Diabetes and Foot Health: A Path to Long-Term Care Unless You Take Proactive Action
What starts as a missed blister could change your life—or your loved one's. If you have diabetes or you're caring for someone who does, you already know it's a complex condition.
But what's often missed is the silent damage happening to your feet. A small sore that goes unnoticed can quickly spiral into a life-altering infection, a hospital stay, or even an amputation. And once that happens, the path often leads to long-term care—expensive, emotional, and hard on families.
You might not think much about foot care. But for people living with diabetes, it's essential. And it's not just about staying comfortable—it's about staying independent.
What is Diabetes—And Why Does it Harm the Body?
Diabetes is now the fastest-growing chronic disease globally and the most costly chronic condition in the United States. “Most of us know someone affected by diabetes,” says Charles “Chuck” Henderson, CEO of the American Diabetes Association. More than 37 million Americans are living with diabetes — and one in five don’t even know they have it.
Diabetes is a chronic disease that affects how your body turns food into energy. When you eat, your body breaks carbohydrates into glucose (sugar), which enters your bloodstream. Normally, insulin—a hormone made by the pancreas—helps move glucose into your cells.
However, with diabetes, this system doesn't work properly. Either your body:
- Doesn't make insulin at all (Type 1 diabetes), or
- Doesn't use insulin effectively (Type 2 diabetes, the more common form)
As a result, glucose builds up in your blood. Over time, this damages blood vessels, nerves, and organs—including your heart, kidneys, eyes, and feet.
Diabetes Symptoms and Diagnosis
You or your loved one might not even notice the signs at first. Watch for:
- Fatigue
- Blurred vision
- Frequent urination
- Excessive thirst
- Slow-healing wounds
- Tingling or numbness in the feet or hands
Diagnosis is made through simple blood tests, including:
- A1C – measures average blood sugar over 2–3 months
- Fasting blood sugar
- Oral glucose tolerance test
A1C, or hemoglobin A1C, is a simple blood test that reflects your average blood sugar levels over the past two to three months. It measures the percentage of glucose attached to hemoglobin, the protein in red blood cells that carries oxygen. A normal A1C level is below 5.7%, indicating healthy blood sugar control.
Levels between 5.7% and 6.4% suggest prediabetes, a warning sign that you’re at increased risk for developing type 2 diabetes. An A1C of 6.5% or higher is used to diagnose diabetes.
Regular A1C testing is a key tool in both identifying diabetes early and managing it effectively to prevent long-term complications.
Standard Treatment Plans
Diabetes is managed, not cured. Treatment often includes:
- A balanced diet and regular exercise
- Blood sugar monitoring
- Medications or insulin therapy
- Preventive care, including eye, kidney, and foot checks
Even with good blood sugar control, complications—especially in your feet—can still develop over time.
How Diabetes Damages Your Feet
Your feet are especially vulnerable because diabetes affects both circulation and nerve function.
Here's what happens:
- Nerve damage (neuropathy) dulls your ability to feel pain, heat, or injuries
- Poor blood flow (peripheral artery disease) slows healing and weakens tissue
- Small cuts or blisters go unnoticed and untreated
- Infections develop and worsen quickly
- Ulcers or gangrene may lead to amputation
Top podiatrists, like those in Boca Raton, Florida, see the consequences regularly.
"We treat patients who say they didn't feel anything until it was too late. Many end up in surgery or rehab. It's heartbreaking because in many cases, it's preventable."
According to the American Diabetes Association, about 1 in 4 people with diabetes will develop a foot ulcer in their lifetime. See a Boynton Beach foot doctor or one near you to maintain healthy feet.
Real Cost of Foot Problems
When foot ulcers get infected, the outcomes can be serious and life-changing:
- Hospital stays for wound care or IV antibiotics
- Surgery to remove dead tissue or perform amputations
- Physical rehab to regain strength or learn to walk again
- Home health aides or long-term care in a facility like assisted living,m or even a nursing home to help with mobility and daily tasks
Tom, 67, from Boston, knows this first-hand.
I stubbed my toe and didn't even realize it. A week later I was in the hospital. I lost the toe and needed home care for two months. It changed everything.
Everyday activities like grocery shopping, cooking, and navigating one's home can become difficult, significantly impacting independence. Assistance with bathing, dressing, and other personal care tasks may be needed. If independent living becomes impossible, assisted living facilities or nursing homes may be necessary.
