Diabetes and Foot Problems​​

Diabetes describes a group of metabolic diseases where those affected suffer from high blood glucose (blood sugar). Diabetes may be caused by inadequate insulin production or because of the body cells failing to respond appropriately to insulin. 

Diabetes can make you more vulnerable to infections, which can lead to major health complications. Foot infections are a major cause of ailment for patients with diabetes. If left untreated for too long, there is an increased risk amputation. The two main diabetes-related feet problems are:

  • Diabetic neuropathy – If your diabetes is not managed properly and you suffer from chronically high blood sugar levels, it can lead to extensive damage to​ your nerves. If the nerves in your feet and legs are impacted, you may suffer from “sensory diabetic neuropathy”; you may be unable to feel temperature (heat or coldness) or pain.  There is the risk that if you get a cut on your foot, you may not feel it due to neuropathy. This cut could get worse and become infected.  Additionally, the functioning of the muscles in your foot may also be negatively impacted due to damage to the nerves that make them work. This could lead to a case where your foot will not align properly, creating excess pressure on the other foot. You are also at an increased risk of getting a foot ulcer, due to nerve damage, or due to peripheral vascular disease.

  • Peripheral vascular disease – The disease is a circulation disorder which can result in inadequate blood flow to your arms and legs. If you suffer from compromised blood flow, it will mean that cuts and sores will take longer to heal than normal. If you develop an infection that does not heal in a timely manner due to low blood flow, it puts you at greater risk of developing ulcers or gangrene (this refers to the death of tissue as a result of a lack of blood).    

Additionally, people with diabetes are at greater risk of developing other feet related problems, such as:

  • Athlete’s foot 

  • Fungal nail infections 

  • Calluses 

  • Blisters

  • Bunions

  • Dry skin

  • Foot ulcers

  • Hammertoes​

  • Ingrown toenails

  • Plantar warts

There is increased risk of developing infection, and in serious cases may even lead to a necessary amputation. 

Possible symptoms that indicate that you are at risk of a foot-related ailment are:

  • Changes in the colour or temperature of your skin

  • Swelling in your foot or ankle 

  • Development of corns, calluses, ingrown toenails, toenails infected with fungus, athlete’s foot or infected toenails. 

  • Skin becoming increasingly dry or cracked 

  • Leg pain

  • Foul/unusual odour from feet

  • Oozing open sores that seem to be draining, and/or take longer to heal 

It is absolutely essential that you visit your doctor working with the <GI and Surgery Service Line> at The Aga Khan University Hospital as soon as possible if you have a foot injury or are experiencing any adverse feet-related symptoms. The complications of feet problems can be very serious when you are a diabetic patient. 

You should also seek medical attention urgently if you notice any signs of new ulcer development. The Aga Khan University Hospital's <GI and Surgery> team can help in the diagnosis and treatment of your ailment. ​

Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to h​​elp get you started.​​

If you are experiencing a foot related problems and have been diagnosed with diabetes, your doctor will begin with a complete medical examination. This will include questions about your symptoms, medical history, the medications you are taking and your family medical history. They will then perform a physical examination, and inspect the problem area. They may perform a variety of tests in order to assess which form of treatment would be best for you. The diagnostic procedures will be largely clinical, and may include:

  • Laboratory tests – such as blood, kidney function and enzyme tests

  • X-rays – to look for bony involvement.

  • Ultrasound doppler – to examine the blood flow in your arteries and veins in the lower extremities

  • Angiograms – this procedure may be performed pre-treatment to look for the site of problem in the blood vessel. 

  • Consultations with other specialists.

Mild infections can be treated with antibiotics and daily dressings at home. Severe infection may need admission in hospital, injectable antibiotics, cleaning of wound in operating room and good sugar control. If not responding to all these measures, amputation may be the only solution to save life.

Early intervention and proper treatment is essential in improving your chances of a good outcome. 

The outcome of surgical intervention will largely depend on the expertise, quality of care and skill of your surgeon. The <GI and Surgery Service Line> at The Aga Khan University Hospital is dedicated to achieving the best outcomes possible for their patients. They will do their best to maintain the structural and physical integrity of your foot while giving you the best chances for a successful recovery. ​

Please click here for some guidelines on “what to do before your surgery”​​

Every surgical procedure involves a certain degree of risk. The specific risks of your surgery will depend on what form of foot-related problem you have, the extent of the disease/infection, and the surgical procedure that is chosen to treat your problem. However, every surgical procedure performed on your feet has the potential risk of altering the mechanics of your foot, and therefore affecting its function. There is also the risk of the recurrence of disease or infection, thereby requiring further non-surgical or surgical intervention. 

Be sure to discuss all the possible risks and complications of surgery with your doctor, as well as the likely outcome so that you may have a thorough understanding of your treatment course and options.   ​

Please click here for some guidelines on “what to do on after your surgery”

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage.

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.