Diabetic Foot Complications — what to watch for and what to do

Up to 25% of people with diabetes will get a foot ulcer in their lifetime. That sounds scary, but many problems start small and stay small if you act quickly. This page gives clear, usable steps to spot trouble early, protect your feet daily, and know when to get medical help.

How to spot trouble early

Loss of feeling (neuropathy) and poor blood flow are the two main culprits. Neuropathy can let a small cut or pebble in your shoe turn into a wound you never felt. Poor circulation slows healing and raises infection risk. Check your feet every day: look for cuts, blisters, red spots, swelling, dry cracks, or changes in skin color. Test for sensation by lightly touching different areas or using a monofilament if your clinic gave you one. Also feel your foot pulses—if your feet are cold, pale, or you can’t find pulses, that suggests poor blood flow and needs attention.

Watch for these warning signs that need prompt care: increasing pain, spreading redness, warmth, pus or drainage, foul smell, fever, or a wound that doesn’t start to improve in a few days. Even small ulcers can hide deep problems; don’t wait to see if it gets better on its own.

Practical prevention and daily care

Daily habits matter more than fancy treatments. Wash feet gently with warm water and mild soap, dry well—especially between toes—and moisturize dry areas (but not between toes). Trim nails straight across or have a podiatrist do it if vision or numbness is a problem. Avoid walking barefoot; always wear socks and well-fitting shoes. If a shoe rubs, stop wearing it until fixed. Try shoes with a roomy toe box and avoid high heels. Consider diabetic socks that reduce friction and improve comfort.

Control your blood sugar, blood pressure, and cholesterol. Smoking narrows blood vessels and makes healing worse—quitting helps. Schedule an annual foot exam with your primary care doctor or podiatrist; people with nerve loss or circulation issues need checks more often. If you have a foot ulcer, many clinics offer wound care teams that use cleaning, debridement, special dressings, and off-loading methods (casts or special shoes) to speed healing.

Treatments vary: cleanings and dressings for minor wounds, antibiotics for infection, and vascular tests if circulation is poor. Serious infections or gangrene may require hospitalization or surgery. Hyperbaric oxygen and skin grafts are options in specific cases, but basic prevention and early care usually avoid complex treatments.

Small daily actions prevent big problems. Look at your feet every night, keep sugars in range, wear proper shoes, and call your healthcare provider the moment a sore, swelling, or drainage appears. Quick action saves toes and avoids hospital stays.