Foot Surgery When You Have Diabetes: Wound Healing, Blood Sugar and Extra Precautions

The bunion had been nagging for years. What finally pushed one reader to ask about surgery was not the pain but a sock that kept wearing through at the same spot, and a blister underneath it she had not felt forming. Then came the hesitation familiar to many people living with diabetes: is foot surgery with diabetes even a safe idea?

The question lands differently depending on who is asking. For some, the operation is elective, a chance to fix a deformity before it causes a wound. For others, surgery arrives urgently, to clear an infection or remove bone that will not heal. In both situations the same three things shape the plan: how well wounds will close, how steady blood sugar is, and how carefully the team watches for trouble.

This explainer walks through all three, with the evidence and the trade-offs laid out plainly, so the conversation with your surgeon starts from solid ground.

Why foot surgery with diabetes needs a different plan

Any operation on the foot asks a lot of the body. Skin must knit, bone must bridge, and the tissue has to fight off bacteria while bearing weight sooner than almost anywhere else. Diabetes affects every one of those jobs, which is why surgeons treat foot surgery with diabetes as a distinct category rather than a routine procedure with a footnote.

Three mechanisms sit behind the extra caution. High glucose stiffens and narrows small blood vessels over time, so less oxygen reaches the wound edge. The same process damages nerves, so a person may not feel a rubbing cast or a developing pressure sore. And persistently raised sugar blunts the immune cells that would normally swarm an incision, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which notes that roughly half of all people with diabetes have some form of nerve damage.

None of this means surgery is off the table. It means the preparation is more deliberate. Expect your team to look beyond the foot: at your most recent A1C, at the pulses in your ankles, at your kidney function and at how you will manage stairs, dressings and footwear during recovery. A good plan also includes the people around you, because someone who cannot feel their foot needs a second pair of eyes on it after the bandage comes off.

The honest framing is this: diabetes raises the stakes of a foot operation, and it also raises the stakes of leaving certain problems alone. A deformity that rubs can become an ulcer; an ulcer can reach bone. The decision is about weighing those two risks for one specific foot, and that weighing belongs to you and your treating team.

How does diabetes affect foot health in the first place?

Picture the foot as the farthest outpost of the circulation, the place where blood arrives last and returns with the most effort. When glucose runs high for years, the lining of arteries thickens and fatty deposits build faster, a process called peripheral artery disease, meaning narrowed vessels in the limbs. Less blood means less warmth, slower nail and skin growth, and a wound that stalls instead of closing.

Nerves suffer in parallel. Diabetic peripheral neuropathy, nerve damage caused by diabetes, usually starts in the toes and creeps upward. Some people feel burning or pins and needles; others feel nothing at all, which is the more dangerous version. The CDC describes how a person with neuropathy can walk on a pebble in their shoe for a day without noticing, and MedlinePlus lists numbness, tingling and loss of sensation as the common signs clinicians look for during a foot check.

The muscles are affected too. When the small nerves to the foot’s intrinsic muscles fail, the toes can claw and the fat pads under the ball of the foot shift forward, leaving bone close to the skin. Sweat glands lose their nerve supply, so skin dries and cracks. Each change on its own is minor; together they explain why a callus in someone with diabetes deserves more respect than the same callus in someone without.

So what do diabetic feet look like? Often entirely normal, which is the point. Early changes are felt, or not felt, before they are seen. That is why guidelines from the CDC and NIDDK recommend a professional foot examination at least once a year and a personal look at both feet every day, not because every foot is in trouble, but because the warning system has been switched off.

What actually happens before, during and after foot surgery with diabetes

The process begins long before the operating room. At the first consultation your surgeon will want to know how your diabetes has been behaving, usually by looking at the A1C, a blood test that reflects your average glucose over the past three months, according to MedlinePlus. They will feel for pulses at the ankle and top of the foot, test sensation with a thin nylon filament, and may order a Doppler scan, an ultrasound that measures blood flow in the arteries. If flow looks poor, a vascular specialist is often asked to assess the leg before any foot surgery is scheduled.

You may also meet an anesthetist earlier than usual. Many foot operations can be done under a regional block, an injection that numbs the leg while you stay awake or lightly sedated, which avoids some of the glucose swings that general anesthesia and fasting can cause. The anesthesia team will give you specific instructions about food, drink and your diabetes medicines on the day; these instructions come from them, not from a general article, because they depend on exactly what you take.

