D4S_1668_LargeDiabetes is a world wide epidemic. In recent years, the incidence of diabetes has increased dramatically.

Diabetes can have severe effects on the whole body, however early signs of change can be identified in the feet.

It is recommended that every diabetic patient have a vascular and neurological assessment of their feet every year.

This is to diagnose and establish any possible changes and prevent them becoming more serious.

At The Walking Clinic, we pride ourselves on having the latest technology in assessment and diagnosis of conditions of the feet and lower limb. This gives the best possible understanding and assessment of your feet.

The comprehensive assessment involves many different aspects from blood flow assessment, sensory perception assessment and a gait analysis.

What is diabetes?

Diabetes is a condition in which the amount of glucose (sugar) in the blood is too high because
the body is unable to use it properly. This is because insulin is lacking or the body’s way of
making glucose into energy is not working properly.

There are two common forms of diabetes:

Type 1 is also know as insulin dependent diabetes. This usually starts in children and young
adults. People with this type of diabetes require daily insulin injections.

Type 2 is the most common and usually affects people over the age of 40 years.  People living with type 2 diabetes may be managing their condition with any combination of diet, exercise, oral or injectable medications.

How diabetes can affect your feet

Your feet are supplied with blood to keep them healthy. They also have lots of nerves as a
warning system. For example, if you have a stone in your shoe, nerves will send a message to
your brain.

However, if your diabetes is poorly controlled for a long period of time, this may lead to:

  • Nerve damage which reduces feeling in the feet, and/or
  • Poor circulation

Nerve damage may mean that you no longer notice the stone in your shoe, due to loss of feeling
in your feet. This could then lead to an injury you can’t feel, and possibly infection.

If you have poor circulation, any injuries or infection affecting your feet (i.e. cuts, burns or
scratches) will take longer to heal. This is due to less blood flowing into your feet. Blood
provides energy to muscles and aids in healing any tissue damage.

If you have poor circulation, you will need to take extra care to protect your feet from injury.

Most foot problems in people who have diabetes occur when injuries – and often infections –
go unnoticed and untreated, or when healing is delayed due to poor circulation.

How can I detect any changes early?

A six monthly check by your podiatrist will help to detect any changes early – before they
become a problem.

Your podiatrist will examine your circulation by feeling foot pulses. They will also examine
sensation by testing reflexes, vibration and pressure sensitivity, and other tests may be
conducted as necessary.

Your podiatrist will also look for general foot conditions which may lead to future problems.
They will work with you to show you how to monitor your own feet in between consultations.

To prevent problems

  • Protect your feet from injury
  • Inspect your feet every day (your podiatrist can show you how)
  • See your podiatrist immediately if something is not healing or you find a red swollen area

As a general guide

  • Maintain recommended blood sugar levels
  • Don’t smoke
  • Exercise regularly
  • Avoid barefoot walking
  • Keep your feet clean
  • Wear well-fitting shoes
  • Cut and file nails carefully, or seek regular care from a podiatrist if you can’t reach, see or operate clippers confidently
  • Have corns, calluses and other foot problems treated by a podiatrist
  • Seek your podiatrist’s advice if you have any foot concerns

Footwear advice

The best type of footwear fits well and protects your feet. Wherever possible, wear shoes to
avoid injury to your feet.

Some other pointers:

  • Where possible, wear lace-up shoes which are deep and broad enough, especially at the toes
  • Check inside your shoes for rough edges or exposed tacks – shake them out to make sure
    there is nothing inside
  • Cotton hosiery, socks and tights, worn with leather upper shoes are good choices.


  • Altered sensations may be indicated by numbness in the feet. Cuts, blisters, ingrown toenails
    and corns may go unnoticed
  • Reduced blood supply (poor circulation) can slow down the healing process
  • PROTECT your feet from injury
  • INSPECT your feet everyday
  • Have a REGULAR foot assessment

Text reproduced with permission from the Australasian Podiatry Council