Diabetic Foot Ulcers 101
September 7, 2017
Approximately 15% of people with diabetes will suffer from a diabetic foot ulcer during their lifetime. This common complication is the result of skin tissue breaking down and forming an open sore or wound.
DFU's can result in further damage and complications if left untreated. In fact, upwards of 24% of individuals with diabetes who have a DFU will require an amputation. Furthermore, approximately one-third of diabetes treatment costs in the United States is spent on treating diabetic foot ulcers
Anyone with any form of diabetes has the potential to develop a foot ulcer, and the risk of ulceration increases for those with neuropathy. Today, we're breaking down the basics of diabetic foot ulcers to better inform you of the dangers, causes, symptoms, preventive measures, and treatment.
What is a diabetic foot ulcer?
A diabetic foot ulcer is an open sore or wound that typically develops on the bottom or sole of the foot.
Who gets diabetic foot ulcers?
Anyone who has diabetes may develop a foot ulcer, but some people are more likely to ulcerate than others due to varying risk factors.
Some of the risk factors include:
- Neuropathy: For individuals with diabetes and neuropathy, the normal signaling pathway to alert the body of an injury is impaired due to nerve damage. Because individual's with neuropathy cannot feel a small cut or injury, it may quickly become worse and develop into a foot ulcer.
- Previous Foot Ulcer or Amputation: If you have had an ulcer before, you're at an increased risk to develop an ulcer again.
- Peripheral Arterial Disease: PAD results in a decreased ability of the body to heal and impedes the repair process. This makes it easier for small wounds to not heal and develop into ulcers.
- Physical Deformities: If you have a bunion or other physical deformity this increases the likelihood of a DFU.
- Injury: If you have an injury or current trauma, without proper care this may develop into an ulcer.
- High Blood Glucose Levels: Having elevated blood glucose may diminish the body's ability to fight off infection, slow healing, and result in conditions like neuropathy.
If you're concerned you may be at risk for developing a DFU, consult with your doctor or CDE. If you have numbness, pain or loss of feeling in your feet and/or toes you may also want to discuss testing for neuropathy.
What to do if you have a foot ulcer
If you notice a foot ulcer, seek care with a podiatrist immediately and notify your primary care doctor. The sooner that you seek care, the sooner that your podiatrist and doctor can start a treatment plan for you.
Every minute and day counts when it comes to a foot ulcer to prevent infection, heal the ulcer and prevent amputation and the loss of a limb.
Foot Ulcer Diagnosis and Treatment
When it comes to foot ulcer treatment and management healing quickly and correctly is paramount. The sooner you heal the ulcer, the more likely you are able to avoid infection and amputation.
Some of the treatment for diabetic foot ulcers includes:
- Taking the pressure off the area - your podiatrist may refer to this as "off-loading". Your doctor may have you reduce your activity, wear a boot, or even use a wheelchair
- Removing dead skin and tissues, also known as debridement
- Creating a holistic health plan including management of blood glucose levels and other associated conditions like neuropathy
- Infection prevention
- Utilization of medications and/dressings to keep the wound protected and clean
Your podiatrist and primary care provider will help you determine the best course of treatment and action.
Foot Ulcer Prevention and Early Detection
There are a number of ways that you can protect your feet against ulcers and amputations.
- Regular visits with your primary care doctor, CDE, and podiatrist - your care team can help determine your risk level as well as proper preventive measures.
- Check your feet daily - do a full and comprehensive visual and physical check
- Get a monofilament test - find out if you have neuropathy
- Wear proper fitting shoes and socks daily
- Keep your feet clean
- Treat your associated conditions - if you have high blood pressure, high cholesterol, neuropathy or other associated conditions discuss treatment and care options with your care team
- Continuously monitor temperature - find foot problems early by utilizing continuous temperature monitoring to alert you of the first signs of an injury.