Diabetes and feet: why 80% of amputations are preventable

Updated August 2024 | 5 min read  
Expert contributor Dr Peter Lazzarini, Co-chair of Diabetic Foot Australia  
Words by Karen Burge 

When it comes to diabetes and feet problems, prevention is key. Here’s how to stay one step ahead of diabetic foot disease. 

Diabetic foot disease, which includes ulcers, infections and ischaemia (severe circulation restriction), is Australia’s leading cause of amputations. Each year there are 10,000 hospital admissions in Australia for diabetes-related foot ulcers and more than 4,400 amputations, according to Diabetes Australia.

But there are ways to prevent foot problems from spiralling out of control.

According to Diabetes Feet Australia, 80% of diabetes-related amputations are preventable with good management and ongoing care.

The connection between diabetes and feet problems

About 1.3 million Aussies have diabetes, and damage to nerves in the feet is a common complication for people with this disease. The damaged nerve function is known as ‘peripheral neuropathy’ and 50,000 Aussies are living with diabetes-related foot disease.

It can result in pain, tingling, weakness or reduced feeling in the feet and lower limbs, causing an abnormal walking pattern and creating pressure on certain parts of the foot.

New calluses might develop, giving an early warning sign, but it’s the continued abnormal walk that increases the chance of it turning into a sore. If feeling to the area is reduced, pain can go unnoticed and a person might not detect the warning symptoms. Without adequate circulation, healing is also impeded.

People with diabetic foot disease may be asymptomatic, which means there are no obvious signs. This makes regular foot checks essential.

Preventing diabetic foot disease

Co-chair of Diabetic Foot Australia, Dr Peter Lazzarini, says the most important thing people with diabetes can do for their feet is to have an annual check-up to find out if they have any risk factors for foot disease.

“This foot screen can be done quickly and painlessly by visiting a GP or podiatrist,” he says. “[They] will test your feet to see if you have any poor feeling (peripheral neuropathy) or poor circulation (peripheral arterial disease, which can lead to ischaemia).”

According to Dr Lazzarini, if you don’t have either of these risk factors, your risk level for developing foot disease in the next year is low. You may be able to stick to annual check-ups unless you have any concerns.

But if these risk factors are picked up, Dr Lazzarini says you may need regular preventive care every few months at your podiatrist or GP. You’ll also need to check your own feet daily.

“The podiatrist [or doctor] will check to see if your feet have any early damage and treat that early damage (like calluses, corns or blisters) before it may lead to foot disease and, in particular, foot ulcers,” he explains.

They can advise on appropriate footwear and perhaps insoles to help protect your feet from damage.

The early warning signs of diabetic foot disease

There are opportunities to bring diabetes under control before it impacts your feet. The signs that your diabetes isn't under control can include high blood glucose levels, high blood pressure and high cholesterol.

“It’s the high blood glucose levels in particular that, over time, really do the damage to the nerves and blood vessels in the feet,” Dr Lazzarini says.

Also, see your GP regularly to monitor and manage your diabetes. Your doctor may suggest strategies to help you stay healthy, including:

• a diet and exercise plan
• home monitoring of blood glucose levels
• referring you to other health experts
• starting or increasing medication to keep your diabetes under control.

Tips for looking after diabetic feet

It’s important to keep on top of a daily foot-care routine. Diabetic Foot Australia recommends you practise a ‘check, wash, watch’ routine before your shower or at bedtime.

• Check for damage, which includes ulcers, sores, cuts, bruises and new callouses. Feel your feet, paying attention to any numbness or tingling. Check your foot temperature to see if there are any hot or cold changes across your foot.
• Wash daily using soap, dry thoroughly, and ask for help if you can’t reach.
• Watch for any changes to your overall diabetes health, maintaining toenail health, wearing good shoes and avoiding sudden temperature changes, such as walking on hot ground.

See a health professional straight away if you notice any changes to your feet.

Healthier with support

If you have diabetes, you can trust HCF to help you be your healthiest self. That’s why we’ve launched The COACH Program^®. Delivered by qualified health professionals, this telephone support program is provided by health coaches, at no extra cost for eligible members^* with diabetes and heart conditions.