Diabetic Foot Ulcers: Prevention and Warning Signs

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INTRODUCTION

References

  1. American Diabetes Association. (2025). Standards of Care in Diabetes—2025. Diabetes Care, 48(Supplement_1). American Diabetes Association. https://diabetesjournals.org/care/issue/48/Supplement_1

  2. International Working Group on the Diabetic Foot (IWGDF). (2023). IWGDF Guidelines on the Prevention and Management of Diabetes-Related Foot Disease. https://iwgdfguidelines.org/

  3. Centers for Disease Control and Prevention (CDC). (2025). Diabetes and Your Feet. https://www.cdc.gov/diabetes/living-with/diabetes-and-your-feet.html

  4. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2024). Diabetic Foot Problems. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems

  5. National Health Service (NHS). (2024). Diabetic Foot Problems. https://www.nhs.uk/conditions/diabetic-foot-problems/

  6. Diabetes UK. (2025). Looking After Your Feet. https://www.diabetes.org.uk/guide-to-diabetes/complications/feet

  7. World Health Organization. (2025). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes

  8. Armstrong DG, Boulton AJM, & Bus SA. (2017). Diabetic Foot Ulcers and Their Recurrence. New England Journal of Medicine, 376(24), 2367–2375. https://doi.org/10.1056/NEJMra1615439

  9. Bus SA, Lavery LA, Monteiro-Soares M, et al. (2023). Guidelines on the Prevention of Foot Ulcers in People with Diabetes (IWGDF 2023 Update). Diabetes/Metabolism Research and Reviews. https://onlinelibrary.wiley.com/journal/15207560

  10. Boulton AJM, Armstrong DG, Albert SF, et al. (2008). Comprehensive Foot Examination and Risk Assessment. Diabetes Care, 31(8), 1679–1685. https://doi.org/10.2337/dc08-9021

Medical Disclaimer

This article is intended for educational purposes only and should not be considered medical advice. People with diabetes are at increased risk of foot ulcers, infections, and amputations. Daily foot care, proper footwear, regular blood sugar management, and routine foot examinations are essential for prevention. Always consult your healthcare provider or a qualified podiatrist if you notice foot pain, numbness, swelling, skin changes, blisters, sores, or wounds that do not heal. Never delay seeking medical attention for a diabetic foot ulcer or infection, as early treatment can help prevent serious complications.

"Healthy Feet, Healthy Life – Protect Your Feet Every Day."


  

About the Author

Uche Flora Okonkwo, MPH, is the founder and writer of Wellness by Flora. She develops practical, evidence-informed community-health education to help readers make informed health decisions.

Medical Disclaimer

This article provides general educational information. It is not a diagnosis or a substitute for individualized advice from a qualified healthcare professional.

A practical daily foot-care routine

Daily foot care can help a person notice small problems before they become more serious. Choose a regular time each day to look at the tops, soles, heels, and spaces between the toes. A mirror can help with the soles, or a family member can assist if bending is difficult. Look for cuts, blisters, cracks, redness, swelling, drainage, colour changes, or areas that feel unusually warm or cold.

Wash feet in warm—not hot—water, then dry gently, especially between the toes. Moisturiser may help dry skin on the tops and bottoms of the feet, but it should not be placed between the toes, where excess moisture can irritate the skin. Avoid walking barefoot, including inside the home. Comfortable, well-fitting shoes and clean socks help protect the skin from unnoticed injuries.

Footwear and self-care precautions

Check the inside of shoes before putting them on. Small objects, rough seams, or worn areas can cause pressure or rubbing without being felt by someone with nerve damage. Shoes should have enough room for the toes and should not rub the heel or sides of the foot. Do not cut corns or calluses yourself or use strong chemical corn removers. A clinician or foot-care professional can advise on safer treatment and whether special footwear or inserts are appropriate.

When to contact a clinician

Contact a healthcare professional promptly for a new sore, blister, crack, cut, ulcer, ingrown toenail, increasing pain, numbness, swelling, or skin colour change. A wound may not hurt when nerve damage is present, so it should still be assessed. Seek urgent medical care for spreading redness, pus or other drainage, fever, chills, a black or blue area of skin, or feeling generally unwell. Do not try to treat a suspected ulcer at home or continue wearing a shoe that rubs the affected area.

Make foot checks part of diabetes care

Blood glucose management, blood-pressure care, not smoking, regular movement when appropriate, and routine medical appointments all support overall circulation and healing. Ask your diabetes care team to examine your feet at regular visits and to explain your individual risk. People with previous ulcers, loss of feeling, poor circulation, foot shape changes, or kidney disease may need more frequent assessment and a personalised prevention plan.

Questions to take to an appointment

  • Can you check my foot sensation, skin, pulses, and footwear?
  • Do I need a referral to a podiatrist or diabetes foot-care clinic?
  • What signs mean I should call the clinic the same day?
  • Are my current shoes appropriate for my feet and activity?

Sources

This article is for general education and does not replace medical diagnosis or treatment. For a new wound, suspected infection, or rapidly worsening foot problem, seek timely medical care.

Hello! I'm Uche Flora — a Public Health Professional, Community Health Advocate, Nurse, and Founder of Wellness by Flora, My passion is empowering individuals and families with trusted, evidence-based health information that helps them live healthier, longer lives.

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