Diabetic Foot Ulcers

Anyone who has diabetes can develop a foot ulcer, but Native Americans, African Americans, Hispanics and older men are at greater risk. You're also at greater risk if you use insulin, are overweight, or drink alcohol or smoke.

Diabetic foot ulcers are caused by a combination of factors, including:

• Lack of feeling in your feet, caused by nerve damage that can occur with diabetes. This makes it difficult to notice irritation or pressure on your feet, which can lead to sores.
• Narrowing of blood vessels that go to your feet (peripheral artery disease ).
• Foot deformities or trauma.

Prevention

Foot ulcers are a leading cause of amputations in people with diabetes, but they’re preventable. You can lower your risk of developing foot ulcers by managing your diabetes — and other underlying health problems — and adopting healthy habits:

• Check your feet daily. Look for any cuts, bruises, blisters or other abnormalities — use a mirror if you need to. If you notice any changes, talk to your doctor right away.
• Don’t smoke. Smoking reduces blood flow and puts you at greater risk for foot sores and other complications.
• Don't remove corns, calluses or other foot problems. Let your doctor treat these conditions.
• Keep your toenails trimmed. Make sure you cut straight across, and don't leave any sharp corners that could injure another toe or lead to an ingrown toenail. If you’re unable to do it safely, have someone else do it for you.
• Always wear shoes and socks. Make sure shoes fit you properly and socks don't cut off circulation. Always check the inside of your shoes and socks for rough edges before you put them. Never go barefoot.
• Wash and moisturize your feet daily. If you use a foot bath, make sure you test the water with your hand to make sure it’s not too hot. Dry your feet completely (especially between your toes), and apply lotion to prevent cracking. Don’t put moisturizer between your toes, which could lead to infection.

Symptoms

Many people who get foot ulcers don't have feeling in their feet, so they don't feel pain. The first thing you may notice is redness or swelling on your foot, or a stain on your sock from the sore’s drainage.

Treatment

Your doctor will develop a treatment plan to help the foot sore heal as quickly as possible to avoid infection. Your treatment may include one or more wound care therapies, such as:

• Special wound care dressings and debridement (removing dead tissue).
• Skin substitutes applied for the treatment of chronic venous and diabetic ulcers to promote healing of the wound.
• Taking pressure off your foot ulcer by using crutches or a wheelchair or by wearing special shoes.