Foot Wounds and Diabetes: What You Need to Watch For

On a foot with normal sensation, a small sore is an annoyance. On a foot with diabetes, the same sore is a different situation entirely, because the two things that would normally protect you are often compromised at once: the nerves that tell you something is wrong, and the blood supply that would close it up. That combination is why a wound the size of a pencil eraser can turn into a hospital admission.

This page covers what to look for, what counts as urgent, and the daily routine that prevents most of it. We see diabetic patients for foot checks and wound care at our offices in Homewood, Mokena and South Chicago Heights.

Medically reviewed by Dr. Timothy Horak and Julia Shauger, board-certified podiatric specialists serving Homewood, South Chicago Heights & Mokena. Last reviewed July 2026.

Why Diabetes Puts Your Feet at Risk

Nerve damage

No warning signal. You may not feel a stone in the shoe, a hot bath, or a blister forming.
Injuries go unnoticed. Cuts and pressure sores are often found days after they started.
The foot changes shape. Nerve damage weakens small muscles, which lifts the toes and pushes load onto the ball of the foot.

Reduced blood flow

Less oxygen reaching the tissue. Repair work slows down or stops.
Antibiotics have trouble arriving. A drug only reaches where the blood reaches.
Wounds turn chronic. A wound with poor supply can sit open for months without changing.

High blood sugar

Slower repair. High glucose interferes with how collagen is laid down.
Weaker defence. White cells work less effectively when sugars run high.
Joint and bone changes. Including Charcot foot, where the arch can collapse with little or no pain.

Pressure points

Bunions and hammertoes. Bony prominences concentrate load in one small spot.
Shoes that are too tight or too new. Friction you cannot feel is still friction.
Thick calluses. A callus acts like a stone pressed into the skin, and ulcers very often form directly beneath one.

Warning Signs: What Needs a Same-Day Call

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• Pus, drainage, or any odor
• Redness or warmth spreading away from the wound
• New pain in a foot that is usually numb
• Any black or grey tissue
• Fever or chills
• Swelling of one foot that appeared over a day or two

Book within the week

• A cut, blister or callus that is not improving
• A callus with a dark spot in the middle
• An ingrown toenail
• Dry cracked heels that are starting to split
• A new area that rubs in a shoe you have worn for years
• Any change in the shape of your foot

The Daily Routine That Prevents Most of This

Checking and caring for the skin

Look every day. Top, sole, heel, and between every toe. Use a mirror if you cannot see the bottom.
Wash and dry properly. Warm water, not hot, and dry carefully between the toes.
Moisturize the skin, not the toe webs. Cream between the toes traps moisture and invites infection.
Leave calluses and corns to us. No blades, no medicated corn pads at home.

Shoes and socks

Never barefoot. Not in the house, not for a quick trip to the mailbox.
Check inside the shoe with your hand. Every time, before you put it on.
Break new shoes in slowly. An hour a day at first, then check the skin.
Seamless, moisture-wicking socks. Fitted, not bunching, and changed daily.

What We Do at a Diabetic Foot Visit

A proper foot exam

Testing protective sensation with a monofilament, checking pulses, and looking at how you load the foot when you walk. This is how we find the spots most likely to break down before they do.

Callus and nail care

Reducing calluses before they become ulcers, and trimming nails safely. Routine, unglamorous, and one of the most effective things we do for diabetic feet.

Offloading and wound care

When there is an ulcer: debridement, the right dressing for how wet the wound is, and a boot, insert or cast that takes the load off the exact spot causing it.

Why We Push So Hard on Early Care

The evidence on this is consistent: diabetic foot ulcers treated early by a specialist are far less likely to end in serious infection, hospital admission or amputation than the same ulcers treated late. The great majority of severe diabetic foot complications begin as something small that stayed open too long.

That is the whole reason we would rather see you for something that turns out to be nothing than see you six weeks after it stopped being nothing.

Explore our diabetic wound care →

What to Realistically Expect

We will not give you a healing timeline before examining the foot, because with diabetes the timeline depends almost entirely on two things we have to measure first: how much blood is reaching the wound, and whether the pressure causing it can genuinely be taken off. A shallow ulcer on a well-perfused foot that is properly offloaded often closes in a matter of weeks. A deeper one on a foot with arterial disease can take much longer, and may need a vascular opinion before it will close at all.

What we can promise is that we will tell you honestly which situation you are in, and that the offloading device is not optional. It is the part patients abandon first and the part that decides the outcome most often.

Common Questions

How often should I check my feet if I have diabetes?

Every day, and at the same time each day so it becomes automatic. Look at the top, the sole, the heel and between every toe. If you cannot see the bottom of your foot, use a mirror on the floor or ask someone to look for you. Most diabetic foot ulcers are found by the patient, not by a doctor, and the ones found early are the ones that end well.

Why does my foot wound not hurt?

Because diabetes damages the nerves that carry pain, and that damage usually starts in the toes and works upward. A wound that does not hurt is not a milder wound, it is a wound without an alarm attached. That is exactly why diabetic foot wounds are so often found late, and why the daily visual check matters more than how the foot feels.

Can a diabetic foot ulcer heal on its own?

Some very superficial ones will if the pressure is removed and the blood flow is good. Most will not. The ulcer usually sits at a point that takes load with every step, so it is being re-injured constantly, and high glucose slows repair at the same time. An ulcer that has been open more than two weeks needs professional care rather than more waiting.

When is a diabetic foot wound an emergency?

Call the same day if there is pus or an odor, if redness or warmth is spreading up the foot or leg, if the area is newly and unusually painful, if any tissue has turned black, or if you have a fever or chills. If you cannot reach us, go to an emergency department. Infection in a diabetic foot can move faster than people expect.

Foot Wounds and Diabetes