Woman wearing warm socks

Do your feet and hands often feel cold, even when the air is warm? If you have diabetes, the culprit may be poor blood circulation. How exactly does diabetes cause poor circulation?

Blame high blood sugar, which can damage the lining of blood vessels, explained Juan Zapata, MD, a vein care expert at The Vein Center at Water’s Edge Dermatology. That damage makes plaque (fatty deposits) more likely to form.

“Damage to the inner lining of an artery is the domino that starts the process of artery narrowing,” said Dr. Zapata. The narrower the artery, the less blood, oxygen and nutrients it delivers. Besides making your extremities cold, narrowed arteries increase the risk of heart disease.

High blood sugar can also damage the nerves that send signals to your brain about temperature, touch and pain. About half of people with diabetes have this problem, called diabetic neuropathy. It can cause tingling, burning or numbness in the hands and feet. A loss of feeling in the feet means you could develop a cut or blister — and even an infection — and not realize it.

Cold feet might seem like a minor annoyance, but over time, poor circulation can put you at risk of serious complications, including kidney failure, blindness and even limb amputation. “These complications can be avoided by staying alert to warning signs and taking appropriate action,” Dr. Zapata said.

Signs of poor circulation

Here are some of the signs and symptoms of poor circulation in people with diabetes.

Cold hands and feet. Narrowed blood vessels, along with nerve damage, conspire to make the hands and feet feel chilled.

Numbness or tingling in the feet and hands. The restricted blood flow that makes your feet cold can also produce a feeling of numbness or “pins and needles.”

Swelling, particularly in the legs, ankles and feet. This condition, called edema, happens when poor circulation causes fluid to build up in certain parts of the body. If your clothing or jewelry starts to feel tight or your feet or ankles feel heavy, that may be due to swelling from poor circulation.

Itchy skin. Skin dryness and itching are common in people with a diabetes for a number of reasons. If your lower legs and feet are itchy, poor circulation is a likely cause. A separate problem, diabetic neuropathy, contributes to dry skin on the feet.

Skin color changes. Are your hands, feet, ears, nose or lips unusually pale or even a little blue? Poor circulation could be the culprit.

Slow wound healing. When wounds heal more slowly, there’s a greater chance of infection, especially when it comes to foot wounds. That’s why it’s so important to check your feet daily for problems such as cuts, sores, blisters, redness, cracked skin, ingrown toenails and fungal infection. See a doctor if you notice an issue so it can be treated promptly.

Leg pain when walking. This is a sign of peripheral artery disease, in which narrowed arteries reduce blood flow to the limbs, usually the legs.

How to improve circulation

If you have diabetes and you’ve noticed one or more signs of poor circulation, don’t panic. There are many things you can do to improve your circulation and reduce the risk of the complications that can result.

Exercise. “One of the most important things you can do to improve blood flow to your hands, feet, legs and the rest of your body is exercise,” said Dr. Zapata. “Exercise also helps manage your weight, which can lead to better blood glucose control.” Aim for 30 minutes of aerobic exercise at least five days a week. Anything that gets you moving and gets your heart pumping harder will do, including biking, walking and swimming.

Manage your blood sugar. Keeping your blood sugar within the range recommended by your doctor is key to minimizing the blood vessel damage that leads to poor circulation.

Put your feet up when sitting. This makes it easier for the body to deliver blood to them. Also, get in the habit of wiggling your toes for a few minutes at a time throughout the day.

Wear compression socks or stockings. These are designed to improve circulation by gently squeezing the foot and calf muscles. They come in different levels of compression, and more compression is not necessarily better, so talk with your doctor about the right product for you.

If you smoke, stop. Smoking impairs circulation. It can also make it harder to control diabetes.

Get high blood pressure and high cholesterol under control. Both can negatively affect circulation.

Follow a heart-healthy diet. What’s good for your coronary arteries is good for all your arteries, and your circulation.

Many of these same strategies can also help prevent chronic venous insufficiency, which increases the risk for varicose veins and may cause leg pain, cramps and swelling.

Above all, work with your doctors. Report any signs or symptoms of poor circulation, as well as any wounds. Daily vigilance can help keep small problems from becoming big ones. Also keep up with regular checkups, including foot and eye exams.

Noted Dr. Zapata, “When it comes to complications stemming from poor circulation, prevention is key.”

Article Written By: Gina Shaw, an award-winning writer based in New Jersey who has covered health and medicine topics for more than 20 years.
Medical Review By: Juan Zapata, MD


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