Feet rarely make headlines, but they carry some of the body's earliest warning signals. Around 130,000 of the roughly 200,000 lower-limb amputations performed in the United States each year involve people with diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Most of those amputations begin as subtle changes that go unnoticed. The good news is that many of the underlying problems are treatable when they are caught early. Health authorities including the American Diabetes Association, the National Heart, Lung, and Blood Institute and Mayo Clinic point to a short list of foot signs that deserve attention.
Cold or discolored toes
Persistently cold feet, especially when only one foot feels colder than the other, can signal narrowed arteries. The National Heart, Lung, and Blood Institute lists among the symptoms of peripheral artery disease that "one foot may feel colder than the other" and that "your foot or leg may become pale, discolored, or blue."
Peripheral artery disease, or PAD, occurs when plaque narrows the arteries and reduces blood flow to the limbs. The Cleveland Clinic notes that a sudden blockage can make the skin turn "purple, green, black or very pale" and feel cool to the touch. Toenails and leg hair may also stop growing.
Also read: If you take ACE inhibitors for blood pressure, these foods could raise your potassium dangerously
Smoking and diabetes are two of the strongest risk factors. Cleveland Clinic notes that people in those groups are two to four times more likely to develop PAD.
Tingling, numbness or burning in the feet
A creeping loss of sensation in the toes is one of the most common signs of diabetic peripheral neuropathy, the nerve damage caused by long-standing high blood sugar. Mayo Clinic describes symptoms that usually start with numbness, prickling or tingling in the feet before spreading upward, sometimes with a sharp, jabbing or burning pain that is often worse at night.
The problem is not just discomfort. The American Diabetes Association warns that when nerve damage lessens the ability to feel pain, heat and cold, "you may not notice a foot injury until the skin breaks down and becomes infected." Numb hands and feet can carry a range of meanings, and persistent symptoms warrant a medical evaluation.
Dry, cracking skin
Skin on the feet that suddenly becomes very dry, flaky or fissured can be another downstream effect of nerve damage. The American Diabetes Association notes that in people with diabetes, "at times your foot may become very dry. The skin may peel and crack."
Also read: 8 warning signs of rheumatoid arthritis most people mistake for normal aging
The reason is that the same nerves that carry sensation also help control the sweat glands. When they are damaged, the skin loses moisture. Cracks then become entry points for bacteria and fungi, raising the risk of infection.
Slow-healing sores or ulcers
A cut, blister or sore on the foot that does not heal within a few weeks is a red flag. Poor circulation and reduced immune response, both common in diabetes, slow the healing process.
The American Diabetes Association points out that foot ulcers most often appear on the ball of the foot or the bottom of the big toe, and that "every ulcer should be seen by your doctor right away. Neglecting ulcers can result in infections, which can lead to limb loss." The NHLBI lists sores or wounds that "may heal slowly, or may not heal at all" among the signs of advanced PAD.
Swollen feet and ankles
Puffiness in the feet has many causes, from a long flight to a hot day, but when it lingers it can point to something more serious. The National Kidney Foundation identifies swelling in the hands, feet or ankles as a warning sign that "your kidneys aren't doing their job," because struggling kidneys can allow fluid to build up. The same swelling can appear in heart failure, when the heart cannot pump efficiently and fluid collects in the lower body.
Also read: Your home may have dangerous lead dust even without lead paint, new research warns
When to see a doctor
The common thread across these signs is simple. Any change that appears suddenly, does not resolve within a couple of weeks, or affects only one foot deserves a medical check. That includes a sore that will not heal, new numbness or tingling, a foot that turns pale, blue or cold, or persistent swelling.
The American Diabetes Association urges people with diabetes to check their feet daily for blisters, cracks and other signs of injury. For anyone else, a change that seems small can still be the earliest hint of a circulation, nerve or heart problem worth catching now rather than later.
Also read: How eating garlic every day can affect your heart, immunity and gut
This article is made and published by Jesper Bengtson, who may have used AI in the preparation.