How Diabetes and Heart Disease Affect Your Feet
(With advice from the American Diabetes Association and the American Heart Association)
Diabetes and heart disease are closely related conditions that often coexist. According to the American Heart Association (AHA), adults with diabetes are at significantly greater risk of developing cardiovascular disease than those without diabetes. The American Diabetes Association (ADA) even classifies cardiovascular disease as the leading cause of death among people with diabetes.
Although most people associate heart disease with chest pain and shortness of breath, early warning signs can sometimes appear much lower in the body — in the feet.
Understanding how diabetes and heart disease affect foot health is crucial to preventing serious complications.
Proven Link Between Diabetes and Cardiovascular Disease.
The ADA Standards of Care for Diabetes (2024) states that chronic hyperglycemia contributes to microvascular and macrovascular damage. This includes:
Damage to small blood vessels (microvascular complications such as neuropathy)
Damage to larger arteries (macrovascular diseases such as coronary artery disease and peripheral arterial disease)
Similarly, the AHA Scientific Statement on Cardiovascular Disease in Diabetes explains that diabetes accelerates atherosclerosis—the buildup of plaque in the arteries—increasing the risk of heart attack, stroke, and peripheral artery disease (PAD).
When blood vessels narrow or stiffen due to plaque buildup, circulation in the lower extremities decreases. The feet, being the furthest point from the heart, are particularly vulnerable.
Why feet are more vulnerable
Two main mechanisms link diabetes, heart disease, and foot complications:
1. Peripheral neuropathy (ADA)
According to the American Medical Association (ADA), diabetic peripheral neuropathy is one of the most common complications of diabetes. It results from long-term high blood glucose levels, which damage nerves.
Symptoms may include:
Numbness
Tingle
Burning sensation
Limited ability to feel pain or temperature
When sensation is impaired, minor injuries may go unnoticed.
2. Peripheral Arterial Disease (PAD)
The American Heart Association (AHA) identifies peripheral artery disease (PAD) as a symptom of systemic atherosclerosis. PAD reduces blood flow to the legs and feet due to narrowing of the arteries.
Reduced blood flow leads to:
