With an estimated 7 in 10 South African adults aged 20–79 living with diabetes still undiagnosed, KROKO is using Diabetes Awareness Month to urge South Africans to make daily foot checks, good home care and early action part of their routine.
KROKO is urging South Africans living with diabetes to check their feet every day this Diabetes Awareness Month, warning that nerve damage can allow small injuries to go unnoticed and become serious without causing pain.
The undiagnosed figure, about 1.6 million of the estimated 2.3 million adults living with diabetes, means some people may already have diabetes-related complications by the time they are diagnosed. Numbness or tingling in the feet, or a sore that is slow to heal, should be checked by a clinic, and a healthcare professional can assess the symptoms and arrange appropriate blood tests for diabetes.
KROKO sat down with clinic nurse practitioner and certified diabetes nurse educator Sydney Southern to unpack her expert advice and the consequences of delayed foot care she sees in practice.
Her warning is simple. Do not wait for a foot injury to hurt before taking it seriously.
“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.”
In one case Southern treated, a man continued walking on a blister caused by his dress shoes because it did not hurt. Within four days, the skin had broken down and become infected. He needed hospital admission, intravenous antibiotics and surgery to remove damaged tissue.
Small injuries can have serious consequences
Diabetes can damage nerves in the feet, reducing the ability to feel pain, heat or pressure. It can also reduce blood flow, making wounds harder to heal. A blister, heel crack or pressure injury can go unnoticed, develop into an ulcer and become infected. In severe cases, complications can lead to amputation.
That does not mean every small injury will become an emergency. It means the absence of pain is not proof that an injury is harmless.
“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.”
Good foot care starts at home
Daily home care plays an important role in keeping feet healthy, protecting the skin and spotting changes early. KROKO recommends building a simple, consistent routine that keeps feet clean and dry, supports the skin barrier, and helps identify changes that need professional attention.
Wash feet in lukewarm water and dry them carefully, particularly between the toes. Avoid very hot water and prolonged soaking. Wear comfortable, well-fitting shoes, including indoors where appropriate, and check footwear regularly for small stones, rough seams, or anything that could cause rubbing or irritation.
For dry, rough skin, KROKO Heel Balm can help restore moisture and soften hardened areas, while KROKO Foot Powder helps absorb excess moisture and keep feet feeling dry and comfortable. Moisturiser should be applied to dry areas of the feet, but not between the toes, where excess moisture can encourage skin problems.
Open cracks, sores, ulcers or any wound that is slow to heal should not be treated as part of a normal home-care routine and should be assessed by a healthcare professional.
For people living with diabetes, extra care is important when choosing foot-care products. Products containing salicylic acid, including some medicated corn, callus, and wart treatments, should generally be avoided unless specifically recommended by a healthcare professional. Reduced sensation can make it more difficult to notice irritation or skin damage, so ingredients and usage instructions should always be checked carefully.
Corns and calluses should never be cut away at home using blades or scissors. Persistent or painful areas are best assessed by a podiatrist or other qualified foot-care professional.
Important: People living with diabetes, reduced sensation, poor circulation or an existing foot condition should follow the advice of their healthcare professional when introducing any new foot-care product or treating a specific concern.
Look. Check. Act.
LOOK Inspect both feet every day, including the soles, heels and between the toes. Look for blisters, cuts, cracks, redness, swelling, discharge or a change in colour. Use a mirror or ask someone to help if seeing the soles is difficult.
CHECK Check shoes before putting them on, and pay attention to anything different from the previous day. Do not rely on pain to tell you something is wrong.
ACT Contact a clinic, doctor or diabetes foot-care team promptly about a new blister, cut, break in the skin or an unusually hot, red or swollen foot. Seek assessment within 24 hours rather than waiting for the next routine appointment. Spreading redness, blackened skin, pus or foul-smelling discharge needs immediate medical attention. A foot problem accompanied by fever, chills or feeling unwell is also urgent.
Daily care should sit alongside regular professional foot assessments, at least annually and more often if advised according to individual risk.
KROKO is also encouraging families and caregivers to help relatives check their feet and access care when needed. A person who cannot feel an injury may need someone else to notice it.
This World Diabetes Day, the message is simple. Care for your feet every day. If something changes, do not wait for it to hurt.
