standard-title Medical pedicure: diabetic foot Diabetic foot is a combination of multiple foot problems, caused by diabetes.

Medical pedicure: diabetic foot

Diabetic foot is a combination of multiple foot problems, caused by diabetes.

Diabetic foot

Diabetic foot is a combination of multiple foot problems, caused by diabetes, which can lead to foot ulcers that cannot heel without adequate treatment.

The most common damaging circumstances that lead to ulcers are: poor blood circulation, nerve damage (diabetic neuropathy), infections and foot deformities.

Arteriosclerotic narrowing of the walls of blood vessels that supply blood to the foot can reduce the supply of blood that impedes the renovating of soft tissue and treating of the infection.



Nerve damage (diabetic neuropathy) causes a progressive loss of feeling sensation and also sensation for hot, cold  and pain. The foot becomes insensitive particularly in the fingers, but also as a whole. Sometimes insensitivity extends to the knees. Such foot is in great danger of being damaged.

Adverse effects normally sensitive foot immediately detects and we can avoid danger areas quickly. The most important is the sense of touch. Healthy foot detects any pressure on the skin without any difficulty. This so-called buffer sense of touch is weakened or absent if a person has diabetic foot. Therefore such a foot is highly exposed to foot injuries.medicnska pedikura Ljubljana

Everyday threat of injury are:

  • long-standing pressure on the foot, for example because of tight fitting shoes or objects in the shoe,
  • sharp object, for example stone, nail, drawing pin,
  • very hot object, for example hot-water bottle or heating brick for warming of legs, butt, embers etc.

With reduced sensitivity usually occurs also loss of strength in the muscles of the fingers and feet. Fingers do not carry enough body weight and more pressure receives the soles, especially the front parts. The pressure on the skin should not be too strong or else extra problems can occur.

It pressures on the soft tissue beneath and therefore eventually forms cavity with blood. The dry horn of the skin can easily crack. Through the cracks infectious calls come into the affected tissue and thus causing a festering infection. In the insensitive feet all this can occur without noticing.

Infection is caused by the intrusion of germs through the damaged skin. Good blood circulation and relief of the affected foot is a condition for normal treatment. Long-term treatment with antibiotics is often necessary, because it is impossible to improve blood circulation.
People with an ulcer should follow the instructions on foot-relief and if it is not implemented as it should be then the patient has a problem (eg. Patient walking along with the ulcer on the sole while he doesn’t feel the pain).
Treatment for diabetic foot ulcers and foot pain varies depending on their causes.

Fingers or soles deformities expose abnormal convex portions on pressed footwear.

In places of greater pressure the same changes occur as at incorrect distribution of forces on the sole – to corneous layers, formations of follicles in depth and cracking of horny skin cover.

Foot ulcers

Foot ulcers are wounds that cannot heel (or unusually very slowly) without adequate treatment. This is a dangerous complication that is often the result of a very ordinary skin damage:

  • mechanical damages (cutting sores, blisters, having too long tight shoes, etc.),
  • pressure of thick layer of horny skin on the soft tissue underneath,
  • hot burns (from hot-water bottles or heating pillows),
  • injuries by chemicals (eg. softening corns chemical means).


Nerve damage (diabetic neuropathy) can be recognized by the insensitivity of touch. Touch the skin of the fingers and feet with pieces of cotton wool.
Poor blood supply/circulation can be recognized by those signs and difficulties: the foot is cold, the patient has often cold feet, after walking a longer distance – pain in the calf or thigh appears. The skin of the feet is cold, lightly cherry-like coloured, nails are thickened, skin is dry and is peeling off. Ask your doctor to feel your vein pulse on the instep.
Hard and horny skin is a sign of excessive pressures during walking. Healthy foot skin at these points is normally thin and soft.

The ulcer can be very painful if the skin nerves are healthy or you can feel completely no pain, if the nerves are destroyed. Ulcers mainly caused by the slow blood flow (ischemic ulcers) occur typically at the edges of feet or toes where the tissue was subjected to longer pressure (several hours is already enough). Ulcer caused by rupture of horny skin at longer exposure to increased pressure during walking – is surrounded on the sole by a wreath of horn remainder. It is typical for severe foot nerve damages and it rarely hurts, because the nerves that should detect pain – are destroyed.

Gangrene and amputation

Gangrene is the dying of the tissue. We differentiate between dry and wet gangrene. Dry gangrene is caused by interruption of blood supply where dead tissue becomes hard and black. On the other hand wet gangrene is an infection that causes fluid oozing because of inflammation in the still living tissue.
Decayed tissue has to be removed by surgery (must be amputated). The range of amputation (finger, part of the foot, foot, shin or above the knee) depends on the extent of decayed tissue and on the condition of the arterial blood circulation. Part of the limb that remains has to be well blood circulated so that the wound heals well after amputation.


QUICK ADVICES: how can you help yourself


Check-up your feet by yourself.  If you have nerve or vein damages, you have to check-up your feet every day.  Most easily you can check-up the feet after washing or after a shower when you dry the feet with a towel or before putting on the socks.

Don’t overlook areas between fingers. For easier sole check-up help yourself with a mirror.


Wash your feet with running tepid water and mild soap. If your don’t feel your feet – measure the water temperature or at least check the heat of the water with your hand. Wash the feet as a whole but one by one. If the feet have some open wounds, be careful to make the water run away from the wound.
After washing wipe and dry the feet with soft towel, even between the fingers.
After washing and drying put a neutral moisturising cream on the dry feet, but not between the fingers.
Wear comfortable shoes and clean socks. Buy shoes in the afternoon when the feet are already swelled. The inner  part of a shoe should be smooth and the leather soft. Socks should be without distinct stitches.

If your feet start to swell wear shoes with shoelaces that must be well relaxed.

If your feet are constantly cold – wear warm socks, even by night if needed. Don’t get warm by electric cushions or other hot objects or devices that can burn you without even feeling the pain.

Clip the nails correctly. A quick advice for those who have damaged sense of touch and of pain: wear footwear to avoid injury. Don’t walk barefoot if you don’t feel your feet well. Before wearing the shoes check inside the shoes for any small object. Check also the socks that are fitting the feet without any wrinkle.


Even though you don’t have feet issues let the shoes be comfortable. For longer walks running shoes are most appropriate shoes to wear. If you have visible nerve damages or poor blood circulation protective shoes are necessarily to wear in your home or outdoor.
Walking shoes should have enough room for fingers, soft upper part, removable shoe sock and thick rubbery sole.


Regular pedicure is very important part of foot care. The pedicure is performed by pedicurist who knows that diabetics are endangered group and knows how to deal with diabetic feet.

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