Around 7 in 10 South African adults living with diabetes don't know they have it. Changes in your feet could be an early warning sign.
With an estimated 7 in 10 South African adults aged 20–79 living with diabetes still undiagnosed, understanding the connection between diabetes and foot health has never been more important.
This Diabetes Awareness Month, KROKO is encouraging South Africans to pay closer attention to their feet, make daily foot checks part of their routine and recognise the importance of early intervention.
After all, when it comes to diabetic foot care, waiting until something hurts could be a costly mistake.
An estimated 1.6 million of the 2.3 million South African adults living with diabetes are undiagnosed. This means many people may already be experiencing diabetes related complications without realising it.
Diabetes can damage the nerves in your feet, reducing your ability to feel pain, heat, cold or pressure. It can also affect circulation, making it harder for wounds to heal.
What might initially seem like a harmless blister, dry heel crack or small cut can therefore develop into a more serious problem if left unnoticed.
Numbness, tingling in the feet or a wound that is slow to heal should never be ignored. These symptoms warrant medical assessment, and a healthcare professional can arrange appropriate testing to investigate possible diabetes.
To better understand the risks and the importance of good foot care, KROKO spoke to clinic nurse practitioner and certified diabetes nurse educator Sydney Southern about the warning signs she regularly sees in clinical practice.
Her advice is straightforward: Never assume an injury is harmless simply because it doesn't hurt.
"The single most common mistake is delaying care because 'it doesn't hurt'," says Southern.
"People naturally associate pain with danger. When nerve damage reduces sensation, a deep ulcer or spreading infection can feel completely painless, leading patients to assume everything is fine until they see blood on a sock or notice an odour."
Southern recalls treating a man who continued walking on a blister caused by his dress shoes because he felt no pain. Within four days, the skin had broken down and become infected. He required hospital admission, intravenous antibiotics and surgery to remove damaged tissue.
One of the biggest misconceptions about diabetic foot complications is that they begin with a significant injury.
In reality, something as minor as a new shoe rubbing against the skin, a dry heel crack or a thick callus can become a serious concern.
"I see this almost weekly in clinical practice," says Southern. "A high proportion of severe diabetic foot complications don't start with major trauma. They begin with a tiny friction blister from a new shoe, a dry heel crack, or a thick callus."
When nerve damage reduces sensation, these injuries can go unnoticed. If circulation is also compromised, the body's ability to heal is affected.
Without early attention, an injury can develop into an open wound or diabetic foot ulcer, which may become infected. In severe cases, this can lead to tissue damage and even amputation.
The important thing to remember is that the absence of pain does not mean the absence of a problem.
Good diabetic foot care starts at home. A consistent daily routine can help protect the skin, reduce avoidable irritation and identify potential problems before they become more serious.
KROKO recommends incorporating a few simple habits into your everyday foot care routine.
1. Wash and dry your feet properly
Wash your feet daily using lukewarm water. Avoid very hot water and prolonged soaking, particularly if you have reduced sensation.
Dry your feet carefully with a clean towel, paying particular attention to the areas between your toes. Excess moisture can encourage skin problems.
2. Moisturise dry, cracked skin
Dry skin and cracked heels can compromise the skin's natural protective barrier.
For dry, rough areas, KROKO Heel Balm helps restore moisture and soften hardened skin. Apply moisturiser to dry areas of your feet but avoid applying it between your toes.
3. Keep your feet feeling fresh and dry
Excess moisture can contribute to skin irritation and other foot problems.
KROKO Foot Powder helps absorb excess moisture and keeps feet feeling dry and comfortable.
4. Wear comfortable, well-fitting footwear
Shoes that rub, pinch or create pressure points can cause blisters and skin damage.
Choose comfortable, well-fitting footwear and check the inside of your shoes before putting them on. Look for small stones, rough seams or anything that could cause friction.
Where appropriate, wear protective footwear indoors too.
5. Never attempt to remove corns or calluses yourself
Avoid cutting away corns or calluses using blades or scissors. Persistent or painful areas should be assessed by a podiatrist or qualified foot care professional.
People living with diabetes should also be particularly careful with medicated corn, callus and wart treatments containing salicylic acid. These products should generally be avoided unless specifically recommended by a healthcare professional.
Reduced sensation can make it difficult to recognise irritation or skin damage, so always check product ingredients and follow professional advice.
An important reminder: If you have diabetes, reduced sensation, poor circulation or an existing foot condition, consult your healthcare professional before introducing new foot care products or treating a specific concern. Open cracks, sores, ulcers and wounds that are slow to heal require professional assessment, not just home treatment.
A simple way to remember your daily foot care routine is KROKO's LOOK. CHECK. ACT. approach.
LOOK – Inspect your feet every day
Take a few minutes each day to examine both feet carefully.
Look for:
Remember to check the soles of your feet, your heels and between your toes. Use a mirror or ask someone to help if you struggle to see the soles of your feet.
CHECK – Pay attention to changes
Check your shoes before putting them on and look for anything that could cause rubbing or irritation.
Pay attention to changes from one day to the next. A small blister or patch of redness might not seem significant, but it deserves attention, particularly if you have diabetes.
Don't rely on pain as an indication that something is wrong.
ACT – Don't delay getting help
If you notice a new blister, cut, break in the skin or an unusually hot, red or swollen foot, contact your clinic, doctor or diabetes foot care team promptly. Aim to have it assessed within 24 hours rather than waiting for your next routine appointment.
Spreading redness, blackened skin, pus or foul smelling discharge requires immediate medical attention. If a foot problem is accompanied by fever, chills or feeling unwell, seek urgent medical care.
People living with diabetes should also have regular professional foot assessments, at least once a year, and more frequently if advised based on their individual risk.
For someone living with diabetes, daily foot checks can make a real difference.
However, reduced sensation, poor eyesight or limited mobility can make it difficult for some people to inspect their own feet properly.
KROKO encourages family members and caregivers to get involved, helping loved ones check their feet and seek medical attention when something doesn't look right.
Sometimes, noticing a small change early can prevent a much bigger problem later.
Diabetes related foot complications can be serious, but daily attention, good skin care and early medical intervention can help reduce avoidable risks.
Whether you are living with diabetes, caring for someone who is, or simply want to be more aware of your health, looking after your feet should be part of your everyday routine.
Look. Check. Act.
Because when it comes to your feet, don't wait for something to hurt before you take action.
KROKO – Care starts from the ground up.
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