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Family Foot & Ankle

Daily Care to Avoid Diabetic Ulcers

Most people know that diabetes is a disease that affects your body’s ability to regulate sugar levels on its own—either because the body can’t produce enough insulin, or because the body’s cells lose the ability to respond to insulin properly. However, there are many other potential complications of diabetes, including the development of chronic wounds on the feet—diabetic ulcers.

Anybody with diabetes is at increased risk for these sores, which commonly appear on soles—generally the ball of the foot, or under the big toe. About 1 in 6 people with diabetes will ultimately suffer from ulcers, and among them perhaps one fifth will eventually require an amputation as a result of ulcer infection. That’s why diabetic wound care (and prevention) is so critical—even minor scrapes can have disastrous consequences if left unchecked.

Why Do People with Diabetes Get Ulcers?

Diabetes results in poor circulation, slows down your healing process, and can impair proper nerve functioning. In concert, these complications make it more likely that a cut or sore will become infected, and less likely you’ll notice it. In fact, for those with significant nerve damage (called neuropathy), the first sign of a diabetic ulcer isn’t pain, but visible drainage in socks.

Without proper circulation or nerve sensation, cuts, blisters, scrapes, and sores that result from foot deformities, or friction from bad shoes, or even cracked and dry skin, can quickly spiral into a significant wound, breaking down skin and exposing sensitive lower layers. If you’re overweight, abuse alcohol, smoke, or have a kidney or cardiovascular disease, this magnifies your risk even more.

Treating Open Sores

As soon as you notice any ulceration, get off your feet and call Family Foot and Ankle Center immediately—the more you continue to put pressure on the area, and the longer you wait to get help, the more likely the consequences will be severe.

Treatment will depend on the type and severity of the wound. Our doctors may choose to remove the dead skin and inspect the site for any stowaway foreign objects, a process called debridement. Certain protective devices, including diabetic shoes, braces, compression wraps, or orthotics may also be recommended or prescribed.

If the wound is infected, emergency care will need to be provided. Tissues samples or an X-ray may be required to determine the most beneficial antibiotic or to check for signs that the infection has reached the bone. Other strategies may include disinfecting the skin, using enzyme treatments or antibacterial dressings, and changing dressings repeatedly in order to keep the wound dry.

At home, until the wound heals, follow your doctor’s orders to the letter—you may have to cleanse the area and change dressings daily (or more) and stay off your feet for a certain period of time, until the risk of infection has completely passed.

Preventing the Wounds

Of course, the best way to prevent a complication from becoming serious is to avoid developing a diabetic ulcer in the first place.

As with other diabetes-related complications, properly managing your condition by keeping blood sugar levels stable dramatically decreases your risk of ulcer formation. Beyond that, begin or maintain a careful home foot care regimen. Exercise good hygiene by washing your feet thoroughly every day and keeping them both dry and moisturized (so cracks don’t lead to bleeding or other problems). Inspect your feet every day (including between the toes), using a mirror if necessary, since you can’t always rely on a pain response to let you know when something is wrong. If you’re having persistent problems with diabetic ulcers, we may also recommend a custom orthotic or diabetic shoes to correct any structural problems that may be causing chronic wounding.

Calling for Help

You may not always be able to prevent a diabetic ulcer from forming, but if you are vigilant with inspection and maintenance and you always contact the experts as soon as you notice a sore begin to form, you dramatically improve your odds at avoiding a disastrous result such as amputation. To set up a regular diabetic check-up or for diabetic wound care, call Greater Cincinnati’s experts, Family Foot and Ankle Center, at (513) 728-4800 or (859) 282-1572.