Diabetes-Related Foot Disease Explained


Published: 04 July 2022

What is Diabetes-Related Foot Disease?

Diabetes-related foot disease (DFD) is the name given to a condition most commonly experienced by people with diabetic peripheral neuropathy. It results in an insensitive and often deformed foot (Better Health Channel 2014).

A common sign of diabetic foot is when a patient displays an unusual manner of walking (DFA 2020a).

High or fluctuating blood glucose levels caused by diabetes decrease blood flow to the extremities and nerve damage will prevent the skin from repairing itself (DFA 2020b).

Consequently, even minor trauma can create ulceration (a break in the skin) on the foot (DFA 2020b).

DFD can occur in patients with both Type 1 and 2 diabetes (DFA 2020b).

diabetes-related foot disease ulcer

Diabetes-Related Foot Disease Presentation and Complications

DFD occurs due to neuropathic pain, tingling weakness or reduced sensation in the feet (DFA 2020b).

Due to this loss of sensation, the person is unlikely to notice that they have injured their foot, and furthermore, are unlikely to realise that their condition is worsening. This is one of the reasons why this condition is so serious (DFA 2020b).

The foot sores, cuts and ulcers incurred by the patient may become infected. These infections can potentially spread to the bone and ulcers can lead to tissue death.

As a result of this, the amputation of a toe, foot or even the lower leg may be necessary (Mayo Clinic 2020).

Diabetes-Related Foot Disease in Numbers

Around 1,300,000 (1 in 20) Australians have diabetes (ABS 2022). Diabetes presents a considerable challenge to Australia’s healthcare system and is one of the fastest-growing chronic conditions in Australia (Diabetes Australia 2022a).

It’s likely the prevalence of diabetes is underestimated, with the ABS finding that for every four adults with diagnosed diabetes, there is one who is undiagnosed (AIHW 2020).

Over 4,400 amputations related to diabetes are performed every year in Australia (Diabetes Australia 2020), yet, it’s believed that 80% of these are avoidable if correct care and prevention are observed (DFA 2020b).

The solution most often suggested to patients is a daily foot care routine and regular foot monitoring with the help of a healthcare professional (DFA 2020b).

Diabetes-Related Foot Disease Treatment

In the majority of cases, foot ulcers will heal if the correct procedures are followed.

It’s worth noting that even the best wound care cannot compensate for ongoing damage to the wound bed, inadequately treated ischaemia or infection. Patients with a deep ulcer often require intensive treatment or may need to be admitted to hospital (DFA 2020a).

The following treatment strategies are recommended:

  • Protecting the ulcer and relieving it from pressure
  • Ensuring skin perfusion
  • Infection control
  • Metabolic control and treatment of comorbidities
  • Wound care
  • Educating patients and relatives about foot care
  • Taking preventative measures to avoid recurrence
  • Advising patients to seek immediate medical attention if they notice an ulcer, unusual swelling, redness, blisters, ingrown toenail(s), bruising or cuts.

(DFA 2020a)

When to Escalate Care

Diabetic foot being treated

Patients should seek immediate medical attention if they notice any of the following signs:

  • Unusual swelling
  • Redness
  • Blisters
  • Ingrown toenail(s)
  • Bruising or cuts.

(Diabetes Australia 2022b)

Prompt medical attention (not necessarily immediate but still within a week’s time frame) is to be advised if patients notice:

  • Broken skin between the toes
  • A callus
  • A corn
  • Changes in foot shape
  • Cracked skin
  • Nail colour changes.

(Diabetes Australia 2022b)

Preventing Diabetes-Related Foot Disease

The following preventative measures are recommended to avoid the escalation of this condition:

  • Assess all people with diabetes and determine their risk of developing foot complications
  • Frequently inspect and examine the at-risk foot
  • Educate the patient, family and healthcare providers
  • Advise patients to wear appropriate footwear (i.e. well-fitting, protective and closed)
  • Advise patients to perform daily foot care (washing and thoroughly drying feet, assessing for signs of infection, moisturising dry skin)
  • Attend to pre-ulcerative signs
  • Ensure the patient’s toenails are kept trimmed and filed.

(Better Health Channel 2014)

Impacts on Health

A study conducted by the University of Wollongong in 2018 found that people with DFD ulcers tended to have an overall low quality of life - even more so in those with larger ulcers, chronic ulcers and ulcers complicated by infection (Khunkaew et al. 2019).

Researchers collected data from 12 different studies looking into health-related quality of life in people with DFD and found that patients had poorer physical functioning, vitality and overall quality of life (Khunkaew et al. 2019).


The severity of DFD should not be underestimated. As the prevalence of diabetes continues, DFD will remain a prominent health issue.

Diabetes-related foot ulcers are globally-recognised as the primary cause of diabetes-related hospitalisations and amputation, with mortality rates comparable to those of many cancers (DFA 2020a).

Education and prevention are vital to improving the quality of life in people with diabetes and to curbing high rates of avoidable amputations.


Test Your Knowledge

Question 1 of 3

Which one of the following is not a preventative measure of diabetic foot?


educator profile image
Ausmed View profile
Ausmed’s editorial team is committed to providing high-quality, well-researched and reputable education to our users, free of any commercial bias or conflict of interest. All education produced by Ausmed is developed in consultation with healthcare professionals and undergoes a rigorous review process to ensure the relevancy of all healthcare information and updates to changes in practice. If you have identified an issue with the education offered by Ausmed or wish to submit feedback to Ausmed's editorial team, please email ausmed@ausmed.com.au with your concerns.