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Diabetes and Leg Circulation: Warning Signs and How to Protect Your Feet
Leg pain, cramping, or a sore on your foot that will not heal can be more than a nuisance when you have diabetes. Diabetes can damage both the nerves and the blood vessels in your legs and feet, and over time that damage can lead to poor circulation, slow-healing wounds, and serious complications. The good news is that daily care can lower your risk.
How diabetes affects blood flow in the legs
Diabetes can lower the amount of blood flowing to your feet. When your legs and feet do not get enough blood, a sore or an infection has a harder time healing. In some cases a bad infection never heals and can lead to gangrene, and gangrene or foot ulcers that do not improve can lead to amputation of a toe, part of the foot, or part of the leg. Reduced blood flow is also linked to peripheral artery disease, a condition in which the arteries in the legs become narrowed or blocked. When blood flow is reduced, the foot has less ability to fight infection and heal.
Nerve damage and why you may not feel a problem
Over time, diabetes can also cause nerve damage called diabetic neuropathy. Neuropathy can cause tingling and pain and can make you lose feeling in your feet. If you lose feeling in your feet, you may not feel a pebble inside your sock or a blister on your foot. A small cut or sore can then become infected without you noticing. Nerve damage decreases your ability to feel pain, heat, and cold, which is why injuries on the feet can go unnoticed until the skin breaks and becomes infected.
Warning signs to look for
If you have diabetes, tell your health care team about any of these problems, especially if they appear with leg pain or cramping when walking:
- Cuts, sores, or red spots on the feet
- Swelling or fluid-filled blisters
- Leg pain or cramping that starts with walking and eases with rest
- Cold, numb, or tingling feet
- Skin on the legs that is smooth, shiny, or cool to the touch
- A sore that is slow to heal or lasts longer than 1 to 2 weeks
- Ingrown toenails, corns, or calluses
- Changes in the shape of your feet
Because many foot problems can be painless, checking your feet each day helps you spot trouble early before it gets worse.
How to protect your feet each day
Daily foot care is the single most effective way to reduce your risk of serious complications. These habits are recommended for anyone with diabetes.
Check your feet every day
Look at the tops, soles, sides, heels, and between your toes for cuts, sores, blisters, redness, or warm spots. If you cannot see your feet easily, use a mirror or ask someone to help.
Wash and dry carefully
Wash your feet with mild soap in warm (not hot) water and test the temperature first. Do not soak your feet. Dry them gently, especially between the toes, and apply lotion to dry skin without putting cream between the toes.
Smooth corns and calluses gently
Do not cut corns or calluses, and do not use medicated corn removers, which can damage the skin. Talk with your foot doctor about safe ways to care for them.
Trim toenails straight across
Cut toenails straight across and avoid cutting into the corners. If you cannot see, feel, or reach your feet, or if your nails are thick, have a foot doctor trim them.
Wear shoes and socks at all times
Never walk barefoot, even indoors. Wear well-fitting shoes with clean, lightly padded socks, and check the inside of your shoes before putting them on.
Protect from heat and cold
Do not use a heating pad or hot water bottle on your feet. Wear shoes at the beach and on hot pavement, put sunscreen on the tops of your feet, and keep your feet away from heat sources.
Keep blood flowing
When you sit, put your feet up. Wiggle your toes and move your ankles through the day. Avoid tight socks, and choose activities gentle on the feet, such as walking, swimming, or bicycling.
When to see a medical professional
See your health care professional or foot doctor if you have any of these signs:
- An open sore, blister, or bleeding on the foot
- Swelling, pain, warmth, or a change in skin color in the foot or leg
- A sore that does not heal after 1 to 2 weeks or that gets bigger
- A sore so deep you can see the bone
- A bad smell coming from a wound
This article is for general information and is not a substitute for evaluation by your health care team. Dr. Emilio B. Hisse evaluates and treats leg circulation problems, peripheral artery disease, and non-healing leg and foot wounds in Houston. If you have diabetes and are experiencing leg pain, cramping, cold feet, or a wound that will not heal, call 713-667-3885 to schedule an evaluation.