🦶 Men's Health

Diabetic Foot Care

Preventing the leading cause of non-traumatic amputation in Nigeria.

Diabetic foot complications — ulcers, infections, and amputations — are the most feared and most preventable diabetes complication. Nigeria has extremely high rates of lower limb amputation from diabetes, almost always preceded by a small wound that was ignored or treated too late. Daily foot care and prompt attention to any injury can prevent this outcome.

Signs and Symptoms

✓ Tingling, burning, or numbness in the feet (nerve damage)

✓ Reduced or absent sensation — unable to feel pain, heat, or touch normally

✓ Cold feet with thin, shiny skin — poor blood flow

✓ Slow-healing cuts, blisters, or sores

✓ Calluses and corns — from pressure and reduced sensation

✓ Cracking skin between toes — entry point for infection

✓ Redness, warmth, or swelling around any foot wound

✓ Discharge from a foot wound — sign of active infection

✓ Dark discolouration of toes — very serious, may indicate gangrene

✓ Foot ulcers — any open wound, no matter how small, needs medical attention the same day

Risk Factors

Peripheral neuropathy — nerve damage from chronically high blood sugar
Peripheral arterial disease — reduced blood supply to the feet
Poor glucose control (high HbA1c)
Diabetes duration — longer-standing diabetes increases risk
Previous foot ulcer — strongest predictor of future ulcer
Smoking — dramatically worsens blood supply to feet
Walking barefoot — the most common way foot injuries begin in Nigeria
Wearing tight or poorly fitting shoes

When to Seek Help

NowAny foot wound that is red, warm, swelling, producing discharge, or smelling foul — diabetic foot infections progress rapidly and can become limb- or life-threatening within days.

NowBlack or dark discolouration of any part of the foot or toes — requires emergency vascular assessment.

SoonAny new blister, cut, callus, corn, or skin break — even if it seems minor. Diabetics cannot rely on pain to warn them because neuropathy removes the signal.

RoutineAnnual foot examination by a doctor or nurse — to assess sensation, blood flow, skin condition, and footwear. More often if previous foot problems.

Tests & Diagnosis

🧪 Monofilament Sensation Test

A simple 10-gram monofilament pressed to different points on the foot assesses protective sensation. Failure to feel it at multiple points indicates high-risk neuropathy.

🧪 Doppler Ankle-Brachial Index (ABI)

Compares blood pressure at ankle versus arm — detects peripheral arterial disease (poor blood flow to feet) that impairs wound healing.

🧪 Wound Swab Culture & Sensitivity

For any infected wound — identifies the bacteria causing infection and which antibiotics will work. Critical for choosing the right antibiotic in diabetic foot infections.

🧪 X-ray of the Foot

Detects gas in tissues (severe infection), bone destruction (osteomyelitis), or foreign bodies in wounds.

🧪 Blood Glucose and HbA1c

High blood sugar impairs wound healing, immune function, and blood flow — optimising control is part of wound management.

Treatment Options

Daily Foot Inspection

Every day, check both feet — all surfaces including between toes. Use a mirror if needed. Report any new finding immediately. This simple habit prevents the majority of amputations.

Proper Footwear — Always

Never walk barefoot, including indoors. Wear well-fitting, closed-toe shoes. Check inside shoes for foreign objects before wearing. Custom diabetic footwear for high-risk feet.

Wound Care

Clean any wound gently with saline or clean water. Cover with a clean dressing. Do not apply traditional remedies, kerosene, or toothpaste. See a doctor the same day.

Antibiotics and Debridement

Infected diabetic foot wounds require appropriate antibiotics (based on wound culture) and regular cleaning and removal of dead tissue by a healthcare professional.

Blood Glucose Optimisation

Wounds heal much faster when blood sugar is well controlled. A temporary intensification of diabetes treatment during wound healing is often needed.

Vascular Assessment and Intervention

If blood flow is compromised, angioplasty or bypass surgery may restore circulation and allow healing of wounds that would otherwise not heal.

Frequently Asked Questions

My feet are numb — is that dangerous?

Yes — numbness (neuropathy) is one of the most dangerous aspects of diabetic foot disease because it removes the pain signal that warns of injury. You must inspect your feet daily and protect them carefully, because you cannot rely on pain to alert you.

A small cut on my foot is not healing — how long should I wait?

Do not wait. Any wound in a diabetic that is not healing within a few days, or is showing any signs of redness or infection, must be seen by a doctor the same day. Diabetic foot infections can deteriorate from a small wound to a serious infection requiring hospitalisation within 48 hours.

Can amputation always be prevented?

Not always — but 80% of diabetic amputations are preventable with proper foot care, daily inspection, prompt treatment of any wound, and good blood sugar control. The goal is to prevent the first ulcer, and to treat any ulcer aggressively before it progresses.

What kind of shoes should I wear?

Closed-toe, well-fitting shoes with a wide toe box and cushioned sole. Avoid narrow, pointed, or high-heeled shoes. Have feet measured properly — diabetes can change foot shape. Consider diabetic footwear from a specialist if you have neuropathy or previous ulcers.

I found a black toe — what should I do?

Go to hospital immediately. Black discolouration of toes indicates gangrene — tissue death from absent blood supply or severe infection. This requires emergency vascular and surgical assessment. Do not delay.