Diabetic Foot Manual - Episode 5 - Deformities, Calluses & Early Warning Signs

Meet Milagros: 52 years old, diabetic for eight years, irregular glucose, and a love of high heels. She also has a callus — and for a person with diabetes, that callus is the whole story. When neuropathy mutes pain, pressure points from poorly chosen shoes turn into wounds long before anyone notices.

This episode of the Diabetic Foot Manual reframes the callus as a pre-malignant sign, not a cosmetic nuisance, and walks through the four deformities every patient and clinician should be able to name on sight.

The four deformities to know

• Hammered toes — toes bend permanently downward, so friction lands on the tip and top of each toe.
• Hallux valgus (bunion) — the big toe angles inward, creating a bony bump that rubs the inside of narrow shoes.
• Claw toes — toes curl under, creating two danger zones: the top of the bend and the tip.
• Metatarsal prominences — bony bumps under the ball of the foot where pressure builds into a callus, then an ulcer.

Naming the shape tells you exactly where to inspect for wounds.

The do / don't list

Do:

• See a podiatrist regularly.
• Wear the correct shoe for your foot shape.
• Hydrate your feet daily and inspect them every day.

Don't:

• Shave or cut a callus with a razor blade.
• Use chemical callus removers — they can burn the skin.
• Walk barefoot.
• Wait for an open wound to act.

Three takeaways from Milagros: mind your shoes, respect the callus, and see the specialists — a podiatrist and traumatologist catch problems before they open up. Next episode, you'll meet Pedro and learn exactly what to do the moment a wound appears.

Original content by Alianza Para El Salvataje del Pie Diabético, Peru — brought to you by Pingoo and WoundScribe AI's diabetic foot care solution, with image-anchored tracking via AI-powered wound imaging.