Clinical researcher explains the effect of diabetes on foot health, lists 5 warning signs not to be ignored

Diabetics can have a small foot injury transform into a serious wound if they are not careful about it, cautions clinical researcher Krishna Sai Penumarthi.

Diabetes has become an increasingly common chronic condition in India, but one of its often-overlooked complications is the risk of serious foot problems. The situation can rapidly escalate, especially if the early warning signs are ignored, shared Arizona-based clinical researcher Dr Krishna Sai Penumarthi (PharmD) with HT Lifestyle.

“What might seem like a small injury can turn into a serious wound, especially if nerve damage, poor circulation, or slow healing gets in the way of recovery,” noted the expert, adding that spotting these changes early and getting medical help right away can be crucial in avoiding long-term issues.

He went on to highlight five signs that need immediate attention, which are presented as follows.

1. Sensations like tingling, burning or numbness

Penumarthi explained that persistent tingling, a burning discomfort, or a decrease in sensation in the feet could be a sign of diabetic peripheral neuropathy, a form of nerve damage linked with diabetes.

Small cuts and blisters can become serious when diabetes affects circulation, sensation or wound healing. Sores that persist, enlarge or show signs of infection need prompt medical assessment.

“Two patients with similar wounds can heal very differently. Circulation, infection, blood sugar control and the care they receive all play a role. That's why a wound that isn't healing as expected should never be ignored,” stated the expert.

A foot injury can heal slower in a person with diabetes.

3. Changes in skin colour or temperature

A foot that becomes unusually pale, bluish, darker or noticeably colder than the other may indicate a problem with blood circulation. Redness or unusual warmth can also signal inflammation or infection.

According to Penumarthi, any sudden change in colour or temperature should be assessed promptly, especially when accompanied by pain, swelling or a wound.

4. Swelling or changes in foot shape

The clinical researcher warned against dismissing sudden swelling, changes in foot shape or difficulty wearing previously comfortable footwear.

“A foot that becomes unusually warm and swollen, even without pain, may indicate Charcot foot, a serious condition affecting the bones and joints. Prompt medical assessment is essential to help prevent further damage,” he stated.

5. Cracked skin, thickened nails or signs of infection

Dry, cracked skin creates openings through which bacteria can enter, cautioned the researcher. Fungal infections between the toes, thickened toenails, corns and signs of infection also deserve attention.

“People with diabetes should avoid cutting corns or calluses themselves, as this can cause injuries that are difficult to heal,” he stated.

“Daily foot inspection is a simple but important habit. Check the soles, heels, spaces between the toes and around the nails. If you cannot examine your feet easily, use a mirror or ask someone to help. Any new wound, swelling or change in sensation should be assessed by a healthcare professional,” added Penumarthi.

Making foot care part of daily diabetes management

People with diabetes should inspect their feet daily, wear well-fitting footwear, avoid walking barefoot and wash and dry their feet carefully, particularly between the toes. The expert noted that regular foot examinations are important even when there are no obvious symptoms.

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Dr Krishna Sai Penumarthi , PharmD, PgDip.RA, MSRA, CCRP, is a US-based clinical research professional and Clinical Research Manager at Advanced Foot Care in Phoenix, Arizona. His expertise spans clinical trial operations, regulatory affairs, and advanced wound-care research, with a particular focus on diabetic foot ulcers.