Health & Fitness

May 20, 2014

Diabetic? You could be at risk for foot ulcers

If you have type 1 or type 2 diabetes, you know the health risks posed by your blood sugar and insulin. But diabetes also puts you at risk for painful – and dangerous – infections.

If you have type 1 or type 2 diabetes, you know the health risks posed by your blood sugar and insulin. But diabetes also puts you at risk for painful – and dangerous – infections.

What are diabetic foot ulcers?

Ulcers, which can occur nearly anywhere in the body, are slow-healing wounds on the skin.

People with diabetes are particularly susceptible to diabetic foot ulcers because diabetes can damage nerves in your legs and feet. It can also cause problems with your blood flow, which delays healing.

Typically, diabetic foot ulcers are caused by repetitive trauma or pressure on the foot, puncture wounds or objects in your shoes that damage your skin. These problems, while painful or annoying for most people, can go unnoticed by people with neuropathy (numbness in your feet) or peripheral vascular disease (poor circulation in your legs), both of which are common among diabetes patients.

You are further at risk for foot ulcers if you have a previous foot deformity, history of smoking, wear poorly fitted shoes or no shoes at all.

Check your feet

Do you have any warning signs for diabetic foot ulcers?

Pay attention to your symptoms if you have sores or blisters on your feet or lower legs, as well as any pain or difficulty walking. Notify a physician immediately if you notice any black, blue or red discoloration in your feet or signs of infection, such as fever or swelling.

If your doctor thinks you have, or are at risk for, diabetic foot ulcers, he or she will conduct a physical exam, and you may be referred to a diabetic specialist. You will likely have a wound culture test performed to determine whether or not you have an infection.

Your doctor may also order scans such as X-rays, CT or MRI to get a thorough look of your foot – inside and out. If your doctor needs to check the blood flow to your feet, you may also undergo an ankle-brachial pressure test or Doppler study.

How are foot ulcers treated?

Wesley Medical Center’s Mid-West Center for Wound Care and Hyperbaric Medicine will evaluate your wound to determine what treatment options are needed. This assessment includes a physical exam, nutrition assessment, measurement of tissue oxygen levels, evaluation of pressure relief methods and consultations with your family physician and with any surgical subspecialists, if needed, to ensure comprehensive care.

The treatment for diabetic foot ulcer ranges from relatively simple steps – such as lifestyle modification and blood sugar control – to more extensive measures.

Good wound care is imperative to healing. If you have a diabetic foot ulcer, your doctor will likely give you specific instructions on how to clean the wound and change any dressings. It is imperative to follow those directions, especially if you are prescribed antibiotics for infection.

You may need more advanced wound care, such as hyperbaric oxygen therapy, where pure oxygen is pumped into a chamber to increase oxygen levels in your blood.

If your ulcer goes untreated, or if it doesn’t heal properly, you may need a skin graft. During this procedure, skin is surgically removed from elsewhere on your body and placed over the wound.

In some extreme cases, dead tissue builds up inside and around the ulcer, which requires surgery to remove – a procedure called debridement. And if blood flow becomes too restrictive, you may require bypass surgery to help re-open your arteries.

Rarely, diabetic ulcers become too infected or severe to treat. As a last resort, amputation may be needed to stop the infection from spreading throughout the body.

Prevent diabetic ulcers from forming

Approximately 15 percent of all diabetes patients will develop foot ulcers at some point. However, there are precautions you can take to lessen your risk.

Most importantly, clean and dry your feet daily, especially between the toes, before putting on shoes and socks. You should also examine your feet every day and look for sores and blisters you may not be able to feel.

When you moisturize your feet, use an unscented lotion or petroleum jelly. Also, don’t rub lotion between your toes – the extra moisture might attract bacteria.

If you think you’re at risk for diabetic ulcers, ask your doctor if you should use a special infrared thermometer. It can check the temperature of your feet and help you recognize infection early.

These efforts should be in addition to other healthy habits, such as not smoking and exercising regularly.

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