Diabetes and Feet
Diabetes and foot health are strongly correlated. If a patient does not properly manage their diabetes, they could develop a diabetic foot ulcer. At that point, they’ll need to see a foot and ankle specialist for treatment.
What Is a Diabetic Foot Ulcer?
About 15% of patients with diabetes end up developing a diabetic foot ulcer, which is an open wound that usually occurs on the bottom of the foot. Unfortunately, about 6% of these cases require hospitalization because of infection or other complications.
Left untreated, diabetic foot ulcers can lead to amputation. About 14% to 24% of people with diabetes who develop a diabetic foot ulcer eventually need an amputation.
In particular, older men, Hispanics, African Americans, and Native Americans are most at risk for developing a diabetic foot ulcer. Other risk factors include using insulin, drinking alcohol, using tobacco, being overweight, and having heart, kidney or eye disease. Patients with these risk factors should schedule regular appointments with a podiatrist to maintain their foot and ankle health.
Causes and Symptoms of a Diabetic Foot Ulcer
The symptoms of a diabetic foot ulcer vary, but some warning signs patients should watch for include:
These abnormalities can happen anywhere on the foot or ankle, including between the toes and on the sole.
Causes of a diabetic foot ulcer include:
- Poor circulation in the feet
- Foot deformities
- Irritation from pressure or friction
- Neuropathy or numbness in the feet
Overall, people with diabetes-related conditions like neuropathy are more likely to develop a diabetic foot ulcer. In neuropathy, nerve damage caused by elevated blood glucose levels causes loss of sensation in the feet. As a result, the individual may not experience the pain associated with an ulcer.
People with diabetes are also more likely to have vascular disease, which limits their ability to heal. This increases the chance of developing infection and drastically increases risks associated with diabetic foot ulcers.
Diagnosis and Treatment of a Diabetic Foot Ulcer
Podiatric specialists may be able to diagnose a diabetic foot ulcer upon initial examination and recommend a course of treatment. The treatment procedure may include:
- Treating infection by prescribing an antibiotic.
- Removing pressure from the area, known as off-loading. This may involve using a wheelchair or crutches or a specific boot or shoe to give the foot time to heal.
- Removing dead tissue and skin from the ulcer, a process called debridement.
- Dressing the ulcer to keep the wound moist so it can heal. The doctor may also prescribe topically-applied medications to facilitate healing.
- On some occasions a podiatrist may recommend a skin graft to encourage healing of the wound.
- Monitoring blood glucose and other diabetic conditions to prevent the ulcer from getting worse. Patients may need to work closely with their medical doctor or an endocrinologist to manage their diabetes.
To prevent infection, the podiatrist may recommend cleaning the ulcer daily and keeping it covered with a bandage at all times. Patients should not walk barefoot and should pay close attention to their blood glucose levels.
In some cases surgery may be required. Typically, surgery is reserved for cases where there is an underlying deformity or infection. Growths, tissue, or bone may be shaved away to help reduce pressure on the wound.