage in your foot. Next, the blister gets infected. If blood sugar is high, the extra sugar feeds the germs. Germs grow and the infection gets worse. Poor blood flow to your legs and feet can slow down healing. Once in a while a bad infection never heals. The infection might cause gangrene (GANG-green). If a person has gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

To keep gangrene from spreading, a doctor may have to do surgery to cut off a toe, foot, or part of a leg. Cutting off a body part is called an amputation (amp-yoo-TAY-shun).

What are common diabetes foot problems?

Anyone can have corns, blisters, and athlete's foot. If you have diabetes and your blood sugar stays high, these foot problems can lead to infections.

Corns and calluses are thick layers of skin caused by too much rubbing or pressure on the same spot. Corns and calluses can become infected.

• Blisters can form if shoes always rub the same spot. Wearing shoes that do not fit or wearing shoes without socks can cause blisters. Blisters can become infected.
   

• Ingrown toenails happen when an edge of the nail grows into the skin. The skin can get red and infected. Ingrown toenails can happen if you cut into the corners of your toenails when you trim them. If toenail edges are sharp, smooth them with an emery board. You can also get an ingrown toenail if your shoes are too tight.
   

• A bunion forms when your big toe slants toward the small toes and the place between the bones near the base of your big toe grows big. This spot can get red, sore, and infected. Bunions can form on one or both feet. Pointy shoes may cause bunions. Bunions often run in the family. Surgery can remove bunions.
   

• Plantar warts are caused by a virus. The warts usually form on the bottoms of the feet and tend to go away without treatment.
   

• Hammertoes form when a foot muscle gets weak. The weakness may be from diabetic nerve damage. The weakened muscle makes the tendons in the foot shorter and makes the toes curl under the feet. You may get sores on the bottoms of your feet and on the tops of your toes. The feet can change their shape. Hammertoes can cause problems with walking and finding shoes that fit well. Hammertoes can run in the family. Wearing shoes that are too short can also cause hammertoes.
   

• Dry and cracked skin can happen because the nerves in your legs and feet do not get the message to keep your skin soft and moist. Dry skin can become cracked and allow germs to enter. If your blood sugar is high, sugar feeds the germs and makes the infection
   

• Athlete's foot is a fungus that causes redness and cracking of the skin. It is itchy. The cracks between the toes allow germs to get under the skin. If blood sugar is high, the sugar feeds the germs and makes the infection worse. The infection can spread to the toenails and make them thick, yellow, and hard to cut.
   

• All of these foot problems can be taken care of. Tell your doctor about any foot problem as soon as you see it.