Diabetic Foot Care: Warning Signs You Should Not Ignore

If you have diabetes, any change in the sensation, colour, temperature, or skin integrity of your feet should be assessed by a healthcare provider. Key warning signs include numbness or tingling, wounds that heal slowly, skin colour changes, persistent coldness in one foot, and new calluses or areas of pressure.

Go to a chiropodist, walk-in clinic, or emergency department immediately if you notice:

• An open wound, blister, or ulcer on the foot: especially if it is not healing or appears infected (redness, warmth, pus, odour)
• Sudden change in foot colour (very pale, blue, or dark/black areas)
• Red streaks travelling up the foot or leg
• Fever combined with any foot wound
• A foot that is significantly more swollen, warm, or red than the other: this could indicate a Charcot foot emergency

Even small wounds can escalate quickly when diabetes affects circulation and nerve function. Early intervention is critical.

Prolonged high blood sugar levels can damage two systems that protect your feet:

1. Peripheral Neuropathy (Nerve Damage) Damaged nerves reduce sensation in the feet, meaning you may not feel cuts, blisters, pressure sores, or temperature extremes. An injury you cannot feel can worsen before you notice it.

2. Peripheral Arterial Disease (Poor Circulation) Diabetes can narrow blood vessels, reducing blood flow to the feet. With less blood flow, wounds heal more slowly and the risk of infection rises.

Together, these factors mean a small problem (a pebble in a shoe, a tight shoe rubbing, an ingrown nail) can become a serious wound if not caught early. Learn more on our diabetic foot care page.

Sensation changes:

• Numbness, tingling, or a "pins and needles" feeling in the toes or feet
• Burning sensations, especially at night
• Loss of ability to feel temperature (hot or cold)
• Reduced ability to feel pain from a cut or blister

Skin and nail changes:

• Dry, cracked skin that does not improve with moisturiser: especially cracked heels
• New or changing calluses or corns: these indicate areas of abnormal pressure
• Thick, discoloured, or fungal toenails
• Blisters, sores, or ulcers that appear without obvious cause

Circulation signs:

• One foot feeling colder than the other
• Shiny, thin, or hairless skin on the legs and feet
• Pale, blue, or reddish-purple colour when legs are dangled
• Slow-healing cuts or wounds

Structural changes:

• Swelling in one foot or ankle (without explanation)
• Changes in foot shape: a collapsed arch, rocker-bottom appearance, or new deformity could indicate Charcot neuroarthropathy, a serious condition requiring immediate care

If you have diabetes, these daily habits can help protect your feet:

• Inspect your feet every day: check the tops, bottoms, heels, and between the toes. Use a mirror or ask someone for help if needed.
• Wash and dry feet gently: use lukewarm water (test with your elbow, not your foot). Dry thoroughly between the toes.
• Moisturise: apply unscented lotion to prevent cracking, but avoid between the toes.
• Trim nails carefully: cut straight across, not too short. If you have difficulty seeing or reaching your feet, a chiropodist can do this safely at a medical nail care appointment.
• Wear well-fitting shoes: check inside shoes for seams or objects before putting them on. Avoid walking barefoot.
• Manage blood sugar levels: work with your diabetes care team to keep glucose levels in the target range.

See our full guide: Daily Foot Care Tips for People with Diabetes.

Diabetes Canada recommends that people with diabetes have their feet assessed by a qualified foot care professional at least once a year, and more often if you have neuropathy, circulatory problems, or a history of foot ulcers.

A chiropodist experienced in diabetic foot care can:

• Perform a neurological and vascular assessment of the feet
• Identify early warning signs before they become serious
• Safely manage calluses, nails, and skin conditions
• Prescribe pressure-relieving orthotics if needed
• Provide wound care and monitoring for existing injuries
• Coordinate with your diabetes care team

References:

• Diabetes Canada Clinical Practice Guidelines: Foot Care: diabetes.ca
• Canadian Association of Wound Care: Diabetic Foot Ulcer Best Practices: woundscanada.ca

This article is for general information only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.

If you are in Vaughan or nearby York Region communities and your symptoms persist, worsen, or affect walking, an in-person foot assessment can help determine the appropriate next step. Book an appointment online or call (647) 689-7533.