Do you have a sore on your foot that’s been there for a while without
improving? If you have diabetes, chances are you’ve developed a
diabetic ulcer.
In that case, it’s important to understand what the ulcer is, what
caused it, what risks it presents, and how you can treat it.
What’s a diabetic ulcer?
According to the American Podiatric Medical Association, diabetic foot
ulcers affect approximately
15 percent of people with diabetes. They’re open sores on the feet from the
ankle down. Most develop on the bottom of your feet, particularly under
your big toe or the ball of your foot. Typically, ulcers begin with foot
injuries, such as cuts or blisters.
These wounds can linger for weeks without improvement. Between
14-24 percent of ulcers end with amputation.
Who’s at risk?
Some individuals face a higher ulcer
risk. Native-American, African-American, and Hispanic patients are more likely
to develop ulcers, as are men and patients over 60. Additionally, individuals
with vision problems, chronic kidney disease, and obesity experience greater
risk. Heart disease and high blood sugar also impede your body’s
ability to heal and fight infection.
Some behaviors also make foot ulcers more likely to develop. Alcohol consumption,
poorly-trimmed toenails, tobacco use, poor hygiene, and wearing poorly-fitted
shoes (ones without enough cushioning or room for your toes) can promote
ulcer formation.
What causes ulcers?
In addition to high blood pressure and injury, there are other
causes of ulcer development and poor healing. In fact, nearly 43 percent of ulcers
occur in people with both of these conditions:
-
Diabetic neuropathy: This common complication involves nerve damage in your feet, frequently
leading to total sensation loss. This makes it harder for you to notice
any scrapes, cracks, or blisters.
-
Peripheral artery disease (PAD): This condition blocks arteries in your legs, strictly limiting blood flow.
Without proper circulation, your body can’t get enough oxygen to
the wound for healing.
Are ulcers life-threatening?
They can be. Without treatment, infectious bacteria can damage and kill
your skin and tissues. It can also infect your blood stream or cause a
bone infection (osteomyelitis), both of which can lead to sepsis.
If you have PAD, an untreated ulcer can also lead to ischemia where tissue
dies, becomes gangrene, potentially leading to death.
What can you do?
Seek treatment for a foot ulcer within
six weeks. Waiting longer drastically reduces your chances to heal.
Your doctor will prescribe medication to prevent or treat infection and
will remove dead skin or tissue (debridement). He or she will tell you
to alleviate pressure from your foot by wearing a brace, specialized cast,
or using a wheelchair or crutches. Control your blood sugar levels (between
80-130 mg/dL before eating and under 180 mg/dL after eating) and monitor
your feet daily for any injuries or changes.
With this knowledge, you can keep track of any lingering wounds on your
feet and pursue your best treatment options.
For more information or to schedule an appointment, please contact the
Torrance Memorial Wound Care and Amputation Prevention Center at (310)
517-4736 or visit
torrancememorial.org/APC.