Diabetes and Foot Problems

1. Diabetic Peripheral Neuropathy Slideshow
2. Diabetes and Foot Problems Slideshow
3. Diabetes Quiz: Test Your Medical IQ

Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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• Two main conditions, peripheral artery disease (PAD) and peripheral neuropathy, are responsible for the increased risk of foot problems in people with diabetes.
• People with diabetes have an increased risk of ulcers and damage to the feet.
• A number of different kinds of foot problems can occur in people with diabetes. These include bunions, corns, calluses, hammertoes, fungal infections, dryness of the skin, and ingrown toenails.
• Treatment depends on the exact type of foot problem. Surgery may be required for some cases.
• Gangrene (dry gangrene) is tissue death due to absence of blood circulation. It can be life-threatening if bacterial infection develops (wet gangrene).
• Many diabetes-related foot problems can be prevented by good control of blood sugar levels combined with appropriate care of the feet.

Both type 1 and type 2 diabetes cause damage to blood vessels and peripheral nerves that can result in problems in the legs and feet. Two main conditions, 1) peripheral artery disease (PAD), and 2) peripheral neuropathy are responsible for the increased risk of foot problems in people with diabetes.

• Peripheral artery disease (PAD), sometimes referred to as peripheral vascular disease (PVD), means that there is narrowing or occlusion by atherosclerotic plaques of arteries outside of the heart and brain. Diabetes is a known risk factor for developing peripheral artery disease. In addition to pain in the calves during exercise (intermittent claudication), the signs and symptoms of peripheral artery disease relate to a decreased delivery of oxygen to the lower legs and feet. In severe cases, the lack of oxygen delivery to tissues can result in ulcers and even gangrene (tissue death).
• Peripheral neuropathy refers to damage to the peripheral nerves directly as a result of diabetes. Symptoms of peripheral neuropathy include decreased sensation in the nerves of the legs and feet, making it difficult to perceive injuries due to lack of feeling. It can also cause the muscles of the feet to work improperly, leading to misalignment of the foot that can put pressure on certain areas of the foot.