In the operating room, the procedure itself is largely the same as for anyone else. The differences are in the details: gentler handling of tissue, careful attention to closing the skin without tension, and sometimes a decision to leave a wound partly open and let it fill in from the base if infection is present.

Afterward, glucose is checked frequently, often more than you are used to at home. The surgical stress response pushes sugar up even in people who are usually steady, and the team will manage that in hospital. Before discharge you should leave with a plan for dressings, weight-bearing limits, glucose targets and a named contact for problems.

Which types of diabetic foot surgery exist, and why the reason matters

The phrase covers a wide range of operations, from a quick nail procedure under local anesthetic to a multi-hour reconstruction. Grouping them by purpose makes the risk conversation clearer, because the acceptable level of risk depends heavily on what the surgery is trying to achieve.

Category	Typical examples	Main goal	Usual timing
Elective (planned)	Bunion correction, hammertoe straightening, tendon lengthening	Correct a deformity or relieve pain before it causes a wound	Scheduled once glucose and circulation are optimized
Prophylactic	Removing a bony prominence under a recurring callus or healed ulcer	Prevent an ulcer from forming or returning	Scheduled, often after an ulcer has closed
Curative-intent wound surgery	Debridement (removing dead tissue), excising infected bone, flap closure	Help an existing ulcer heal	Semi-urgent, timed around infection control
Emergency	Draining an abscess, removing gangrenous tissue	Stop a limb- or life-threatening infection	Within hours to days
Reconstruction	Charcot foot realignment and fusion	Restore a stable, shoeable foot	Staged over months, once inflammation has settled

The table carries one quiet lesson. The further down you read, the less choice anyone has about timing, and the more the outcome depends on what was done in the months before. An elective operation can wait for a better A1C; an abscess cannot. People who keep their yearly foot checks and act on early changes tend to spend their surgical lives in the top rows, where planning is possible and recovery is more predictable.

The word “curative” in the third row is the surgical term of art for operations aimed at closing a wound; it describes intent, not a guarantee. Many ulcers need a combination of surgery, offloading and vascular treatment to close, and some close only partly. Your surgeon should be able to tell you which row your procedure sits in and what success would realistically look like for your foot.

Who is usually offered elective foot surgery with diabetes, and who is asked to wait

Elective foot surgery with diabetes is generally considered when a deformity or painful condition is likely to cause harm if left alone, and when the person is in a position to heal. Both halves matter. A hammertoe that rubs against the shoe and has already caused one ulcer is a stronger candidate than a mild bunion that is only cosmetically bothersome, because the first carries a known risk of a wound and the second does not.

On the healing side, surgeons weigh several factors, none of which is an absolute rule:

• Recent glucose control, usually judged by A1C and by day-to-day readings
• Blood supply to the foot, assessed by pulses, Doppler or more detailed vascular imaging
• Whether sensation is intact enough to notice a cast or dressing problem
• Kidney function, since advanced kidney disease is linked with slower healing
• Smoking status, which narrows vessels further and is a common reason to defer
• Practical support at home for dressings, offloading and transport to appointments

People are commonly asked to wait when glucose has been poorly controlled recently, when circulation is inadequate and needs vascular treatment first, when there is an active infection elsewhere, or when a nearby ulcer is still open. Waiting is not a refusal. In most cases it comes with a plan: a target A1C range set by the diabetes team, a referral for vascular assessment, help to stop smoking, or specialist footwear to protect the foot in the meantime.

Two groups deserve particular mention. Those with an acute Charcot process, discussed below, are almost always asked to wait until the bone has stopped actively breaking down. And those whose deformity is causing no symptoms and no skin changes may be advised that no operation is needed at all, only monitoring. A surgeon who says “not yet” or “not necessary” is doing part of their job well.

Diabetes and wound healing after surgery: what the evidence actually shows

Wound healing follows a sequence. First, clotting and inflammation clear debris. Then new blood vessels and collagen fill the gap. Finally the skin edges contract and remodel. Diabetes interferes at each stage, and understanding where helps make sense of the precautions.

Inflammation lasts longer in high-glucose conditions because white blood cells function less efficiently and clear bacteria more slowly. The NIDDK and MedlinePlus both describe how raised glucose impairs the body’s ability to fight infection and slows healing, which is why a surgical incision in a person with diabetes is watched more closely in the first two weeks than the same incision in someone without.

