Diabetic foot care

When diabetes affects the nerves and blood flow in your feet, even small injuries can turn into bigger problems that make walking and daily activities uncomfortable or difficult. Diabetic foot problems develop gradually, but with the right care, you can protect your feet and stay active. Novant Health's foot and ankle specialists take time to listen to your concerns and build a personalized plan to keep you moving.

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Medical illustration showing layers of foot anatomy including skin, blood vessels, muscles and bones.

Anatomy of the foot

Healthy feet depend on two things working well together: nerves that sense problems and circulation that heals minor injuries. Nerves in your feet alert you to pressure, heat or pain, while blood vessels deliver oxygen and nutrients that repair damaged tissue.

Diabetes can dull sensation and reduce blood flow to the feet. This makes injuries, like a small cut or blister, easier to miss and slower to heal. Without this normal protection and repair, skin can break down more easily under pressure, especially in areas like the soles, heels and toes that already take on more weight or friction.

Overview

Symptoms

You may have diabetic foot problems if you notice:

Numbness, tingling or burning in your toes or feet
Cuts, blisters or sores that are slow to heal
Redness, swelling or warmth in one area
Thick calluses, especially on the heel or ball of the foot
Changes in foot shape or shoes that no longer fit comfortably

These symptoms often develop gradually and can be easy to overlook. Checking your feet regularly can help you catch changes early and seek care sooner.

Causes

Several factors can contribute to diabetic foot problems, including:

Nerve damage (neuropathy): Reduces feeling in your feet, making injuries easier to miss
Poor circulation: Slows healing and limits oxygen delivery to tissues
Foot deformities: Conditions like bunions or hammertoes can create areas of increased pressure
Dry skin and calluses: Cracks in the skin can become entry points for infection
Shoes that don't fit right: Can cause rubbing and blisters, especially when sensation is reduced
High blood sugar: Can affect the body's ability to heal and fight infection

Risk factors

Your risk of developing diabetic foot problems may be higher if you have:

Diabetes that has been difficult to manage over time
A history of foot ulcers or previous foot surgery
Poor circulation or peripheral artery disease
Existing nerve damage in your feet or legs
Foot deformities or a history of wearing poorly fitted shoes

Having one or more of these risk factors doesn't mean you'll develop diabetic foot problems. Understanding your personal risk helps your care team recommend the right prevention plan for you.

Diagnosis

Our foot and ankle specialists take time to understand how diabetes is affecting your foot and ankle health. Your visit may include an exam of your skin, nails and areas of pressure, testing for sensation, reflexes and circulation, and a review of your footwear and how you walk.

If we need a closer look at bones or soft tissues, we may also use imaging like X-rays or ultrasound. We walk through the results with you, answer your questions and explain what they mean for your care.

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We offer leading-edge treatments for most foot and ankle conditions, treating many with medications, bracing and injections.

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