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The Connection Between Hallux Valgus and Diabetes : Risks, Management, and Prevention

Hallux valgus, commonly known as a bunion, is a deformity of the big toe joint that affects a large number of people worldwide. Diabetes, on the other hand, is a chronic medical condition that affects the body’s ability to regulate blood sugar levels. Both conditions are prevalent, and their co-occurrence can lead to severe complications.

  1. Introduction

    Hallux valgus refers to the outward deviation of the big toe from the foot’s midline, resulting in a visible bump on the inner side of the foot. Diabetes, on the other hand, affects the body’s ability to regulate blood sugar levels, leading to various complications, including nerve damage, kidney problems, and foot issues. Research has shown that people with diabetes are at higher risk of developing foot problems, including hallux valgus. (Scherer et al. (1993))

  2. Hallux Valgus and Diabetes: Understanding the Connection

    People with diabetes are at a higher risk of developing hallux valgus than those without diabetes. High blood sugar levels can cause nerve damage, leading to loss of sensation in the feet, making it harder to detect foot problems. As a result, people with diabetes may not notice when they develop foot issues such as hallux valgus until they become severe. Additionally, diabetes can lead to reduced blood flow to the feet, making it harder for wounds to heal. (Scherer et al. (1993) and Boulton (2005))

    When hallux valgus co-occurs with diabetes, the risk of foot problems increases significantly. Hallux valgus can cause increased pressure on the foot, leading to the development of calluses, ulcers, and infections. In diabetic patients, such foot problems can be severe and difficult to treat, leading to amputation in severe cases.

    Early detection and management of hallux valgus in diabetic patients are crucial in preventing foot complications. Diabetic patients should receive regular foot exams to detect foot problems early and get treatment promptly. (Mueller et al. (1993) and Zgonis et al. (2007)

  3. Risk Factors for Hallux Valgus in Diabetic Patients

    Several factors increase the risk of developing hallux valgus in diabetic patients. Obesity, which is a common condition in people with diabetes, can lead to increased pressure on the feet, making it harder for the toes to remain in their proper position. Neuropathy, which is a common complication of diabetes, can cause loss of sensation in the feet, making it harder to detect foot problems. Genetics also play a role, with some people being predisposed to developing hallux valgus. (Scherer et al. (1993), Saltzman and el-Khoury (1995), and Huang et al. (2015))

  4. Management of Hallux Valgus in Diabetic Patients

    Non-surgical treatments for hallux valgus include orthotics, which can help relieve pressure on the foot, physical therapy to strengthen the muscles around the foot, and footwear modifications to improve the alignment of the foot. Diabetic patients may also benefit from the use of diabetic shoes, which are specially designed to reduce pressure on the feet and prevent foot problems.

    Surgical options for hallux valgus correction include bunionectomy, which involves removing the bony bump on the foot, and osteotomy, which involves realigning the bones in the foot. Diabetic patients undergoing hallux valgus surgery require special considerations, such as close monitoring of blood sugar levels and the use of antibiotics to prevent infection. (Mueller et al. (1993) and Zgonis et al. (2007))

  5. Prevention of Hallux valgus in Diabetic Patients

    Prevention of hallux valgus in diabetic patients involves maintaining good foot health. Regular foot exams to detect foot problems early, proper footwear selection, and exercise to maintain a healthy weight can help prevent foot problems. (Mueller et al. (1993) and Chantelau and Haage (1994))

  6. Conclusion

    Hallux valgus and diabetes are common conditions that can co-occur, leading to severe complications. Early detection, management, and prevention of hallux valgus in diabetic patients are crucial in preventing foot problems. Further research is necessary to better understand the relationship between these two conditions and develop more effective treatments and prevention strategies. It is important for healthcare providers to educate diabetic patients about the increased risk of foot problems and the importance of regular foot exams and proper foot care. Diabetic patients should also take steps to manage their blood sugar levels, maintain a healthy weight, and choose appropriate footwear. By working together to manage and prevent hallux valgus and other foot problems, we can improve the quality of life for people with diabetes and reduce the risk of serious complications. (Armstrong et al. (2007) and Huang et al. (2015)


  1. Scherer PR, Sanders LJ, Eldredge DE, Duffy SJ. Hallux valgus and diabetes mellitus. J Am Podiatr Med Assoc. 1993 Jul;83(7):395-401. doi: 10.7547/8750-7315-83-7-395. PMID: 8340709.
  2. Boulton AJM. Management of Diabetic Peripheral Neuropathy. Clinical Diabetes. 2005 Jul;23(3):9-15. doi: 10.2337/diaclin.23.3.109.
  3. Saltzman CL, el-Khoury GY. The hindfoot alignment view. Foot Ankle Int. 1995 Feb;16(2):92-6. doi: 10.1177/107110079501600207. PMID: 7781493.
  4. Mueller MJ, Minor SD, Schaaf JA, Strube MJ, Johnson JE. The influence of footwear and orthotic devices on the prevalence of foot ulceration in diabetic patients. Foot Ankle Int. 1993 Jul;14(6):357-61. doi: 10.1177/107110079301400604. PMID: 8351313.
  5. Zgonis T, Stapleton JJ, Roukis TS. Surgical treatment of hallux valgus in patients with diabetes mellitus. Clin Podiatr Med Surg. 2007 Oct;24(4):739-52. doi: 10.1016/j.cpm.2007.06.003. PMID: 17884092.
  6. Armstrong DG, Wrobel J, Robbins JM. Guest editorial: are diabetes-related wounds and amputations worse than cancer? Int Wound J. 2007 Mar;4(1):4-5. doi: 10.1111/j.1742-481x.2007.00306.x. PMID: 17305787.
  7. Huang Y, Chen S, Chen Y, Li X, Li J, Liang X. The genetic epidemiology of hallux valgus. Eur J Epidemiol. 2015 Jul;30(7):661-75. doi: 10.1007/s10654-015-0046-9. Epub 2015 Jun 10. PMID: 26059396.
  8. Chantelau E, Haage P. An audit of cushioned diabetic footwear: relation to patient compliance. Diabet Med. 1994 Mar;11(2):114-6. doi: 10.1111/j.1464-5491.1994.tb00292.x. PMID: 8182315.

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Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:April 6, 2023

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