The second stage depends on oxygen. New tissue is metabolically hungry, and a foot with narrowed arteries may simply not deliver enough. This is the reason vascular assessment comes before elective surgery: an operation on a foot with poor inflow can create a wound that never closes. When circulation is borderline, surgeons sometimes recommend improving blood flow first, through angioplasty or bypass, so that the later foot operation has a better chance.

Nerve damage affects the third stage indirectly. A wound that is repeatedly loaded, bumped or rubbed without the person noticing will keep reopening. Offloading, meaning keeping weight off the healing area with a boot, cast or crutches, is as much a part of treatment as the stitches themselves.

What the evidence does not support is the idea that diabetes makes healing impossible. People with well-managed glucose and adequate circulation heal from foot surgery routinely. The data consistently show higher complication rates on average across the diabetic population, driven largely by those with uncontrolled glucose, poor circulation or active infection. Where you fall within that range is something your team can estimate from your own tests, which is far more useful than a population average.

Blood sugar around surgery: why the weeks before matter as much as the day

A common assumption is that the main glucose challenge is the morning of surgery, when you are fasting and nervous. That morning does matter, but the weeks beforehand matter more, because the A1C your surgeon looks at reflects average glucose over roughly the previous three months, as MedlinePlus explains. Tissue health at the time of the incision has been set by those months, not by the night before.

Surgical stress itself raises glucose. The body releases cortisol and adrenaline, which tell the liver to release stored sugar and make cells less responsive to insulin for a period. In someone without diabetes this passes unnoticed. In someone with diabetes it can push readings well above their usual range for several days, and high glucose during exactly the window when the wound is trying to seal is the combination surgeons most want to avoid.

The practical consequences, in order of when they happen:

• Before surgery, your diabetes team may adjust the overall plan to bring the A1C into the range the surgeon has requested; this is their decision, based on your current medicines and risks of low glucose.
• On the day, the anesthesia team will give explicit instructions about which medicines to take or hold while fasting; follow those rather than general advice, and ask if anything is unclear.
• In hospital, glucose is checked frequently and often managed with insulin for a short period even in people who do not normally use it. This is a temporary measure during the stress response and does not mean your usual regimen has changed.
• At home, you may be asked to test more often than usual for a while and to report readings outside an agreed range.

If you use a continuous glucose monitor, tell the team in advance. Some imaging and some operating room equipment can interfere with sensors, and they will advise where to place it or whether to remove it temporarily.

Charcot foot and bone surgery: a special case worth understanding

Charcot foot, pronounced “shar-ko”, is a condition in which the bones and joints of a foot with severe neuropathy weaken, fracture and shift, often without much pain. The Cleveland Clinic describes how an early Charcot foot can look like a simple sprain or infection: red, swollen and warm compared with the other side. Because sensation is reduced, people often keep walking on it, and the arch can collapse into a rocker-bottom shape within months.

Surgery for Charcot foot sits apart from other diabetic foot operations for two reasons. First, timing is unusually strict. During the active phase the bone is soft and inflamed, and operating on it tends to fail, so the standard approach is immobilization in a total contact cast, a snug plaster cast that spreads pressure across the whole foot and lower leg, for a period that commonly runs into months, according to the Cleveland Clinic. Only once the warmth and swelling settle and the bone consolidates does reconstruction become an option.

Second, the goals are different. The aim is not a cosmetically normal foot but a stable, plantigrade one, meaning a foot that sits flat on the ground and can fit into a protective shoe without creating pressure points. Reconstruction may involve removing bony prominences, realigning the midfoot and fusing joints with internal or external metalwork. Recovery is long, with extended periods of non-weight-bearing, and the hardware is under more strain than in a foot with normal bone and sensation.

For someone facing this, the most useful question is not “can it be fixed” but “what is the realistic goal for my foot, and what will the alternative be if I do not have surgery.” In some cases a well-made custom brace achieves the same stability without an operation. In others, deformity has progressed to the point where ulcers recur and surgery offers the better route to a foot that can be protected. Your team should walk you through both.

How can diabetic patients treat ingrown toenails, and when is surgery needed?

An ingrown toenail, where the nail edge grows into the skin beside it, is a minor nuisance for most people and a genuine hazard for someone with diabetes. The broken skin is a door for bacteria, and reduced sensation means the first sign may be swelling or discharge rather than pain. MedlinePlus is clear on the key point: people with diabetes should not attempt to cut out an ingrown nail themselves and should see a clinician early.

