How to Manage Foot Health When You Have Diabetes

Vanessa Rissetto M.S., RD, CDN
·6 min read
Hand Touching Feet In Pain
Hand Touching Feet In Pain

Getty Images / Anupong Thongchan / EyeEm

You may have heard that diabetes can cause foot pain and affect foot health, but how exactly are the two connected? Let's break down a common side effect of diabetes complications, peripheral neuropathy and how you can optimize your diet to protect the health of your feet.

What is Diabetic Neuropathy?

Peripheral nerves are found throughout our body (think: hands, feet, arms and legs) and are responsible for transmitting messages back to the central nervous system (i.e. the brain and spinal cord). In uncontrolled diabetes, chronically high blood sugar can lead to complications like damage in peripheral nerves called neuropathy, especially those found in the feet. This neuropathy in feet is what is referred to as peripheral neuropathy.

Research states that high blood sugar interferes with the ability of nerves to send signals to other body tissues, like the feet. This leads to inflammation, which further damages the nerves and eventually causes neuropathy. Symptoms of neuropathy range from numbness, tingling, and increased sensitivity, to more severe problems like ulcers and infections. Research shows that there are several risk factors that are associated with neuropathy, including weight, body-mass index (BMI), waist circumference and high cholesterol levels. In fact, obesity is now considered the second biggest risk factor for neuropathy after diabetes.

The good news? Changes to diet and lifestyle can impact your blood sugar, weight and cholesterol levels, helping to prevent nerve damage and keep your feet healthy.

How to Help Prevent Neuropathy If You Have Diabetes

Keeping your blood sugar in the target range and maintaining a healthy weight are two of the most important ways to prevent nerve damage and neuropathy if you have diabetes. According to the CDC, target blood sugar ranges should be 80-130 mg/dL before a meal, and an individual's target blood sugar range should take factors into account, such as age and overall health. You can stay within your target range by eating balanced meals and snacks with the correct portions of specific food groups.

5 Ways to Balance Your Blood Sugar

Balancing your blood sugar might feel overwhelming, but it doesn't have to be complicated, especially when it comes to what's on your plate. Here are some tips to help you eat in a way that helps keep your blood sugar in check.

1. Start with a balanced plate.

Fill half of your plate with non-starchy vegetables like leafy greens, peppers, onions and tomatoes, a quarter of your plate with a lean protein source like eggs, tofu, fish or chicken, and the last quarter with a whole grain like brown rice or quinoa or starchy vegetable like potatoes or squash. Eating several food groups at each meal helps you meet your needs for protein, carbohydrates and fat, which helps food get digested at a healthy rate so your blood sugar can stay steady. Plus, getting ample non-starchy vegetables can help you meet your nutrient needs. This can help you eat to balance your blood sugar, and also is in accordance with the MyPlate recommendations for a healthy eating pattern in general. Need some inspiration? We have several easy, balanced plate meals to get you started.

2. Be carb conscious.

Many people think that because they have diabetes, they need to avoid all carbs, but this is not true. Carbohydrates are an important part of a balanced diet, even for people with diabetes. What matters is the quality and quantity of the carbs you're choosing. Instead of refined and highly processed carbohydrates (think: cookies, pretzels, chips, soda and other sweetened beverages, baked goods, white rice, high fructose corn syrup, etc.), choose whole grains, starchy vegetables, beans, and whole fruit. Other nutritious choices include quinoa, lentils, millet, farro, buckwheat, corn, butternut squash, apples, berries, and sweet potatoes, just to name a few. There are several delicious and carbohydrate-rich foods that are diabetes-friendly and will please any palate.

3. Always pair your carbs with lean protein and/or healthy fat.

Pairing a carb-rich food with a lean protein and/or healthy fat can help slow down how you digest it, so you blood sugar increases more slowly. This can also help you have more sustained energy and feel full for longer. If you're using the balanced plate method mentioned above, you'll already be nailing this at meal times. But don't forget to balance your snacks too. Here are a few quick and easy snack ideas that will keep your blood sugar nice and steady.

  • 1 banana + a handful of walnuts

  • 1 container of plain, low fat Greek yogurt + ½ cup of blueberries

  • 1 apple + 1 tbsp. almond butter

  • 1 cup cucumber and bell pepper slices + ¼ cup hummus

  • 1 slice whole wheat toast + ¼ of an avocado, mashed (top with a squeeze of lemon juice)

4. Be mindful of portion size.

Although portion sizes are very individualized since everyone's needs are different, it's important to bring some awareness to how much you're eating, especially with carbohydrate containing foods. Make sure to read labels and use measuring cups (at least at first) to get an understanding of what an appropriate amount looks like.

Related: Food Serving Sizes: A Visual Guide

5. Eat at regular intervals.

Yes, this means eating 3 meals per day and including snacks when needed. Try to avoid waiting until you're starving to have something to eat. Going long periods (think more than 4 to 5 hours) without eating causes your blood sugar to plummet, which leads to cravings for refined carbohydrates and potentially overeating as well. This can lead your blood sugar to spike, and subsequently plummet again. Get ahead of hunger by trying to eat a meal or snack at regular intervals throughout the day.

Other Factors That May Contribute to Neuropathy

Even though diabetes is the most common risk factor for neuropathy, it's important to consider other lifestyle factors that may contribute to the disease. Managing your weight is key for overall health, and also for the health of your feet. In fact, research shows that obesity might be associated with neuropathy, even when blood sugar levels are normal.

Abnormal cholesterol levels have also emerged as a possible risk factor for neuropathy, particularly in people who already have diabetes. Scientists suspect that abnormal lipid levels lead to inflammation that damages the peripheral nerves, especially in the toes of the feet. So if you want to keep your feet healthy, watch your blood sugar, but also manage your weight and cholesterol levels too.

The Bottom Line

We don't typically think much about the health of our feet, but it's so important to keep them in mind when you have diabetes. Make sure to check your feet daily for cuts, swelling, or any other abnormal changes. You should also be getting your feet checked regularly at your doctor's visits. Staying on top of your foot health can prevent some serious complications, including infections and even amputations. Be sure to balance your blood sugar, manage a healthy weight, and keep your cholesterol in check to help keep your feet healthy.