Diabetic foot infections: what to watch for and what to do

If you have diabetes, a small cut on your foot can turn into a big problem fast. High blood sugar, poor circulation and nerve damage all raise the risk of infection. This guide tells you how to spot infection early, what treatments are commonly used, and daily steps you can take to avoid problems.

Spot the signs and act fast

Check your feet every day. Look for redness, swelling, warmth, drainage, new or worsening pain, or a bad smell. Because neuropathy can blunt pain, also watch for changes in skin color, open sores that don’t heal, or any new swelling. If you see spreading redness, fever, chills, or feel generally unwell, seek medical care right away — those are signs the infection may be serious.

At the clinic they’ll examine the wound, check pulses and sensation, and often take a swab or tissue sample for culture. Blood tests and imaging (X-ray, ultrasound, or MRI) help find deeper infection like abscesses or bone infection (osteomyelitis). Treating early infections is usually straightforward; delayed care often needs more aggressive steps.

Treatment basics—what to expect

Treatment depends on how bad the infection is. Simple, superficial infections can be managed with proper wound care and antibiotics tailored to the culture results. More severe infections may need hospital care, IV antibiotics, surgical drainage or debridement (removing dead tissue). If blood flow is poor, a vascular specialist may need to fix circulation before the wound will heal.

Doctors choose antibiotics based on the likely germs and the wound culture. That may include coverage for common skin bacteria plus, in some cases, MRSA or gram-negative organisms. Don’t try to pick or dose antibiotics yourself — follow a clinician’s plan and finish the full course unless told otherwise.

Offloading is critical: reduce pressure on the wound using special shoes, casts or boots. Even the best antibiotics won’t heal a sore that keeps getting pressed every step. For deep or non-healing wounds, a multidisciplinary team (podiatry, infectious disease, vascular surgery, wound care nurse) gives the best outcomes.

Prevention is easier than treatment. Keep blood sugar under control, wash and dry feet daily, trim nails carefully, and treat dry skin to prevent cracks. Wear well-fitting shoes and socks, avoid walking barefoot, and get regular foot exams from a clinician. If you notice a callus or blister, have it checked before it breaks down.

Few things are more urgent than a spreading foot infection in someone with diabetes. If you’re unsure, err on the side of seeing a healthcare provider — early care saves tissue, time and sometimes the foot itself.