Diabetic foot ulcers can begin in a mundane way. Maybe it’s a new pair of shoes or an extra long walk. Next thing you know, you have a small callus or blister on your foot.
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The problem arises when you lose feeling in your feet. If you keep walking instead of stopping or changing shoes, a small sore may turn into a more serious wound. Up to 10 percent of people with diabetes will end up with a foot ulcer, podiatrist William Scott, DPM, says.
“Patients come to see me and they say, ‘One day, I just took off my sock, and I saw blood. I have no idea why or how it happened,’” he says.
These ulcers cause the skin to wear away, most commonly because of damaged nerves in the hands and feet (peripheral neuropathy), resulting from diabetes. Although ulcers are sometimes dangerous and can lead to amputation, the key is prevention, Dr. Scott says.
How can you prevent foot ulcers?
Here are some tips to preventing foot ulcers:
- Watch your blood sugar. The best way to prevent diabetic foot ulcers is to keep your blood sugar levels under control. Uncontrolled glucose is often behind neuropathy, which causes loss of feeling in the feet and may allow a sore to go unnoticed. Maintaining normal glucose levels will also help any sores on the foot heal faster. This can help keep ulcers from developing.
- Pay attention to your feet. Dr. Scott says it’s important to conduct daily foot inspections if you have diabetes. Catching a sore early can go a long way in preventing major problems. Can’t see the bottoms of your feet? Try this: Put a mirror on the floor and hold each foot over it. Or ask a family member to check all areas of your feet regularly.
How can you treat foot ulcers?
Typical wound care for a foot ulcer is debridement (a doctor removes unhealthy tissue from the wound). Taking this tissue off sparks the body’s natural healing mechanism, Dr. Scott says.
Your doctor will then apply a dressing to the wound, which you’ll need to change regularly.
You’ll also have to “offload” the affected part of the foot, he says. Continued pressure on the sore will only worsen it. So you’ll likely wear a cast, surgical shoe or boot that keeps weight off the injured site while the wound heals.
If the ulcer hasn’t healed in four weeks or you have a bone infection, your doctor may recommend more advanced therapies.
These may include:
- Living cellular skin substitute
- Hyperbaric oxygen therapy (breathing pure oxygen in a pressurized room) to promote healing
What makes foot ulcers so serious?
The soft tissue of the foot isn’t like that on other parts of the body, so an infection can get to the muscle and bone very quickly. Infection and poor blood flow can lead to more serious complications, Dr. Scott says.
That infection is what ultimately can lead to amputation. For this reason, you need to see your doctor quickly if you suspect you have a foot ulcer.
Your doctor may order an X-ray, and possibly an MRI, if you have an ulcer that is worsening. This will show whether there is any infection in the bone.
If you do get a foot ulcer, you need to keep your sugars under control and follow up regularly with your doctor.
It’s important not to ever let a wound linger without treatment. As time passes, the chances of it healing decrease. Be sure to see your doctor right away. If you don’t have a podiatrist, you’ll need to get one to help you keep tabs on your foot health, Dr. Scott says.