Diabetes-related nerve damage can leave people vulnerable to foot ulcers, infections and other complications, while fungal infections and ingrown toenails are among the other conditions that can cause foot discomfort.
Diabetic peripheral neuropathy (DPN), a form of nerve damage associated with diabetes, can reduce sensation in the feet, making it difficult for patients to notice injuries, blisters or developing sores. High blood glucose levels can damage nerves over time, while diabetes can also interfere with wound healing.
The International Diabetes Federation estimated that 24 million adults aged 20 to 79 were living with diabetes in its Africa region in 2021. The figure was projected to rise to 33 million by 2030 and 55 million by 2045, according to its 10th edition Diabetes Atlas.
Foot care can help people identify problems early, but not every condition is suitable for home treatment. People with diabetes, particularly those with reduced sensation or poor circulation, should seek medical advice when they notice new foot problems.
Treating athlete’s foot
Athlete’s foot is a fungal infection that commonly affects the skin between the toes and on the soles. Symptoms can include itching, redness, peeling and cracked skin.
The infection spreads in warm, moist environments, including communal showers and changing rooms. Sweaty footwear and damp socks can also encourage fungal growth.
Pharmacy antifungal treatments, available as creams, sprays and powders, are commonly used to treat the infection. Patients should follow the product instructions or seek advice from a pharmacist about the appropriate treatment.
Keeping the feet clean and dry can help prevent the infection from returning. People should dry carefully between their toes, change their socks regularly and avoid sharing towels. Wearing footwear in communal showers and changing rooms can also reduce exposure to the fungus.
Shoes should be allowed to dry thoroughly between uses. Removable insoles can be taken out to improve ventilation, while footwear should be cleaned according to the manufacturer’s instructions.
People with diabetes should not rely on home remedies such as vinegar soaks, particularly if they have broken skin, reduced sensation or circulation problems. They should seek medical advice if an infection persists or the skin becomes increasingly red, swollen or painful.
Managing diabetes-related foot pain
Diabetes can cause nerve damage that produces burning, tingling, numbness or pain in the feet and legs. Some people lose sensation and may not notice injuries that could develop into ulcers or infections.
Treatment depends on the cause of the symptoms. Healthcare professionals may prescribe medicines for nerve pain and recommend measures to improve blood glucose control and manage other cardiovascular risk factors.
Compression socks are sometimes used for particular circulation problems or swelling, but they are not a general treatment for diabetic nerve pain. People with diabetes should consult a healthcare professional before using them, especially if they have poor circulation or suspected peripheral artery disease.
Daily foot inspections are important because nerve damage can prevent a person from feeling cuts, blisters or pressure injuries. People with diabetes should check the soles, heels and spaces between their toes for changes in colour, swelling, blisters, cuts or sores.
They should also wear properly fitting footwear and avoid walking barefoot, including indoors. Any new wound, ulcer or signs of infection should be assessed promptly by a healthcare professional.
When an ingrown toenail needs treatment
An ingrown toenail develops when the edge of a nail grows into the surrounding skin, causing pain, redness and swelling. In some cases, the area can become infected.
Wearing shoes that provide enough room for the toes and trimming nails straight across can help reduce the risk. People without diabetes or other complicating conditions may be advised to use simple home-care measures for mild cases.
However, people with diabetes, poor circulation or reduced sensation should not attempt to lift the nail with cotton or dental floss, cut into the affected edge or treat an ingrown toenail themselves. They should seek professional assessment because even a minor injury can lead to complications.
Severe or persistent cases may require treatment by a healthcare professional, including partial removal of the nail when necessary.
Foot pain that worsens, spreading redness, discharge, swelling or an open wound warrants medical attention. A foot that becomes suddenly discoloured or unusually cold also requires urgent assessment.
Early treatment can help prevent relatively minor foot conditions from developing into more serious problems. For people living with diabetes, regular foot examinations and prompt attention to new symptoms remain central to preventing complications.
