Diabetes and Foot Infection: What Is the Relationship

Over time type 2 diabetes can affect all body parts, including the feet. When blood sugars are not controlled, moist areas in the feet are prone to infections.

People with diabetes can experience nerve damage, lack of sensation, and difficulty with wound healing if their blood sugars are chronically elevated (hyperglycemia). This can increase the risk of ulcers or sores, which can become infected if not detected and treated promptly.

This article discusses diabetes and foot infections, including how to treat and manage the conditions together.

Connection Between Diabetes and Foot Infections

People with diabetes are at an increased risk of peripheral neuropathy, nerve damage that can impact the feet. The risk increases the longer you have diabetes, uncontrolled sugars over long periods of time, if you have hyperglycemia, smoke, and have a family history.

About 50% of peripheral neuropathy is asymptomatic (without symptoms); however, some symptoms may include:

• Numbness
• Tingling
• Burning
• Foot weakness and loss of feeling

When someone has a loss of feeling in their feet, they may not know when they have a foot injury, when their shoes do not fit properly, or when a foreign object is in their shoe. Constant friction can increase the risk of skin tears, sores, and foot ulcers, leading to infection.

You are more likely to have hammertoes if you have diabetes, which can increase the risk of foot ulcers (open sores), especially if you are not wearing properly fitted shoes.

Risks

Identifying risk factors for infections can help prevent them from occurring. Certain risk factors include:

• History of diabetic peripheral neuropathy
• Long-term diabetes
• Chronically high blood sugars
• Vascular disease
• Smoking
• Older age
• Male sex
• Previous infections and foot traumas
• Microvascular (affecting small blood vessels) complications such as retinopathy and nephropathy

Treatment of Diabetes and Foot Infections

Foot infection treatment will depend on the type of infection, history of previous infections, and severity of the infection. Treatment of foot ulcer infections can include:

• Antibiotics (oral and topical)
• Wound cleansing and debridement (removing unhealthy tissue)
• Surgical drainage
• Revascularization (a procedure that restores blood flow to a blocked artery)
• Optimizing glycemic (blood sugar) control
• Total contact casts
• Hyperbaric oxygen therapy

Treatment of fungal infections between the toes or around the nail bed may indicate topical creams or oral medicines. Lamisil (terbinafine), an allylamine antifungal drug, is the first-line agent in treating these kinds of infections.

Managing Diabetes

Managing diabetes by controlling blood sugar levels reduces your risk of developing neuropathy, which can decrease the risk of a foot infection. Good glycemic control can help to heal infections.

Adequate nutrition is also important for treating diabetes and foot infections. A simple and easy meal planning strategy is practicing the plate method. This concept allows for:

• 1/4 lean protein (eggs, chicken, fish, turkey, tofu)
• 1/4 carbohydrates (beans, sweet potatoes, peas, corn, rice)
• 1/2 non-starchy vegetables (salad, broccoli, carrots, green beans, etc.)

Sufficient protein intake, vitamin C, and zinc are also important for wound healing.

Prevention

If you have diabetes, it's important to practice good foot hygiene, control your blood sugars, schedule a foot exam, and adopt healthy lifestyle habits.

Keep Blood Sugar in Good Control

Eating well, exercising, practicing good sleep hygiene, blood sugar monitoring, and health conditions can play a role in managing diabetes. You should reach out to your medical team if you need support or need to be educated or re-educated on a specific topic. Simple tweaks can make a significant impact; for example, the timing of your medicine can impact your blood sugars.

Practice Proper Foot Hygiene

Good hygiene can help keep your feet healthy and lower your risk of infection. For healthy feet, be sure to do the following:

• Change your socks daily.
• Wear clean, dry socks to reduce bacteria and decrease infection risk.
• Do not walk around barefoot, especially if you have neuropathy or a history of infections.
• Shake your shoes out before putting them on (to ensure they are free of foreign objects).
• Inspect your feet with a mirror to identify blisters, calluses, or marks that need attention.

Have a Foot Exam

If you have had type 1 diabetes for five or more years or type 2 diabetes, it's recommended that you get checked every year for diabetic peripheral neuropathy. Your primary care provider or podiatrist can assess your feet with visual inspection and other tests.

Lifestyle Changes

What you eat, how you move your body, and how much you sleep play a significant role in managing blood sugars. A healthy lifestyle can prevent or delay diabetes complications, including foot infections. Eating a diet rich in plants, such as fibrous vegetables, fruits, whole grains, nuts, and seeds, is associated with better blood sugar levels and a reduced risk of diabetes.

Summary

If you have diabetes, certain factors can increase your risk of foot infections. Some of these, such as foot hygiene, glycemic control, and lifestyle factors, are within your control. Other factors, such as genetics, are not. If you are worried about a foot infection, contact your medical team for an evaluation. In some instances, you may need medication to treat it. They can also educate you on proper foot hygiene and help locate resources for which you may be eligible, such as special shoes.

A Word From Verywell

People with diabetes are more likely to experience foot infections if their blood sugars are chronically high, if they smoke, or have other health issues. You can prevent and treat foot infections with lifestyle management. The severity and type of infection will determine treatment. Any time you suspect something is wrong with your feet, contact your healthcare provider for evaluation.