Article: Advanced damage to autonomic nerves in your feet will likely cause you to sweat less, so there will be less moisture in the skin (which become dry, scaly and/or flaky) and toenails (which become brittle). You may notice your toenails start to crumble and look similar to a fungal infection.  If there is concomitant arterial disease caused by diabetes, lower leg skin can turn dark brown due to lack of blood flow. In addition to color changes, the texture of the skin may change, often looking smoother and shinier than before. Ulceration of the skin on the feet is a consequence of advanced sensory nerve damage. Initially, neuropathic ulcers can be painful, but as sensory nerve damage progresses, the ability of the nerves to transmit pain is dramatically reduced. Repeated injury can result in multiple ulcer formation that you may not even notice.  Neuropathic ulcers usually develop on the bottoms of feet, especially in those who constantly walk around barefoot. The presence of ulcers increases the risk of infection and gangrene (tissue death). Completely losing all sensation in your feet is a very dire situation and never considered normal. Not being able to feel the sensations of touch, vibration or pain makes it difficult to walk and puts you in danger of foot trauma leading to infection. In advanced stages of the disease, the muscles of the feet may become paralyzed, making walking without assistance nearly impossible.  Loss of pain and temperature sensation may lead to carelessness about accidental burns and cuts. You may be unaware that you're injuring your feet. Complete lack of coordination and balance puts you at risk for leg, hip and pelvis fractures due to falling.
What is a summary of what this article is about?
Take note of skin and toenail changes. Look for ulcer formation. Beware of complete lack of sensation.