A serious foot problem is when damage to your foot means it needs emergency attention. Having diabetes means that you’re more at risk of serious foot problems.
A minor problem with your feet such as a blister can quickly become infected and lead to a serious foot infection or other serious foot problem such as a diabetic foot ulcer, and these can sometimes lead to amputation.
This is more likely if you’ve been told you have a high risk of getting a foot problem. This usually applies if you have more than one sign of a foot problem, are on kidney dialysis or have previously had an ulcer or amputation.
If you see a change or problem with your feet, there are things you can do to stop it getting worse.
This page covers:
How can diabetes cause serious foot problems or serious foot infections?
What serious foot problems or foot infections can diabetes cause?
Symptoms of a serious foot problem
What to do if your notice a foot problem
Treatment for a serious foot problem
How to reduce your risk of a serious foot problem
How can diabetes cause serious foot problems or serious foot infections?
Over time, raised blood sugar levels, also known as blood glucose levels, can damage the small blood vessels and nerves in your feet. This can stop essential nutrients reaching your feet.
If the nerves in your feet are damaged, you can lose the feeling in your feet, known as peripheral neuropathy. This means you may not feel things properly and can damage your feet without noticing, for example, a cut.
If the blood vessels are damaged, known as ischemia, it can take longer or be more difficult for any wounds to heal. This is because blood vessels carry essential nutrients and oxygen round the body, which are needed for wound healing.
Damage to your feet creates an opening for bacteria and infection to get in.
So common foot problems such as a blister or a problem with a toe can turn into a serious foot problem of infection if left untreated.
Getting the right support and treatment for these foot problems can reduce your risk of foot ulcers getting worse, infections and amputations. Many foot problems can be prevented with good, regular footcare.
What serious foot problems or foot infections can diabetes cause?
Most foot problems are not caused by diabetes but as explained above, having diabetes and high blood sugars can make common foot problems worse. Charcot foot is a serious foot problem associated with having diabetes. Some healthcare professionals use the term ‘diabetic foot’ to refer to Charcot foot but it might mean any foot problem made worse by diabetes.
Charcot foot
If you have diabetes and nerve damage in your feet, you’re more at risk of developing Charcot foot, which can badly affect the joints in your feet, as you’re less likely to notice any pain if it starts. Find out the signs and symptoms of Charcot foot and treatment.
Symptoms of a serious foot problem
If you have nerve damage in your feet you may not notice any new foot problems as you don’t feel pain, which can be one of the symptoms. So it’s important to get into the habit of having a look at your feet every day for any changes.
You’re up to 20 times more likely to have an amputation if you have diabetes, so if you have a foot problem it's important you seek help from your health care team straight away.
When you’re checking your feet, if you notice any of these changes, see your local foot team urgently within 24 hours:
- changes in the colour and shape of your feet over all or part of the foot, especially a red, hot, swollen toe, ankle or foot
- part or all of your foot feels much colder or hotter than usual
- new blisters, cuts or wounds especially if you can see them but don’t feel them
- A cut or wound that smells bad or has started leaking fluid or pus
- new or unexplained pain in your foot.
Symptoms of sepsis
If you have an infection in your foot, you may have a higher risk of sepsis. Sepsis is a life-threatening reaction to an infection. If you have any of these symptoms call 999 or go to A&E:
- confusion, slurred speech or not making sense
- blue, grey, pale or blotchy skin, lips or tongue. If you have brown or black skin, this may be easier to see on the palms of the hands or bottom of the feet.
- a rash that does not fade when you roll a glass over it, the same as meningitis
- fast breathing, difficulty breathing or feeling breathless
- high temperature (above 38.3C)
- heart beating much quicker than usual or more than 90 beats per minute when resting.
What to do if you notice a foot problem
If you see something wrong, it is important to:
- Sit or lie down and take the weight off your foot. If you can, sit with your foot raised on a stool or chair. Put a cushion under your ankle so that no part of your foot is touching anything.
- Contact your GP or foot protection team straight away.
- Go to your nearest out-of-hours healthcare service if your GP or foot protection team aren’t available.
Try and sort out any problems with your feet before they get any worse, no matter how small the change. A serious foot problem for some people can lead to amputation very quickly.
How to reduce your risk of a serious foot problem
Every day check your feet and wear well-fitting shoes
Well-fitting shoes will help reduce your risk of a serious foot problem. And getting into the habit of checking your feet every day. You’ll be able to notice any changes to your feet early – even if you can’t feel them, so you can get treatment sooner to help prevent the problem getting worse.
If you notice any changes or feel unwell when you have a foot problem, do something about it straight away.
Go to your annual foot check
Your annual foot check is one of your diabetes health checks and will help pick up any foot problems. You’ll also be told whether your risk of developing a foot problem is low, medium or high – or it’s active. See what this means on our annual foot check page.
Look after your health and diabetes
If you’re a smoker, giving up smoking is one of the best things you can do to help prevent serious foot problems. You can get help to quit smoking from your GP.
Getting the right support to help manage your diabetes well will also help to prevent serious foot problems.
This includes keeping your blood sugars as close to target as possible. And managing blood fat levels and blood pressure to help protect the blood vessels and nerves. Getting and staying active and healthy eating will also help.
What is the treatment for serious diabetes foot problems?
Treatment depends on the type of foot problem you have. You may need antibiotics, special shoes or boots to help keep the weight off, and regular dressing for any cuts, wounds or injuries.
You might have antibiotic tablets, or injections into your vein or muscle. This can often be a longer course of antibiotics, for example for 6 weeks.
Some people need to stay in hospital. For example, to have surgery to remove dead skin tissue or to treat an infection from a wound.
An amputation
Unfortunately, some people do need to have an amputation. This can be toes, foot or a section of your leg. If this happens, you’ll be seen by a surgeon and an anesthetist. They’ll check that it is safe for you to have an operation and talk to you about what to expect, and what care you will have afterwards. They can also refer you for emotional support if you need it.
After you’ve had the operation, it’s likely you’ll go somewhere else for rehabilitation before you finally go home.
Rehabilitation can take a long time and be difficult, but it will be individual to you, and will aim to get you back to doing as many things as you could before the operation.
You’ll also see a physiotherapist to help you get moving again after the operation, and an occupational therapist to check what you’ll need to be able to manage when you first get home.
The NHS has more information about amputation including what to expect and where to get support.
Coping with serious foot problems
We are here for you if you need support with dealing with any serious foot problems.
Call our helpline
Whether you’ve got a specific question about your symptoms, treatment, or you just want to have a chat with someone who knows about diabetes, give our confidential helpline a call on 0345 123 2399. You’ll be able to speak to one of our trained advisors who can take the time to talk you through your concerns or how you’re feeling.
Reach our for help and support on our forum
There are other people with diabetes who have had foot problems and reaching out to them can help. You can read their experiences in our online forum or sign up to take part in the conversations yourself.
