What is a Diabetic Foot Ulcer?
A diabetic foot ulcer is an open sore or wound that affects about 15% of people with diabetes, most often appearing on the sole of the foot. Among those who develop a foot ulcer, around 6% may require hospitalization due to infection or other complications.
Diabetes is the leading cause of non-traumatic lower limb amputations in the United States. Studies show that 14–24% of patients with diabetes who develop a foot ulcer may need an amputation, with 85% of diabetes-related amputations being preceded by foot ulcers. However, research confirms that many foot ulcers can be prevented with proper care and attention.
Causes
Anyone with diabetes is at risk of developing a foot ulcer. Certain groups, including Native Americans, African Americans, Hispanics, and older men, are more prone to ulcers. People who use insulin, as well as those with diabetes-related complications like kidney, eye, or heart disease, are also at higher risk. Additionally, being overweight and using alcohol or tobacco can contribute to the development of foot ulcers.
Foot ulcers often result from a combination of factors, such as reduced sensation in the feet, poor blood flow, foot deformities, pressure or friction, injury, and the length of time a person has had diabetes. Long-term diabetes can cause neuropathy—nerve damage that leads to a loss of feeling in the feet. This damage can occur without pain, meaning many people may not realize there’s a problem. A podiatrist can easily test for neuropathy using a simple, painless tool called a monofilament.
Poor circulation, or vascular disease, can make foot ulcers more difficult to heal and increase the risk of infection. High blood glucose levels can weaken the body’s ability to fight infections and slow down the healing process. Regular foot care and monitoring are essential in preventing and managing ulcers.
Symptoms
Because many people who develop foot ulcers have lost the ability to feel pain, pain is not a common symptom. Many times, the first thing you may notice is some drainage on your socks. Redness and swelling may also be associated with the ulceration and, if it has progressed significantly, odor may be present.
What other kinds of neuropathy need specialized care?
You can develop peripheral neuropathy affecting your feet for many reasons. You could have a pinched nerve somewhere between your lower back and toes. Or you could have an underlying condition other than diabetes that damages the nerve, like nutritional deficiencies, autoimmune diseases, and viral or bacterial infections.
We use a noninvasive, painless test to diagnose and track the progression of peripheral neuropathy. We also do additional testing and blood work to determine if you have a pinched nerve or have suffered degenerative damage. We provide customized treatment to meet your needs.
When to Visit a Podiatrist
If you notice a foot ulcer, it’s important to seek podiatric care immediately. Treating diabetic foot ulcers early helps reduce the risk of infection and amputation, improves mobility and quality of life, and lowers healthcare costs.
Diagnosis and Treatment
The main goal in treating a foot ulcer is to promote healing as quickly as possible. The faster the wound heals, the lower the chance for infection. Key aspects of treatment include:
- Preventing infection
- Relieving pressure on the affected area (“off-loading”)
- Removing dead skin and tissue (“debridement”)
- Applying medications or wound dressings
- Managing blood glucose and other health conditions
Not all ulcers are infected, but if your podiatrist finds an infection, a combination of antibiotics, wound care, and possibly hospitalization may be required.
To prevent infection, it’s essential to:
- Keep blood glucose levels under control
- Clean and bandage the ulcer regularly
- Use appropriate wound dressings
- Avoid walking barefoot
Prevention
Preventing a diabetic foot ulcer is the most effective approach. Regular visits to your podiatrist help identify risk factors early and implement strategies to prevent ulcers from forming.
You are at higher risk if you:
- Have neuropathy (nerve damage)
- Have poor circulation
- Suffer from foot deformities like bunions or hammertoes
- Wear ill-fitting shoes
- Have uncontrolled blood sugar
- Have a history of previous foot ulcers
At Ashton Podiatry, we are committed to providing expert diabetic foot care to help you maintain healthy, pain-free feet and prevent complications before they arise. Contact our Dallas or Plano office today to learn more or schedule an appointment.
