We have an intricate knowledge of the effects both type 1 and type 2 diabetes has on your foot health. The two main systems effected by diabetes mellitus are the vascular (blood) system and neurological (nerve) system. Below is some information on signs, symptoms & risks to be aware of as well as advice as to how you and your podiatrist can maintain your feet at their optimal level for as long as possible. You should see a podiatrist at least once a year to undertake cursory neurological and vascular assessment. Routine care which involves nail and skin management is recommended on a 6 to 8 weekly basis.

1. The Vascular system

Heightened blood sugar levels can lead to Peripheral Vascular Disease (PVD).This involves damage to the large arteries of the leg that supply blood to the foot as well as the smaller vessels called capillaries which provide blood to the toes. This leads to an overall reduction in the circulation of arterial blood to the feet.

Signs, symptoms & risks of PVD:
Gangrene due to peripheral vascular disease
  • feet always feel cold
  • skin appears flaky and fragile
  • nails acquire a clubbed appearance (rounded surface)
  • toenail growth reduced
  • breaks in skin take longer to heal
  • easily infected following break in skin
  • ulceration
  • gangrene
How your podiatrist will help manage PVD:
  • regularly cut nails and debride callus for client reducing the chance of laceration during self care
  • skin care advice
  • cursory vascular tests: testing tissue perfusion (temperature of skin) and Subpapillary Venous Plexus Filling Time
  • Bidop bi-directional Doppler to  monitor circulation within the Dorsalis Pedis & Posterior Tibial arteries
  • send annual report of vascular status to your GP or specialist
2. The Neurological system
The small nerves that provide sensation to the feet can be destroyed by the heightened blood sugar levels associated with uncontrolled diabetes. This leads to a condition known as Peripheral Neuropathy.
Signs, symptoms &risks of Perpiheral Neuropathy
  • feet feel numb
  • prone to blistering following undetected pressure from footwear
  • prone to ulceration following undetected pressure from footwear
  • prone to undetected laceration, puncture or burns to skin whilst walking barefooted
  • increased risk of infection following undressed wounds the client is unaware of
  • amputation following osteomyelitis
  • osteomyelitis following infection from undressed wound


How your Podiatrist will help you manage Peripheral Neuropathy:
  • regular debridement of callus accumulated from undetected stresses
  • regular assessment of foot for any change in skin integrity via laceration, puncture or burn
  • neuropathic foot care tips e.g. never walk with bare feet, check bottom surface of feet daily
  • cursory neurological testing; monofilament, tunning fork, reflex hammer, proprioceptive testing
  • send annual report of neurological foot status to GP or specialist


Neuropathic ulcer on the bottom of the foot