
Over time, elevated blood sugar, or severe fluctuations between high and low blood sugar can contribute to various changes that can affect your foot health, overall health, and risk or incidence of foot complications. Three main complications can occur in the feet when you have diabetes: peripheral vascular disease (PVD), diabetic neuropathy, and structural foot changes.
Peripheral Vascular Disease (PVD)
Peripheral Vascular Disease includes several conditions that affect the blood vessels located furthest away from the heart; primarily in the arms and legs. Since the blood vessels in the legs are also combating gravity, symptoms of PVD often begin in the feet and lower legs. Symptoms of PVD include:
- Heavy, achy feet or legs
- Numbness or tingling in the feet or legs
- Cold sensation in the feet, or a blue tint to the toes
- Leg cramps that worsen with activity
- Skin redness
- Slow to heal wounds, blisters or cuts
You can help to reduce your risk of developing PVD by managing your diabetes, maintaining a healthy weight and an active lifestyle, choosing healthy foods low in sodium, cholesterol and fat, and not smoking. Daily diabetic foot care at home can also help to identify a small change before it becomes a large problem.
Diabetic Neuropathy
Diabetic Neuropathy is a type of nerve damage that can occur when blood sugar is not well controlled or fluctuates too often. Depending on the affected nerves, symptoms can be very mild (nearly unnoticeable) or significantly disruptive (loss of sensation, pain or skin changes). Common symptoms of diabetic neuropathy include:
- Numbness, tingling or altered sensation in the feet, ankles or lower leg
- Changes in the condition of the skin or nails
- Reduced hair growth
- Increased sensitivity to touch
- Slow to heal wounds, blisters or cuts
Diabetic neuropathy is a common and serious complication of diabetes, but you can manage your risk and slow the progression of your symptoms with tight blood sugar control and a healthy diet and lifestyle.
Structural Foot Changes
Structural changes in the feet are another issue often encountered by people with diabetes. Over time, fluctuations in blood sugar, or prolonged periods of high blood sugar can damage not only the blood vessels and nerves but also other structures in the feet, leading to changes in the foot’s shape and function. Changes in foot shape often parallel the progression of neuropathy, with the changes in foot shape coinciding with progressive nerve damage. Once the motor nerves begin to be affected by neuropathy, how the muscles function within the foot is altered, resulting in changes in foot structure, shape, and movement. Prolonged or extensive damage to the motor nerves can cause tightening and reduced range of motion in some of the joints in the foot, resulting in an exaggerated arch and bony prominences in the forefoot.
Managing Foot Pain & Complications Associated with Diabetes
All complications, changes and conditions of the feet associated with diabetes can be managed with regular foot assessments performed by your healthcare provider, diabetes team, or foot specialist. These assessments will help guide recommendations for treatment depending on your individual needs. Depending on your personal health history, risk level and other individual factors, your healthcare provider may recommend foot assessments every 1, 3, 6 or 12 months.
The best way to manage your risk of foot complications is daily at-home foot care and regular foot health assessments such as your regular foot exam. Looking for more information on how diabetes affects your feet, or looking to book a foot assessment? We can help – contact our team of certified Pedorthists today.