What is diabetic foot?
Diabetic foot is a serious health problem involving wounds, infections and tissue loss in the feet of people with diabetes. A wound that appears small and insignificant can become more complex because of loss of sensation, poor circulation and a tendency to develop infection.
Nerve damage may prevent a patient from feeling a wound, circulation problems may slow healing, and immune problems may make infection more likely. Even a simple callus, shoe-related irritation or a small cut therefore needs careful monitoring.
Diabetic foot is more than a wound. Early awareness and appropriate referral may help reduce the spread of infection into deeper tissues, bone involvement and the risk of limb loss.
Which symptoms matter?
- A wound that does not heal or a new wound, blister or bleeding
- New redness, swelling, increased warmth or a change in shape
- Discharge, an unpleasant odor, fever or chills
- Blackening, a bluish color, pallor or a cold foot
- Numbness, tingling, burning, loss of sensation or balance problems
- Calluses, cracks and areas of repeated pressure
Same-day assessment: Contact a healthcare professional the same day for an open wound, unexplained swelling/redness/warmth, discharge or an unpleasant odor. Go to an emergency department for blackening, rapid deterioration, fever/chills or deterioration in your general condition.
Why does it develop?
Diabetic foot usually develops from the combined effects of loss of protective sensation, poor circulation, repeated pressure and susceptibility to infection, rather than a single cause. Because the contribution of these factors differs in every patient, assessment is individualized.
Nerve damage (neuropathy)
The ability to feel pain, temperature and pressure may decrease. Minor trauma or a foreign object inside a shoe may cause a wound without being noticed.
Poor circulation
Peripheral artery disease may reduce blood flow to the foot and make wound healing difficult. Circulation is not assessed solely from the appearance of a wound.
Pressure, friction and deformity
Unsuitable footwear, calluses, toe deformities or Charcot neuro-osteoarthropathy may increase pressure in specific areas.
Infection
Skin and soft tissue infection may spread to bone in some cases, causing osteomyelitis. Infection is diagnosed through clinical assessment; indiscriminate antibiotic use is not recommended for wounds that do not appear infected.
What does the assessment involve?
The extent of examination varies by patient. In addition to a detailed history and wound examination, the following are assessed:
- Skin, nails, calluses, wound depth and surrounding tissues
- Foot deformity, pressure areas and use of appropriate footwear
- Protective sensation using a 10-gram monofilament and additional methods
- Circulation through pulse checks and, when needed, noninvasive vascular tests
- Severity of infection and tissue/culture samples in suitable cases
- X-rays, MRI or other imaging when bone involvement or deformity is suspected
- Blood sugar control, kidney disease, smoking and previous wounds/amputations
Treatment approach
Treatment involves more than a dressing. The plan considers the wound's location and depth, infection, circulation, pressure, bone structure and general health together.
Pressure relief (offloading)
Reducing repeated pressure on the wound is a core part of the healing plan. The appropriate device and duration of use are selected according to wound location, infection/circulation status and patient safety.
Wound care and removal of dead tissue
Appropriate dressings, debridement when needed and care around the wound are planned. Dressing type is determined by the wound's needs; no single product suits every wound.
Management of infection and osteomyelitis
For clinical infection, appropriate sampling, antibiotics and surgical debridement when needed are planned. The physician determines the antibiotic, route and duration according to infection severity and test results.
Circulation assessment
If ischemia is suspected, assessment by a vascular specialist and procedures to restore blood flow may be considered in suitable cases.
Deformity and limb-preserving surgery
For infected bone, instability, Charcot deformity or recurring pressure wounds, reconstruction, Ilizarov techniques or other limb-preserving surgical options may be considered in suitable patients. The benefits, risks and alternatives of every surgical option are individual.
Multidisciplinary follow-up
Orthopedics may work in coordination with infectious diseases, vascular surgery, endocrinology/diabetes, wound care, orthotics/prosthetics and rehabilitation teams.
Prevention and avoiding recurrence
- Check the top of your feet, the soles and between your toes every day.
- Wash your feet with lukewarm water and dry gently, especially between the toes; moisturize dry skin, but do not apply moisturizer between the toes.
- Do not walk barefoot, even indoors; check inside your shoes before every use.
- Do not use sharp instruments or chemical products on calluses; seek professional help with nail and callus care.
- A comprehensive foot assessment at least once a year is recommended for everyone with diabetes. More frequent checks are planned for loss of sensation, poor circulation, deformity or previous wounds/amputations.
- Appropriate footwear, offloading and regular follow-up should continue after a wound heals.
Scientific sources
Content draft last updated: August 2026. Final medical review by a physician is required before publication on the live site.
