Diabetes-related foot complications

Monday, 30 May 2022

Blood vessel and nerve damage due to ongoing ‘higher than target’ blood glucose levels cause diabetes complications. These complications can affect the whole body including the mind, however often they first show up in the feet.

Every year there are over 4000 diabetes-related amputations in Australia, and unfortunately Indigenous Australians are three to six times more likely to experience diabetes-related foot complications compared to non-Indigenous Australians.

Of these 4000 diabetes-related amputations, 85% are preventable if detected and managed early. Evidence-based culturally appropriate screening and intervention programs and improved access to effective health care services are key to reducing the gap in diabetes-related foot complications between Indigenous and non-Indigenous Australians.

Diabetes foot complications

What are diabetes foot complications (or Diabetes-related Foot Disease (DFD)), and how can we help prevent these complications for people living with diabetes?

Nerves and blood vessels in the periphery of the body (feet and hands) are often the first to be affected by diabetes; ongoinghigher than target’ range blood glucose levels.

This damage to nerves and blood vessels is called peripheral neuropathy and peripheral vascular disease, respectively.

Signs and symptoms of diabetes foot complications

  • Changing toenail colour and or texture (e.g. yellowing and/or chalky toenails)
  • Cracked skin on feet especially on heels and toes
  • Signs of infection on toes, feet or lower legs; pus or bad smells coming from a cut or ingrown toenail, hot, swollen and or red skin
  • Wet, smelly and or white peeling skin between toes
  • Bruises, blisters or hard skin (including callus or corns) on toes, feet and lower legs
  • Numbness, coldness or pins and needles in the feet
  • Feet or lower leg cramps or shooting pains especially when not exercising or moving
  • Ulcers or wounds on toes, feet or lower legs
  • Change in foot shape

Preventing diabetes-related foot disease

“Routine diabetes foot risk screening has shown to be effective at identifying people who are at risk of developing DFD. Unfortunately, only half of people diagnosed with diabetes access routine foot risk screening” www.Footforward.org.au

Empowering and supporting self-management and podiatry services referral pathways or routine screening as trained, is key to preventing diabetes foot complications, and maintaining quality of life for people living with diabetes:

  • Empower people living with diabetes and or their support team, to check and care for feet:
    • Manage blood glucose to within target blood glucose range with the support of medications if needed, access to services; a healthcare team etc., healthier food choices and patterns, regular activity and rest, and other important health-gaining behaviours and checks as part of the annual cycle of care
    • Daily foot checks and care for the person and or their supports living with diabetes:
      • Check feet daily or have a family member help, using a mirror if needed; check skin for colour changes, cuts on heels, toes and sole.
      • Avoid walking barefoot
      • Wash and dry feet everyday
      • Moisturise feet, heels and lower legs with a natural oil or cream including olive or coconut oil. Avoid putting any cream or oil between toes as too much moisture between toes can cause the skin to break and an infection may occur
      • Cut toenails straight across and file edges and or have a family member or podiatrist help, if needed
      • Keep feet away from direct heat such as fires, heaters and hot water bottles
      • Avoid tight fitting shoes and wear supportive well-fitting shoes
      • If any change to toes, feet or lower leg are noticed, especially redness, pus, pain or heat, talk to healthcare team as soon as possible
      • Attend regular diabetes foot checks with a podiatrist at least twice a year and or have a health workforce member trained in foot assessments, check feet regularly
    • Regular diabetes foot assessments and checks
      • Enable and or support the person living with diabetes to access a chronic disease management plan through their GP or similar for diabetes foot assessments by a podiatrist or trained health worker, practitioner or other health professional
      • The Foot Forward program offers FREE e-learning modules for health professionals working in diabetes care; Aboriginal and Torres Strait Islander health workers and practitioners, podiatrists and other allied health, nursing and medical professionals, allied health assistants, clinical support workers, to help with foot risk screening learning and knowledge
      • Other supportive FootForward offerings include:


Further support and information

For more information on diabetes and DFD, please visit the Diabetes NSW & ACT website here or call the NDSS and Diabetes NSW & ACT helpline on 1800 637 700 to speak with a health professional; Credentialled Diabetes Educators (CDE), dietitians, exercise physiologists and a psychologist, who are available, Monday to Friday, business hours and up to 12pm Saturdays.


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