The home measures that are reasonable for others carry risks here. Soaking in very warm water can scald a numb foot. Digging at the nail corner with scissors or a file can create a wound that will not close. What is appropriate at home is modest: keeping the foot clean and dry, wearing shoes with a wide toe box so nothing presses on the nail, and checking the toe daily for redness, swelling, warmth or fluid.

When the nail is embedded or the skin is inflamed, clinicians have a graded set of options. A podiatrist may lift the nail edge and trim it conservatively. If the problem recurs, a partial nail avulsion, removing the offending strip of nail under local anesthetic, is a common office procedure, sometimes combined with a chemical or surgical treatment of the nail root so that the strip does not regrow. In a person with diabetes, this small operation is approached with the same checks as any other: a look at circulation, a conversation about glucose, and a clear wound-care plan afterward, because even a toenail procedure creates a wound that needs oxygen and clean dressings to heal.

The decision to remove part or all of a nail rests with the clinician who has examined the toe. A general rule that does hold across guidelines, including the CDC’s foot care advice, is that nails in diabetic feet should be cut straight across, not curved, and that thick or difficult nails are better trimmed by a professional than wrestled with at home.

When should a diabetic foot be amputated? An honest answer

Few words frighten people with diabetes more, and the fear is understandable. It is worth stating plainly that amputation is not an inevitable destination. The Mayo Clinic and CDC both frame most diabetes-related amputations as the end point of a chain that began with a small, unnoticed wound, which is exactly why daily foot checks and prompt treatment of ulcers are emphasized so heavily.

When amputation is considered, it is usually for one of three reasons. The first is uncontrolled infection that threatens life, where a spreading infection in the foot cannot be contained by antibiotics and drainage alone. The second is tissue death from inadequate blood supply that cannot be restored, where the foot or part of it has no viable circulation. The third, less dramatic but common, is a foot so unstable or deformed that it keeps ulcerating despite every effort, and a well-planned amputation with a prosthesis would allow the person to walk more safely than the foot they have.

Modern practice emphasizes limb salvage, the collection of strategies aimed at keeping as much of the foot as possible: revascularization to restore blood flow, staged debridement, local flaps and minor amputations of a toe or part of the forefoot that preserve walking. A toe amputation is a loss, but it is a very different outcome from losing a leg, and many people walk normally afterward in protective footwear.

The decision is never made by one person or on one test. It typically involves the surgeon, a vascular specialist, the diabetes team and the person themselves, weighing what the foot can realistically do against what living with repeated infections and prolonged non-weight-bearing is costing. If amputation is raised, it is reasonable to ask what has been tried, what would have to change for the foot to be saved, and what function to expect at each level. Those questions deserve clear answers before any consent form is signed.

Diabetic foot surgery recovery: what the following days and weeks usually look like

Recovery from foot surgery with diabetes follows the same arc as for anyone else, stretched and watched more closely. The first few days are about pain control, keeping the foot elevated above heart level to limit swelling, and keeping glucose in the range your team set. Swelling is the enemy of early healing in the foot because it stretches the incision and compresses the small vessels feeding it.

Dressings are usually left undisturbed until the first clinic review unless there is a problem. Resist the urge to peek; each change is an opportunity for bacteria to enter. Your team will tell you what the dressing should look like and what counts as too much drainage.

Weight-bearing instructions vary enormously with the procedure. A nail procedure may allow walking in a stiff-soled shoe straight away. A bunion correction may mean heel-weight-bearing only in a post-operative shoe. A midfoot fusion may mean weeks of no weight at all, usually with a cast or boot and crutches, a knee scooter or a wheelchair. In people with neuropathy, surgeons tend to be stricter about these limits because the usual warning sign, pain when you do too much, is missing.

Skin typically heals before bone does, and both are commonly slower when diabetes is present. Instead of quoting fixed timelines, most surgeons give a range and then adjust it based on what they see at each review and, for bone work, on X-rays. Follow-up visits are more frequent than for a non-diabetic patient, often weekly early on, specifically so that a stalled wound is caught while it is still small.

Later weeks bring the return to shoes, and this is where many problems start. A foot that has been operated on changes shape slightly, and old shoes may now rub in new places. Footwear review by a podiatrist or orthotist is a sensible step before anything is worn for a full day.

