High Blood Sugar Levels Could Lead to a Dangerous Diabetic Foot Ulcer—How to Spot and Treat It Early
Plus see the two home remedies a doctor says may make things worse
You might expect a serious medical problem like diabetic foot pain to cause throbbing pain, swelling or at least a little discomfort. But a diabetic foot ulcer, one of the most dangerous complications of diabetes, can sometimes sneak up without warning.
“In people with long-standing or poorly-controlled diabetes, the nerves in the feet often lose their ability to sense pain,” explains Windy Cole, DPM, CWSP, a Cleveland-based podiatrist and certified wound care specialist. “That means someone can step on a sharp object or wear an ill-fitting shoe and not even know there’s been an injury until it’s already infected.”
This loss of sensation, called peripheral neuropathy, happens when prolonged high blood sugar damages tiny nerve fibers, especially in the feet. Reduced blood flow and a slower immune response make it even harder for diabetic foot wounds to heal.
Woman's World Answers
Who’s most at risk for diabetic foot pain and ulcers?
Anyone with diabetes is at risk, but some people are more vulnerable to foot ulcers than others. That includes people with poorly-controlled blood sugar levels, says Dr. Cole, who teaches at Kent State University College of Podiatric Medicine.
That’s a problem, since an estimated 15 to 20 percent of people with diabetes will develop a foot ulcer during their lifetime, which can lead to serious complications. That’s why identifying your personal risk and taking proactive steps to ward off foot problems is critical.
Dr. Cole says common risk factors for developing a diabetic foot ulcer include:
- A history of neuropathy or nerve pain
- Dry, cracked skin on the feet or heels
- Poor circulation
- Wearing ill-fitting shoes
- Having limited mobility or vision (which makes self-checks difficult)
Even early symptoms like tingling, burning or diabetic foot pain can signal trouble. “In the beginning stages of neuropathy, patients might get a pins-and-needles sensation or a feeling of warmth,” she says. “But when the damage becomes more significant, they just don’t feel pain in the affected area—and that’s what leads to serious complications.”
5 expert-approved ways to prevent a diabetic foot ulcer
Reducing your risk of ulcers—and practicing proper self-care techniques if you already have one—is especially important for those with poorly-controlled type 2 diabetes or diabetic neuropathy. Here’s what Dr. Cole recommends:
Check your feet every day
“Daily foot checks should be the norm for patients with diabetes,” says Dr. Cole. “Look for any areas of redness, blistering, callus tissue or even breaks in the skin.”
She compares calluses on the diabetic foot to finding a lump in the breast: “It’s a serious problem that could mean something dangerous is forming underneath.”
“If you can’t see the bottoms of your feet easily, place a mirror on the floor,” she adds. “Or have someone you trust act as a ‘foot check buddy.’” This includes checking between toes, where infections can hide.
Apply lotion the right way
Because of nerve damage, many people with diabetes also experience dryness due to impaired circulation. “Use creams or lotion on a regular basis to hydrate the skin, but not in between the toes,” Dr. Cole advises. “Those web spaces already retain moisture, and added cream can cause skin breakdown and infection.”
Wear shoes both inside and out
“Improper shoes and walking barefoot are two of the most common ways people injure themselves,” Dr. Cole says. She’s seen patients unknowingly walk on hot pavement or sharp objects because they simply couldn’t feel it.
“That lack of pain sensation is what makes these injuries so dangerous,” she explains. “Good-fitting shoes protect the feet and help prevent ulceration.”
Steer clear of these home remedies
Not everything trending online for foot care is safe for people with diabetes. Dr. Cole advises against these home remedies for diabetic foot ulcers:
Foot soaks: “Foot baths may sound relaxing, but they can be harmful if you have neuropathy,” says Dr. Cole. “You may not realize the water is too hot, which can lead to burns. And if the soak isn’t properly sanitized, you’re introducing bacteria into cracks in the skin.”
Compression wraps or socks: “Compression can be helpful for people with edema or venous insufficiency, but only when we know blood flow to the foot is good,” Dr. Cole cautions. “If you have arterial disease and use compression without a doctor’s evaluation, it could make things worse.”
When to see a doctor about a foot ulcer that won’t heal
The moment you notice a sore that won’t heal, unusual drainage or a sudden odor is the time to react, says Dr. Cole. “Once a diabetic foot ulcer forms, don’t wait. Go to a wound care specialist,” says Dr. Cole. “These are not conditions to manage on your own.”
Treatment depends on the wound’s severity and underlying cause. “If there’s a lot of unhealthy tissue, we might use enzymatic products to help the body remove it,” Dr. Cole explains. These topical treatments use enzymes to break down dead tissue so healthy new tissue can grow, which supports healing and lowers infection risk.
Other options may include antimicrobial dressings, offloading boots or casts and, in some cases, surgery. “There are hundreds of advanced wound care products out there,” says Dr. Cole. “But they only work when matched with the right diagnosis and plan.”
The bottom line: why feeling ‘no pain’ could be a hidden danger
The most serious danger of a diabetic foot ulcer is what you don’t feel. As Dr. Cole explains, “Pain is our body’s natural alert system. But most people who develop diabetic foot ulcers actually have a lack of sensation.”
That’s why daily foot checks and good skincare aren’t just routine—they’re essential tools for catching problems before they become serious.
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