Costs add up quickly. The LTC News Cost of Care Calculator shows both national averages and the cost of care where you live. The national averages are high:
- Home health care averages $5,500/month
- Assisted living costs around $4,900/month (before surcharges)
- Skilled nursing can exceed $10,500/month and can be higher depending on location
And Medicare? It doesn't cover long-term custodial care. Your health insurance and Medicare will only pay for short-term skilled care. Medicaid requires you to have very limited financial resources.
That leaves your personal income and assets, family, or Long-Term Care Insurance. However, you must be in fairly good health to obtain an LTC policy, and most people do so between the ages of 47 and 67.
Prevention: What You Can Do Today
You have the power to prevent foot-related complications with a few simple habits:
Check your feet every day
Look for redness, cuts, swelling, or blisters. Use a mirror or ask for help if needed.
Wash and dry your feet
Use warm water and mild soap. Dry well—especially between the toes.
Moisturize—carefully
Apply lotion to prevent cracks, but not between the toes to avoid fungal infections.
Wear good shoes and socks
Choose shoes that fit well and don't rub. Avoid walking barefoot. Opt for cotton or wool socks that wick moisture.
See a podiatrist regularly
Have your feet professionally examined at least once a year—or more if you've had issues.
Keep your blood sugar in range
Work with your doctor or endocrinologist to monitor and manage your levels.
Caregivers: Your Role Is Critical
If you care for someone with diabetes, you're a key part of their foot health plan:
- Help inspect their feet daily
- Watch for signs of infection—redness, pus, odor, or swelling
- Assist with bathing, drying, and lotion
- Encourage and arrange regular podiatrist visits
- Help them choose safe, supportive shoes
Caregivers often notice problems before the person with diabetes does—especially if they have neuropathy.
When Long-Term Care Becomes Necessary
Despite your best efforts, complications can still happen. And when they do, the need for long-term care can follow quickly:
- Post-amputation recovery may require rehab, home health aides, or mobility aids
- Loss of independence can trigger a move to assisted living or skilled nursing
- Family members may become full-time caregivers or need to hire professional help
Planning now, before health issues and age make it difficult or impossible to get Long-Term Care insurance can protect your finances and reduce stress. Traditional Long-Term Care Insurance or hybrid life/LTC policies and short-term cash indemnity plans will help cover costs most health insurance plans ignore.
Be sure to find qualified long-term care services near your loved one by using the LTC News Caregiver Directory. You can search from over 80,000 caregivers, home health agencies, senior living, adult day care centers, assisted living, memory care, and nursing homes.
If your loved one has a Long-Term Care Insurance policy, be sure to utilize the benefits to pay for quality extended care services.
LTC News also offers free no-obligation assistance processing claims from any Long-Term Care Insurance policy. Partnering with Amada Senior Care, LTC News ensures that you and your loved ones receive quality care without worrying about securing their LTC Insurance benefits, including benefits for home modifications - Filing a Long-Term Care Insurance Claim.
Take Action—Before It's Too Late
The most dangerous foot problem isn't one that hurts—it's the one you don't feel. Conditions like peripheral neuropathy can become a problem.
About half of all people with diabetes will develop peripheral neuropathy—nerve damage that can lead to numbness, tingling, or pain in the feet, according to Lawrence A. Lavery, DPM, MPH, a specialist in diabetic foot complications and professor of orthopaedics at the Joe R. and Teresa Lozano Long School of Medicine in San Antonio.
Chronically high blood sugar can damage nerves, and when feeling is reduced or lost, a small blister or cut can go unnoticed. These minor injuries can develop into ulcers and infections, especially since diabetes also slows the body’s ability to heal.
When a wound hasn’t healed, that is the doorway for bacteria to get in and cause a second infection.
Foot care may not be glamorous, but it can save your limbs, your mobility, and your independence. So don't wait.
Ask yourself:
- When was the last time you checked your feet—or your loved one's?
- Do you have a podiatrist on your care team?
- Are you prepared if long-term care becomes necessary?
See your doctor regularly and get comprehensive blood work daily every year after age 40. If you have diabetes, regular visits to a podiatrist are also essential for early detection and intervention.
Consider at least one annual visit or more frequently if you experience foot problems. Podiatrists can assess for neuropathy, circulation problems, and other potential issues.
Endocrinologists specialize in diabetes management and can help you control your blood sugar. Your primary care physician can also assess your feet during checkups and refer you to specialists if necessary. A collaborative approach is essential.
Controlling blood sugar levels through diet, exercise, and medication, as directed by your doctor, is crucial for improving circulation and promoting healing.
You can act now to prevent pain and protect your quality of life later.