During this period, a person may feel relatively well.
The symptoms of diabetes are not always dramatic. Some people experience increased thirst, frequent urination, tiredness, blurred vision, or unexplained weight loss. Others have few noticeable symptoms until a routine blood test identifies elevated glucose.
Nerve and blood vessel complications generally develop over time, although the timing varies from person to person. In some cases, signs of nerve damage may already be present when type 2 diabetes is first diagnosed.
This is why persistent foot symptoms should not automatically be attributed to aging or uncomfortable footwear, especially in people who have additional risk factors.
Those risk factors can include excess body weight, a sedentary lifestyle, a family history of type 2 diabetes, a history of gestational diabetes, or previous findings of elevated blood glucose.
However, diabetes can occur in people who do not have these risk factors. A healthy body weight and an active lifestyle do not completely eliminate the possibility.
The most reliable way to determine whether blood sugar is elevated is to use appropriate blood tests rather than relying on physical appearance.
7. How Can You Know Whether Your Blood Sugar Is Too High?
If you notice recurring tingling, numbness, unusual dryness, slow-healing wounds, or unexplained changes in your feet, a healthcare professional can help determine whether diabetes testing is appropriate.
Several tests are commonly used.
Fasting plasma glucose
This test measures blood glucose after you have fasted for at least eight hours.
For nonpregnant adults, commonly used diagnostic thresholds are:
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Normal: below 100 mg/dL (5.6 mmol/L).
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Prediabetes: 100–125 mg/dL (5.6–6.9 mmol/L).
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Diabetes: 126 mg/dL (7.0 mmol/L) or higher.
Hemoglobin A1C
The A1C test estimates average blood glucose over approximately the previous two to three months.
Common diagnostic thresholds for nonpregnant adults are:
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Normal: below 5.7%.
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Prediabetes: 5.7–6.4%.
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Diabetes: 6.5% or higher.
Random plasma glucose
A random blood glucose test can help diagnose diabetes when a person has classic symptoms of hyperglycemia. A result of 200 mg/dL (11.1 mmol/L) or higher, together with typical symptoms or a hyperglycemic crisis, can meet diagnostic criteria.
In people without unequivocal symptoms, an abnormal result generally needs confirmation with repeat testing or another accepted diagnostic test.
These thresholds are general diagnostic guidelines. A clinician must interpret results in context, and certain conditions can affect the accuracy of A1C testing.
A home glucose meter may be useful for monitoring blood sugar in people who have been instructed to use one, but a single home reading is not usually sufficient to establish a diagnosis.
If you have symptoms that concern you, arrange testing instead of trying to determine your blood sugar from the appearance of your feet.
8. Other Conditions That Can Cause Similar Foot Symptoms
Although diabetes is an important possible cause of foot changes, it is far from the only explanation.
Tingling and numbness may result from nerve compression, vitamin B12 deficiency, alcohol-related nerve damage, thyroid disorders, or certain medications.
Dry, cracked skin may be caused by eczema, psoriasis, fungal infections, frequent washing, harsh soaps, or unsuitable footwear.
Slow-healing wounds can occur because of poor circulation, infection, repeated pressure, nutritional problems, or other medical conditions.
Cold feet may reflect environmental temperature, circulation problems, or hormonal and metabolic conditions. Swelling may be associated with venous disease, medication side effects, kidney disease, or heart problems.
This overlap is important because treating the wrong cause can delay effective care.
For example, a person with fungal skin disease may need antifungal treatment rather than simply applying moisturizer. Someone with nerve compression may need an evaluation of the affected nerve. A person with reduced arterial blood flow may require a vascular assessment.
The same symptom can also have more than one cause. A person with diabetes may simultaneously have fungal infection, poor circulation, and nerve damage.
A proper examination helps determine which explanation is most likely and what treatment is needed.
9. Daily Foot Care That Can Help Reduce the Risk of Complications
Foot care is especially important for people with diabetes, reduced sensation, poor circulation, or a history of foot ulcers. Simple habits can help identify problems early and reduce preventable injuries.
Check your feet every day
Examine the tops, soles, heels, and spaces between your toes. Look for blisters, cuts, cracks, redness, swelling, discoloration, or drainage.
If you cannot see the soles of your feet easily, use a mirror or ask someone you trust to help.
Do not assume that a wound is harmless simply because it does not hurt.
Wash gently and dry thoroughly
Use lukewarm water and mild soap. Avoid soaking your feet for long periods, particularly if your skin is fragile or your sensation is reduced.
Dry carefully between the toes to reduce excess moisture.
Moisturize dry skin
Apply a suitable moisturizer to dry areas of the feet. Avoid leaving thick layers of cream between the toes.
If you have deep heel cracks, recurring skin problems, or signs of infection, seek professional advice.