_{^{NHS LOTHIAN | PODIATRY SERVICE}}

Diabetes & Feet

Having diabetes means you need to take extra care of your feet.

With the right daily routine, most serious foot problems can be prevented.

How diabetes affects your feet

Diabetes can affect your feet in two main ways – and often both at the same time.

Nerve damage (neuropathy)

Diabetes can damage the nerves in your feet over time, reducing your ability to feel pain, heat or pressure. This means you may not notice a cut, blister or pressure sore forming.

Signs to look for:

• Numbness, tingling or burning in your feet
• Feeling like you are walking on a pebble
• A wound or sore you did not know was there

Why this matters: A small injury you cannot feel can quickly become a serious problem if not spotted and treated early.

Poor circulation

Diabetes can narrow the blood vessels that supply your feet, reducing blood flow. Poor circulation means wounds heal more slowly and infections can take hold more easily.

Signs to look for:

• Leg pain or cramping when walking
• Cold or pale feet
• Wounds that are slow to heal

Why this matters: Even a minor cut or sore can become infected and difficult to heal if blood flow to your feet is poor.

Foot ulcers

Diabetic foot ulcers are open sores that typically develop on the foot. They are often caused by a combination of factors, including poor circulation, neuropathy (nerve damage), footwear and trauma.

Signs to look for:

• A break in the skin that does not heal
• Redness or swelling around an area
• Fluid, pus, or discharge

Why this matters: Foot ulcers can become infected very quickly. If untreated, infection can spread, leading to:

• Cellulitis
• Sepsis
• Permanent tissue damage
• In severe cases, amputation

If you notice a wound or break in the skin, cover it with a clean dressing and contact your podiatry team or GP urgently.

Your risk level

When you are seen by our team you will be placed into one of three categories. This helps us make sure you get the right level of care.

If you are moderate or high risk, your podiatry team will discuss what this means for you and how often you should be seen.

Daily foot care

The single most important thing you can do is check your feet every day. Because nerve damage may mean you cannot feel an injury, looking is your early warning system.