What is Diabetes?

The disease that occurs when your blood glucose (also known as the blood sugar) is too high is called Diabetes. This blood glucose comes from the food we eat and is our main source of energy. It is helped into our cells to be used for energy by a hormone made by the pancreas, called insulin.

What is a Diabetic Foot Ulcer?

Foot ulcers refer to a patch of broken down skin usually on the lower leg or feet and can occur in anyone. However, when blood sugar levels are high or fluctuate regularly skin that would normally heal may not properly repair itself because of nerve damage. Even a mild injury can therefore start a foot ulcer.

Foot ulcers are a common complication of poorly controlled diabetes, they form as a result of skin tissue breaking down and exposing the layers underneath. They're most common under big toes and the balls of the feet, and they can affect the feet down to the bones.

Why are people with Diabetes more likely to get Foot Ulcers?

People with diabetes may have reduced nerve functioning due to peripheral diabetic neuropathy. This means that the nerves that carry the pain sensation from the feet to the brain do not function well and it increases the possibility for damage to occur to the feet without even feeling it. Simple things like treading on something, wearing tight shoes, cuts, blisters and bruises can all develop into diabetes foot ulcers.

Reduced blood flow to the feet from narrowed arteries is also a common occurrence amongst some people with diabetes and this can impair the foot’s ability to heal properly. A foot ulcer can develop when the foot cannot heal.

While anyone with diabetes can develop foot ulcers and foot pain, good foot care can help prevent them. Treatment for diabetic foot ulcers and foot pain will vary depending on their causes. It is advised to discuss any foot pain or discomfort with your doctor immediately to ensure it’s not a serious problem, as infected ulcers can result in amputation if neglected.

What are the Risk Factors for Diabetes Foot Ulcers?

The following can increase the likelihood of developing a foot ulcer:

• Neuropathy
• Poor blood circulation
• Insufficiently well controlled diabetes
• Wearing poor fitting footwear
• Walking barefoot
• Poor hygiene (not washing regularly or thoroughly)
• Improper trimming of toenails
• Alcohol consumption
• Eye disease from diabetes
• Heart disease
• Kidney disease
• Obesity
• Tobacco use (inhibits blood circulation)

People who have diabetes for a longer period or mismanage their diabetes are more likely to develop foot ulcers. Smoking, not doing exercises, being overweight and having high cholesterol or blood pressure can all increase the risk of diabetes foot ulcer. Diabetic foot ulcers are also most common in older men.

How can I avoid Diabetes Foot Ulcers?

The solution is simple- avoiding diabetes foot ulcers is a matter of taking good care of the feet. Get your feet checked at least once a year by a doctor or healthcare professional and recognizing symptoms such as reduced feeling and acting on them immediately should help to avoid diabetes foot ulcers.

Identifying Symptoms

One of the first signs of a foot ulcer is drainage from the foot that might stain your socks or leak out in your shoe. Unusual swelling, irritation, redness and odors from one or both feet are also common early symptoms of a foot ulcer.

The most visible sign of a serious foot ulcer is black tissue (called eschar) surrounding the ulcer. This forms because there is a lack of healthy blood flow to the area around the ulcer. Partial or complete gangrene, which refers to tissue death due to infections, can appear around the ulcer. In this case, odorous discharge, pain and numbness can occur.

However, signs of foot ulcers are not always obvious. Sometimes, you won’t even show symptoms of ulcers until the ulcer has become infected. If you begin to see any skin discoloration, especially tissue that has turned black, or feel any pain around an area that appears callused or irritated, speak to your doctor immediately.

Treating Diabetic Foot Ulcers

Stay off your feet to prevent pain and ulcers. This is called off-loading and it’s helpful for all forms of diabetic foot ulcers. Walking can make an infection worse and an ulcer expand from the pressure. For overweight people extra pressure may be the cause of ongoing foot pain.

Your doctor may recommend wearing certain items to protect your feet:

• Diabetic shoes
• Casts
• Foot braces
• Compression wraps
• Shoe inserts to prevent corns and calluses

Diabetic foot ulcers can be removed by doctors with a debridement, the removal of dead skin, foreign objects or infections that may have caused the ulcer. An infection is a serious complication and requires immediate treatment. Not all infections are treated the same way either. Tissue surrounding the ulcer may be sent to a lab to determine which antibiotic will help. If the doctor suspects a serious infection an X-ray may be ordered to look for signs of bone infection.

Infection of a foot ulcer can be prevented with:

• Foot baths
• Disinfecting the skin around an ulcer
• Keeping the ulcer dry with frequent dressing changes
• Enzyme treatments
• Dressings containing calcium alginates to inhibit bacterial growth