Diabetes is a disease where the body cannot manufacture or properly use insulin. The body then is unable to convert sugars and starches into energy, leaving an elevated amount of blood sugar. Too much glucose in the bloodstream can damage the feet, heart, kidney, eyes and nerves.
Diabetes can be managed with medical care, exercise and the correct diet to avoid complications.
Neuropathy, or nerve damage, results from too much blood sugar. With neuropathy, feeling is reduced in the feet, so any damage such as a cut or scrape can worsen. Because diabetes also causes poor circulation, the healing blood cannot reach the wound, resulting in an infection and a non-healing wound.
Ulcers and Diabetic Wound Care
A diabetic foot ulcer is an open sore or wound that appears on the bottom of the foot and may lead to amputation if not treated quickly.
Two complications from diabetes contribute to foot ulcers:
- Neuropathy, nerve damage, reduces the sensation in the extremities. A small cut, bruise or puncture wound may not be noticed and can worsen into a sore.
- Poor circulation caused by excess blood sugar can inhibit healing blood flow to the feet.
A Podiatrist’s Role
A podiatrist plays an important role on a patient’s diabetes management team due to the frequency of diabetic foot-related complications. Good foot care and frequent visits to the podiatrist are keys in preventing amputations.
Early recognition of problems such as an ulcer, along with regular foot screenings by a podiatrist, can help reduce the risk of lower limb amputation by up to 85%.
Our goal is healing the ulcer as soon as possible to reduce the chance of an infection. To do this, we will take pressure off the area, remove dead skin and tissue and apply medication and dressing.
Using a brace or specialized castings, wearing special footgear or using crutches or a wheelchair can help reduce pressure and irritation.
Wound management includes keeping the area covered and moist. We will apply topical medication and dressings. We will assess blood circulation levels with non-invasive tests.
We may recommend surgery if other measures to heal the ulcer are not successful. A surgical goal would be to relieve pressure on the affected area.
Complete healing of an ulcer in a patient with diabetes may take weeks or even several months.
Preventing an ulcer from developing is its best treatment:
- Visit your podiatrist regularly for comprehensive foot exams.
- Check your feet every day, especially the soles (ask for someone’s help or use a mirror) and between the toes. Look for any changes in the skin such as a cut, bruise, blister, crack, sore or redness.
- Keep blood sugar levels under control.
- Wear appropriate shoes that are supportive, roomy and comfortable.
- Reduce risk factors such as smoking, drinking alcohol and high cholesterol.
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