Diabetes is a chronic disease impacting essential organs, including the skin and musculoskeletal system, often leading to diabetic foot ulcers caused by poorly regulated blood glucose levels.
These ulcers, although common, can be prevented. This article outlines symptoms, causes, risk factors, prevention, and treatments for diabetic foot ulcers.
Recognizing a diabetic foot ulcer
Monitoring diabetic feet is essential due to their vulnerability. Ulcers typically develop in plantar areas such as between or on the toes, on top or center of the foot, near the malleolus, or on the large toe’s side.
Warning signs include:
- Swelling
- Sharp pain
- Redness
- Warmth
- Bleeding corns or calluses
- Non-healing wounds
- Edema
- Foul-smelling or oozing lesions
- Repeated ingrown toenails or infected cuticles
Immediate medical examination is crucial to prevent complications such as foot deformities, spreading infections, sepsis, or gangrene possibly requiring amputation.
The cause of diabetic foot ulcers
High blood sugar levels cause peripheral neuropathy, damaging nerves and desensitizing feet, which can lead to deformities like hammer toes, bunions, or flatfoot.
Diabetes also affects blood circulation by stiffening vessels, resulting in poor blood flow with symptoms such as cold feet, slow-healing wounds, calf pain, and nail changes.
The combination of neuropathy and reduced circulation weakens the foot epidermis, making ulcers more likely.
Risk factors
Both type 1 and type 2 diabetes can cause diabetic foot ulcers, but delayed diagnosis in type 2 increases risk.
Additional risk factors beyond poor glycemic control include:
- Tight or moisture-retaining shoes
- Poor foot hygiene
- Insufficient heel support in footwear
- Fungal infections like athlete’s foot
- Pre-existing foot deformities
- Barefoot walking
- Untreated fractures
- Smoking
- Obesity
Improper footwear is a major contributor; consulting a podiatrist or orthotist for proper shoe selection is advised.
Diabetic foot ulcer prevention
Effective prevention centers on maintaining proper blood sugar levels. However, pre-existing nerve and circulation issues make this challenging.
Additional preventive steps include:
- Wearing correctly sized shoes
- Regular thorough foot inspections from soles to toes
- Following a comprehensive foot care routine
- Avoiding walking barefoot
- Seeing a doctor or podiatrist promptly after any foot injury
Medical treatments
Podiatrists play a key role in treating diabetic foot ulcers by thoroughly examining lesions and ordering tests like biopsies, digital x-rays, MRIs, or ultrasounds.
Treatment depends on severity and may include antimicrobial dressings, boots or casts, orthopedic footwear, custom orthoses, surgical debridement, topical antimicrobials, or systemic antibiotics.
In severe or infected ulcers, partial or full amputation may be necessary.
PiedRéseau – Learn more
For ongoing information on diabetic foot ulcers, PiedRéseau regularly publishes articles addressing this topic.
Nonetheless, nothing replaces a clinical consultation for personalized foot care.
Take care of your feet—they are precious!