New Delhi: Living with diabetes is not easy. Your days revolve around keeping a tab on meal portions, taking medications on time, being constantly attuned to imbalances in energy levels, and adjusting routines accordingly. In this context, it is easy to ignore mild foot pain and dismiss it as something unrelated and inconsequential in comparison to the aspects that demand more immediate attention.
In an interaction with News9Live, Dr. Ameya Thakur, Advanced Laproscopic GI, Hernia, Bariatric & Metabolic Surgeon, Vivaanta Hospital, Pune, spoke about differentiating between normal foot pain and diabetes-related foot discomfort.
This is counterintuitive, as even subtle sensations or discomfort can be early signs of nerve damage or poor circulation, often appearing long before more serious complications develop. In certain cases, pain may actually lessen with progressive nerve damage, which can end up creating a false sense of reassurance. By the time the problem becomes visible again, significant damage may already have occurred… as we will read in more detail below.
Why foot pain in diabetes is different
Foot pain in people without diabetes is often linked to issues with footwear, strain from prolonged standing or physical activity, a minor injury, and/or mechanical stress. In most cases, these problems improve with rest or simple treatment. In diabetes patients, foot pain is not a localised problem; it is often indicative of underlying damage to nerves and blood vessels caused by high levels of blood sugar.
As this nerve damage progresses, normal sensation in the feet becomes altered or reduced. This condition, known as diabetic neuropathy, can cause tingling, burning, pain, or loss of feeling. With reduced sensation, there is a high chance of small cuts, blisters, pressure points, or open sores going unnoticed and untreated. At the same time, damage to blood vessels restricts blood flow, slowing healing and weakening the body’s ability to fight infection.
This combination significantly increases the risk of diabetic foot ulcers. These ulcers are slow to heal and prone to infection. If infection does occur, it can spread and damage tissues, thereby resulting in the amputation of a toe, a combination of toes, the entire foot, or part of the leg to prevent further complications. This is why managing diabetes goes beyond controlling blood sugar levels and must include protecting long-term nerve and vascular health through regular monitoring and early intervention.
Key symptoms that should not be ignored
- A persistent tingling or burning sensation in the feet that does not go away on its own.
- Numbness or a noticeable reduction in feeling, which may make it harder to sense pain or injury.
- Ongoing or unexplained foot pain, even in the absence of a visible injury or bruise.
- Cuts, blisters, or open sores that take longer than usual to heal or do not heal at all.
- Redness or swelling in the feet, which may indicate inflammation or infection.
- Changes in skin colour or temperature, such as the feet feeling unusually cold or appearing darker.
- Pain in the feet during walking or even while resting, which can point to circulation issues.
Daily habits that protect foot health in diabetes patients
- Inspect your feet every day for cuts, blisters, redness, swelling, or any change in the skin, including areas between the toes that are easy to miss.
- Keep your feet clean and dry, and apply moisturiser to prevent cracking, while avoiding excess moisture between the toes.
- Trim toenails carefully and regularly to prevent ingrown nails or accidental cuts.
- Wear comfortable, well-fitting footwear that does not rub or create pressure points.
- Stay physically active, in doctor-approved and comfortable ways, to support circulation in the lower limbs.
- Keeping blood sugar levels within a healthy range helps reduce ongoing damage to the nerves and blood vessels over time.
- Foot discomfort, even if it feels mild or intermittent, should be flagged to a doctor before it gets worse.