If you have diabetes and discover an open wound, blister that has broken, or unexplained skin defect, contact a healthcare professional promptly rather than waiting for it to heal on its own.
Seek urgent care if the wound has spreading redness, warmth, swelling, pus, a foul odor, darkened tissue, or other signs of deterioration.
Do not apply harsh chemicals, cut away tissue, or attempt to treat a deep wound with home remedies.
5. Swelling in the Feet or Ankles
Swelling can occur for many reasons, including prolonged standing, injury, venous circulation problems, medication effects, and conditions affecting the heart or kidneys.
In people with diabetes, swelling deserves attention because it may accompany infection, inflammation, circulation problems, or a condition known as Charcot neuroarthropathy.
Charcot foot can develop when nerve damage reduces protective sensation and repeated stress causes injury to bones and joints. The affected foot may become warm, swollen, and red, sometimes with surprisingly little pain.
Early recognition is important because continued weight-bearing can worsen structural damage.
When is swelling concerning?
A new, unexplained swollen foot, particularly when it is warmer or redder than the other foot, should be assessed urgently in someone with diabetes or neuropathy.
Avoid continuing normal activities on a foot suspected of having Charcot changes until a clinician has assessed it.
Sudden swelling in one leg accompanied by calf pain can also indicate a blood clot. If you develop chest pain or difficulty breathing alongside symptoms suggestive of a clot, seek emergency assistance.
Persistent swelling in both feet may require assessment for heart, kidney, venous, or medication-related causes.
Do not assume that swelling is simply a consequence of diabetes. Its cause needs to be determined.
6. Changes in Skin Color or Temperature
Changes in foot color may provide clues about circulation, inflammation, pressure damage, or infection.
A foot that becomes unusually red, purple, pale, or blue should not automatically be attributed to diabetes, but the change deserves attention when it is new or unexplained.
Redness and warmth
Redness, warmth, and swelling may indicate infection or inflammation.
In someone with diabetic neuropathy, a warm, swollen foot may also be a sign of Charcot neuroarthropathy, even if the person reports little pain.
A red area beneath a shoe strap or over a bony prominence may indicate excessive pressure or friction.
Pale, blue, or cold skin
Poor blood flow caused by peripheral artery disease may make the feet feel colder than usual or appear pale or bluish.
Peripheral artery disease occurs when blood vessels supplying the limbs become narrowed, often because of atherosclerosis.
People with diabetes have an increased risk of developing this condition.
Sudden changes are particularly concerning. A foot that becomes abruptly cold, pale or blue, severely painful, numb, or weak may indicate an acute circulation emergency.
Seek emergency medical care if these symptoms occur.
Dark or black tissue
Dark discoloration may result from bruising or other conditions, but blackened tissue can indicate severe tissue damage or gangrene.
This requires urgent medical assessment, especially in someone with diabetes or poor circulation.
Do not wait for blackened tissue to improve on its own.
7. Thickened Skin, Calluses, and Corns
Calluses form when repeated pressure or friction causes the outer layer of the skin to thicken.
They are common on the feet, especially around the heel and ball of the foot. Shoes that fit poorly, abnormal foot mechanics, and repeated pressure can contribute to their development.
For people with diabetes, however, thickened skin deserves particular attention.
A callus can increase pressure on the tissue beneath it. In a person with neuropathy, the pressure may damage deeper tissues without producing a strong pain signal.
An ulcer may develop beneath the callus while the surface appears relatively intact.
What should you do?
Check whether your shoes are causing friction or pressure.
Use footwear that fits properly and does not rub against the toes, heels, or sides of the feet.
Do not cut calluses with blades, scissors, or other sharp instruments. Avoid chemical corn removers unless a qualified healthcare professional has specifically advised that they are appropriate.
If you have diabetes and develop a thick callus, especially over a bony prominence or near a discolored area, ask a healthcare professional to assess it.
Professional foot care may be appropriate for people at increased risk of ulcers.
8. Toenail Changes and Fungal Infections
Toenails can become thick, brittle, discolored, or distorted for several reasons.
Fungal nail infections are common and may cause nails to turn yellowish, white, or brown. The nails can thicken, crumble, or separate from the nail bed.
Repeated pressure from footwear and previous injuries can produce sim