What is Diabetic Foot Ulcer?
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Diabetic Foot Ulcer?
A diabetic foot ulcer is an open wound or a skin sore on the foot of a person suffering from diabetes. It is commonly seen on the bottom of the foot. The main symptom of diabetes is high blood sugar levels. This can cause damage to the blood vessels and nerves of the body and will lessen the blood flow to the hands, limbs, and feet making it harder for the sores to heal and may even cause an infection. Ulcers may cause some serious infections and gangrene (a condition in which the tissue dies). Sometimes the only way to treat an infection or gangrene is by amputation (cutting off a limb surgically) of the affected area. Diabetes foot ulcers account for nearly 85% of the lower extremity amputations.
In this article, we will be discussing in detail diabetic foot ulcers.
- What are the causes of Diabetic Foot Ulcer?
- What are the risk factors for Diabetic Foot Ulcer?
- What are the symptoms of Diabetic Foot Ulcer?
- How to diagnose Diabetic Foot Ulcer?
- What is the treatment for Diabetic Foot Ulcer?
- How to prevent Diabetic Foot Ulcer?
What are the causes of Diabetic Foot Ulcer?
A diabetic foot ulcer can be caused by vascular (related to the blood vessels and lymph nodes of the body) and neuropathic (nerve-related or nervous system-related) complications associated with diabetes.
- Neuropathic ulcer:
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- The high blood sugar levels associated with diabetes can damage the sensory nerves (nerves carrying messages to the central nervous system, that is the brain and the spine) causing peripheral neuropathy, which is a condition that causes a partial or complete loss of sensation (numbness) and inability to feel pain.
- Peripheral neuropathy is seen in about half of the adults suffering from diabetes.
- This increases the risk of injury to the feet due to cuts, bruises, or pressure.
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- Vascular ulcer:
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- High blood sugar levels can lead to the damage of the blood vessels.
- This decreases the blood flow to the feet (called ischemia) and the skin (called microangiopathy).
- This results in poor healing of the wound and prolonged unhealed ulcers.
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What are the risk factors for Diabetic Foot Ulcer?
The following conditions increase the risk of developing diabetic foot ulcer:
- Type 2 diabetes (seen in adults)
- Diabetes duration of more than 10 years
- Commonly seen in older men
- Obesity
- Poor control of diabetes
- High level of HbA1c (aggregate value of blood sugar for the last three months)
- Past history of diabetic foot ulcer
- Poor quality shoes
- Not washing and drying the feet well
- Smoking and alcohol consumption
- Toenails are not trimmed properly
- Heart disease
- Kidney disease
- Eye disease due to diabetes
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What are the symptoms of Diabetic Foot Ulcer?
The following symptoms may be present in the case of a diabetic foot ulcer:
- Early signs include drainage from the foot that may stain the socks or leak into the shoes.
- Irritation, redness, swelling, and odor from one or both feet are other early symptoms of a diabetic foot ulcer.
- Diabetic Foot ulcer is usually preceded by the formation of a blister (a small portion of skin covered by a fluid-filled, raised bubble).
- Ulcer develops on the thickened and hardened part of the skin (callus) on a pressure point and has a punched-out, circular appearance.
- It is usually painless leading to a delayed diagnosis.
- Tissue around the ulcer may become black in color (called eschar) and lead to gangrene (formation of dead tissue due to lack of blood flow) formation.
- Pedal pulses (pulse point present on the top of the foot, behind sometimes) may be absent, and sensation may be reduced in case of gangrene formation.
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How to diagnose Diabetic Foot Ulcer?
- The doctor will first physically examine the patient to check for any signs of infection, such as redness, discharge, swelling, discoloration, or warmth on the foot.
- The doctor will take note of the medical and family history of the patient, and ask for the presence of any pre-existing medical conditions like diabetes.
The doctor may advise the following diagnostic tests:
- Blood tests: If there are signs of infection during physical examination, the doctor may advise a blood test to diagnose the cause of the infection.
- Blood Glucose levels
- X-ray: X-rays of the foot and the ankle are recommended by the doctor to check for any changes in the alignment of the bones in the foot region, which may contribute to an ulcer formation, or loss of bone mass which may be indicative of diabetes.
- MRI scan: It is an imaging test that uses magnetic waves to create images of the soft tissue inside the body. It helps in determining the extent of damage caused by an ulcer and can also show signs of inflammation or infection.
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What is the treatment for Diabetic Foot Ulcer?
The treatment for a diabetic foot ulcer recommended by a podiatrist (a doctor who specializes in the treatment of the conditions associated with the feet) includes:
- The wound is first cleaned.
- Any pus or fluid is drained from the ulcer.
- The dead or infected tissue is removed by the doctor. This is known as debridement.
- The doctor then applies ointments and special bandages for absorbing any extra fluid, protecting the wound, and helping the wound to heal.
- The patient is instructed to use crutches or a wheelchair to take the weight of the foot that is affected. This is called offloading.
- Oral or intravenous (given through the veins) antibiotics are given to the patient to control and eliminate the infection.
- If the infection is severe, the doctor may recommend hospitalization.
- In extremely severe cases, amputation of the limb may be necessary to prevent the infection from spreading to other parts of the body.
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How to Prevent Diabetic Foot Ulcer?
A diabetic foot ulcer can be prevented by:
- Controlling the blood sugar levels
- Reducing high cholesterol
- Quit smoking
- Avoid excessive consumption of alcohol
- Wearing well-fitted and good quality shoes and socks
- Wash and dry your feet well every day
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We hope we could answer all your questions about Diabetic Foot ulcers through this article.
If you want to get more information and treatment of Diabetic Foot Ulcer, then contact a General Surgeon.
We aim to provide you with information about Diabetic Foot ulcers through this article. We do not recommend any medicine, treatment, or surgery in any way. Only a qualified doctor can give you good advice and the correct treatment plan.