What people often get wrong about foot surgery with diabetes

Myth: diabetes means surgery is too risky, full stop. The evidence shows higher average complication rates, concentrated among people with poor glucose control, poor circulation or active infection. Someone with a well-managed A1C and good pulses is in a very different position from the population average, and declining a needed operation can carry its own risk of a wound that becomes far harder to treat.

Myth: once the incision has closed, the worry is over. The weeks after closure are when new scar tissue is thin and the foot is being asked to bear weight again, often in shoes that no longer fit quite right. A healed wound can reopen under pressure a person with neuropathy cannot feel. Daily checks, including with a mirror for the sole, remain the standard advice from the CDC long after surgery.

Myth: pain is the signal to slow down. For people with intact sensation it is. For people with neuropathy, swelling, warmth and redness take over as the warning signs, and the written weight-bearing limit is the thing to trust, not how the foot feels.

Myth: a good A1C on the day of surgery is what counts. The A1C is a three-month average. A single excellent fasting reading on the morning of the operation says little about the tissue’s condition, which was set over the preceding weeks.

Myth: amputation of a toe means the leg will follow. A minor amputation that removes infected or dead tissue and leaves a healthy, protected foot is a limb-saving operation, not a step toward losing the limb. What tends to follow is determined by what happens next: footwear, glucose, circulation and attention to the remaining foot.

Myth: home remedies for calluses, corns and ingrown nails are harmless. Over-the-counter acid plasters, razor blades and hot soaks can all create wounds in a foot that will not feel the damage. Guidelines consistently advise against them in diabetes.

Questions to ask your care team before foot surgery with diabetes

A consultation goes better when you arrive with questions written down and leave with answers you can repeat back. The ones below are drawn from what people most often wish they had asked.

• What is this operation trying to achieve for my foot, and what is likely to happen if I do not have it?
• Which category does it fall into: elective, preventive, wound-healing or urgent? How much flexibility is there on timing?
• What A1C range are you hoping for before surgery, and who will help me get there?
• Have my circulation and sensation been formally assessed? Do I need a vascular opinion first?
• Will I have a regional block or general anesthesia, and who will give me instructions about my diabetes medicines on the day?
• How will my glucose be monitored and managed in hospital, and what should I do about readings at home afterward?
• What are the specific risks for someone with my test results, rather than for people with diabetes in general?
• How much weight can I put on the foot, for how long, and what equipment will I need at home?
• What should the dressing look like, and what changes should prompt a call?
• How often will I be seen in the first month, and who is my point of contact between visits?
• When will my footwear be reviewed, and will I need custom shoes or insoles afterward?
• If the wound is slow to heal, what are the next steps you would consider?

Bring someone with you if you can. Pre-operative conversations cover a lot of ground, and a second listener catches details that anxiety filters out. If English is not your first language, ask for an interpreter rather than relying on a family member for medical terms. And if an answer feels vague, say so; a surgeon who is confident about a plan can usually explain it in plain words.

When to call your doctor: red-flag signs after foot surgery with diabetes

Because sensation may be reduced, the usual rule of “call if it hurts a lot” is not reliable. The signs below are the ones your team will most want to hear about promptly, often the same day. Contact your surgical team or seek urgent care if you notice any of the following:

• Redness spreading beyond the edge of the dressing, or red streaks tracking up the foot or leg
• Increasing warmth or swelling in the foot compared with the other side, especially after the first few days when swelling should be settling
• Fluid soaking through the dressing, particularly if it is cloudy, green, or has an unpleasant smell
• A fever, chills, or feeling generally unwell; in people with diabetes this can be the first sign of a wound infection even when the foot looks unremarkable
• Blood glucose readings that stay above the range your team gave you despite following their plan, or readings that are unexpectedly low
• New numbness, a change in skin color to pale, blue, dark or black, or a foot that feels cold to touch
• The dressing or cast feeling tight, rubbing, or slipping, or any new wound elsewhere on either foot
• Pain or swelling in the calf, chest pain or breathlessness, which can signal a blood clot and need emergency assessment

For the other foot, the same vigilance applies. Weeks of altered walking and crutches put unusual pressure on the uninjured side, and a new blister or callus there deserves a call too.

Guidance from the NIDDK and CDC adds a general rule that applies whether or not you have had surgery: any cut, blister or sore on a diabetic foot that has not started to improve within a few days should be seen by a clinician. Waiting to see if it settles is the single habit most strongly associated with small problems becoming large ones. When in doubt, the right move is to call; the team would far rather look at a foot that turns out to be fine than hear about one a week later.

