Diabetic foot care: Recognize early signs to prevent potential problems

Dr. Bennett performs a foot examination on a patient at Des Moines University Foot and Ankle.
Dr. Bennett performs a foot examination on a patient at Des Moines University Foot and Ankle.

Diabetes is a complicated disease that leads to a host of secondary complications. Some of the most common problems occur in a strange place: your feet. An estimated 15 percent of all diabetics will develop a serious foot condition in their lifetime — some with little or no warning.

“Diabetic patients may not notice any early symptoms. A lot of times, they’re not going to complain of pain because they have nerve damage,” says John Bennett, D.P.M., FACFAS, Des Moines University Foot and Ankle clinician and associate professor in the DMU College of Podiatric Medicine and Surgery. “Understanding what you should and shouldn’t be looking for really helps prevent complications from occurring.”

A daily visual inspection of the feet is critical to managing your health. Diabetes weakens the immune system, so your body may not respond to infection the same as someone who’s not diabetic. By the time you do see symptoms, the problem is probably much worse than you think. Bennett recommends looking for these signs of foot problems in your daily examination:

  • Changes in skin color – Redness in the skin may be a sign of infection, darkened skin may mean that tissue has died and blue skin may mean poor blood flow.
  • Drainage, bleeding or odor – White or yellow fluid, blood and odor are sure signs of infection.
  • Swelling – A swollen foot may be infected; it can also mean a fracture, which can lead to more serious conditions.
  • Toenail infections – A darkened, flaking or distorted toenail can mean you have a fungal infection. Toenails that are ingrown or too long or pointed can damage the surrounding skin, opening the door for bacteria to creep in.
  • Temperature changes – Poor blood flow can cause cool spots on your skin. Warm spots are yet another possible sign of infection.
  • Changes in feeling – Numbness, burning or tingling may signal nerve damage.
  • Dry or cracked skin – Dry skin easily cracks, allowing germs to enter. High blood glucose feeds the germs, making the infection worse. Dry skin may also occur because your nerves are not getting the message to keep your skin soft and moist.

“A lot of diabetics do end up with ulcerations and infections. Some of the organisms present in these infections are devastating, leading to the loss of soft tissue and, in some cases, a limb,” says Bennett. “These are things we like to prevent from occurring. If you see these signs or think you have an infection, it’s important to seek medical care.”