Fax: (239) 692-9436
Tel: 239-430-3668How Diabetes Puts Your Feet at Risk
December 10 2025
As a podiatrist practicing here in beautiful Naples, Florida, I have the privilege of caring for a diverse community, many of whom share a common, yet often underestimated, health challenge: diabetes. November is Diabetes Awareness Month, a crucial time to turn our focus not just to blood sugar levels, but to the devastating, silent impact this chronic condition can have on the foundation of our mobility – our feet. For those living with diabetes, foot care isn’t just about healthy nails or comfortable shoes; it’s a critical, daily defense against potential limb-threatening complications. This condition requires diligent, consistent attention from the ankle down, because unchecked, the seemingly minor can rapidly escalate into major crises requiring intensive medical intervention.
The Diabetic Foot Triad: A Perfect Storm
Diabetes, whether Type 1 or Type 2, fundamentally alters the body’s chemistry, and these changes manifest severely in the lower extremities. In my practice, I see the consequences of what I often refer to as the Diabetic Foot Triad: Neuropathy, Vasculopathy, and Deformity.
1. Diabetic Neuropathy: The Loss of Sensation
The most insidious threat is diabetic peripheral neuropathy, or nerve damage. High blood sugar levels slowly damage the peripheral nerves, especially those extending to the longest parts of the body – the feet. What does this mean for the patient? Loss of protective sensation. They might step on a sharp object, develop a blister from ill-fitting shoes, or sustain a burn from water that feels only lukewarm, and they won’t feel pain. Pain is the body’s alarm system; without it, a minor injury can progress unnoticed into a deep, infected ulcer. This lack of sensation is why daily foot checks – looking between the toes, checking the soles, using a mirror if necessary – are non-negotiable for my diabetic patients.
2. Vasculopathy: The Circulation Crisis
Simultaneously, diabetes often leads to vasculopathy, the narrowing and hardening of the blood vessels, a condition exacerbated by high glucose levels damaging the vessel lining. This results in peripheral artery disease (PAD), meaning compromised circulation.
When an injury does occur – and because of neuropathy, it often does – the foot lacks the necessary oxygen and nutrient-rich blood flow required for proper healing. A small cut that might heal in a week for a non-diabetic foot ulcer (DFU). In Southwest Florida, where may of our patients enjoy active outdoor lifestyles, this intersection of neuropathy and poor circulation is a major concern.
3. Structural Deformity and Biomechanics
Over time, neuropathy can also affect the small muscles in the foot, leading to musculoskeletal changes. We see common issues like Hammertoes or Claw Toes. These deformities create abnormal pressure points – high-pressure “hot spots” on the bottom of the foot – that are far more likely to break down into calluses, blisters, and ultimately, ulcers, even without the patient noticing the initial trauma.
Prevention is the Podiatrist’s Prescription
In November, as we raise awareness, the most important message I want to convey is that amputation is often preventable. A multidisciplinary approach, with the podiatrist as the foot-and-ankle specialist, is the key.
Yearly Comprehensive Exams: Every diabetic patient need a thorough annual foot screening from a qualified professional like a podiatrist. This includes checking sensation, pulses, and assessing for early signs of deformity or pre-ulcerative lesions. For high-risk patients, checks should be more frequent.
Protective Footwear: Off-the-shelf shoes are often inadequate. We frequently prescribe therapeutic shoes and custom-molded orthotics to redistribute pressure away from dangerous high-pressure areas, effectively cushioning the foot against unnoticed trauma.
Self-Care Education: Patients must be educated on proper foot hygiene: washing with warm water (never hot!), drying thoroughly between the toes, and never attempting to self-treat corns or calluses with over-the-counter chemicals that can severely burn compromised skin.
Team Approach: Successful outcomes rely on tight collaboration between the patient, their endocrinologist, and the podiatrist to manage the underlying systemic issues like blood pressure, cholesterol, and A1C control, alongside local foot care.
Here in Naples, we are committed to keeping our residents walking comfortably and safely. Diabetes 
demands vigilance, especially regarding the feet. Don’t wait for pain; pain often signals a problem that has already become severe. Take this Diabetes Awareness Month as a personal reminder to schedule that preventative podiatric check-up. Your feet are your link to the ground – let’s ensure that connection remains strong and healthy for years to come.
If you are experiencing foot issues as a result of your diabetes, please contact Dr. Bello’s office at (239) 430-3668 (FOOT) or visit us online at www.NaplesPodiatrist.com to schedule an appointment.
Serving Southwest Florida Since 2005, Family Foot & Leg Center has multiple convenient locations throughout Collier, Lee, Charlotte, and Sarasota Counties. Offering pediatric to geriatric family care: Ingrown Toenails, Heel Pain, Bunions, Foot / Ankle Arthritis Pain, Plantar Fasciitis, Foot / Ankle Surgery, Custom Orthotics, and Diabetic Wound Care. In office X-rays, ultrasounds, and minor surgical suite exam rooms. Practice powered by EMR and advanced technologies.
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