Frequently asked questions

Is foot surgery with diabetes safe?

It can be, when glucose is well managed, circulation is adequate and there is no active infection. Diabetes raises the average risk of slow healing and wound infection, but that average hides a wide range. Surgeons estimate your individual risk from your A1C, pulses, sensation and kidney function, and may ask you to wait and prepare rather than decline surgery. The final decision rests with you and your treating team after those checks.

How does diabetes affect wound healing after surgery?

High glucose impairs the white blood cells that fight infection, narrows small vessels so less oxygen reaches the wound, and damages nerves so pressure on the healing area goes unnoticed. Each effect slows one stage of healing. The result is a longer, more closely watched recovery rather than an impossible one; people with steady glucose and good blood supply heal from foot surgery routinely, according to guidance from MedlinePlus and the NIDDK.

What does diabetic foot surgery recovery usually involve?

Early days focus on elevation, pain control and glucose within an agreed range, with dressings left alone until the first review. Weight-bearing limits depend on the procedure and are enforced more strictly when sensation is reduced. Follow-up visits tend to be more frequent than for people without diabetes so a stalled wound is caught early. Skin heals before bone, and your surgeon will give ranges and adjust them at each visit rather than promising fixed dates.

Can I have elective foot surgery with diabetes if my A1C is high?

Usually you will be asked to improve glucose control first. Surgeons commonly set a target range because the A1C reflects the tissue conditions over the previous three months, and a high value is linked with more wound complications. Being asked to wait is not a refusal; it typically comes with help from the diabetes team to reach the target, and the operation is rescheduled once you are in a better position to heal.

How can diabetic patients treat ingrown toenails safely?

See a clinician early rather than treating it at home. Hot soaks can scald a numb foot and cutting the nail corner can create a wound that will not close. A podiatrist can trim the nail conservatively or, if it recurs, remove the offending strip under local anesthetic. At home, keep the toe clean and dry, wear shoes with a roomy toe box, cut nails straight across and check the toe daily for redness or discharge.

What do diabetic feet look like?

Often completely normal, which is why daily checks matter. Early changes include dry, cracked skin, calluses under the ball of the foot, clawed toes, thickened nails and cool or pale skin from reduced circulation. Numbness or tingling is felt rather than seen. Later signs include redness, swelling, warmth, blisters or open sores. Any new change on a diabetic foot that does not improve within a few days should be assessed by a clinician.

When should a diabetic foot be amputated?

Amputation is considered when infection cannot be controlled and threatens life, when tissue has died from blood supply that cannot be restored, or when a foot keeps ulcerating despite every effort and a prosthesis would allow safer walking. Before that point, teams pursue limb salvage: restoring circulation, removing dead tissue and preserving as much of the foot as possible. The decision involves several specialists and the person themselves, never a single test.

Why is my blood sugar higher after foot surgery?

Surgery triggers a stress response in which cortisol and adrenaline prompt the liver to release stored glucose and make cells temporarily less responsive to insulin. In people with diabetes this can push readings above their usual range for several days. Hospital teams expect it and often manage it with short-term insulin even in people who do not normally use it. This is temporary and does not mean your long-term regimen has changed.

Can diabetes and wound healing problems after surgery be prevented?

Risk can be reduced, though not eliminated. The measures with the strongest support are steady glucose in the weeks before and after surgery, adequate circulation confirmed before operating, not smoking, strict adherence to weight-bearing limits, keeping dressings undisturbed between reviews and daily inspection of both feet. Early reporting of redness, warmth, swelling or drainage lets the team act while a problem is small, which is where most of the difference is made.

What is Charcot foot and does it always need surgery?

Charcot foot is a condition in which bones and joints of a foot with severe nerve damage weaken, fracture and shift, often painlessly, sometimes collapsing the arch. It does not always need surgery. The standard first treatment is months of immobilization in a total contact cast until inflammation settles, according to the Cleveland Clinic. Many people then manage with custom footwear or a brace; reconstruction is considered when deformity keeps causing ulcers or cannot be protected.

References

• MedlinePlus: Diabetic Foot
• NIH NIDDK: Diabetes and Foot Problems
• CDC: Diabetes and Your Feet
• MedlinePlus: A1C Test

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.