Life with diabetes is full of challenges, and certainly, diabetic foot ulcers are one of the most serious complications. Essentially, these are open sores or lesions – usually on the underside of the foot – that affect some 15% of people with diabetes at some point in their lives.
Today, we’re going to explore treatment alternatives and see how to avoid these potentially deadly complications.
What is a Diabetic Foot Ulcer?
An open lesion or sore that develops on the foot, usually beneath the great toe or ball of the foot, is known as a diabetic foot ulcer. When the skin tissue breaks down it reveals the layers underneath. Such ulcers require care because diabetes interferes with the natural body’s capability to heal wounds and fight infections. Consider it your body’s natural repair mechanism, working at a slower pace than usual.
Early Warning Signs
The early signs of foot ulcers can greatly improve the likelihood of a successful cure. The first sign that most people notice is an unusual discharge from their foot that tints their socks. You could also see swelling or redness in your feet or smell strange odors coming from your feet or shoes.
A particularly concerning sign is dark tissue (called eschar) around a wound. Any changes in foot color, especially areas turning black, should prompt immediate medical attention. Even seemingly minor symptoms like pain or discomfort in callused areas shouldn’t be ignored.
Understanding the Causes
There are many causes of diabetic foot ulcers, and knowing what they are will help with treatment and prevention.
The first major cause is poor blood circulation. In the presence of diabetes, the blood vessels in your feet may become narrowed and hardened, resembling a partially blocked garden hose unable to deliver sufficient water to thirsty plants. This diminished blood flow translates to less oxygen and fewer nutrients reaching your feet, complicating the healing process of wounds.
High blood sugar is a poison to your body and delays healing. Studies that have appeared in New England Journal of Medicine suggest that patients with better control of blood sugar have 77% higher healing rates. This means that controlling blood sugar for both treatment and prevention of ulcers takes precedence.
Another major risk is nerve damage or neuropathy. Diabetes destroys the nerves in your feet. You may not feel anything at all. Just imagine walking around with numb feet. You might step on something sharp or get a blister, and you wouldn’t even notice it. These minor injuries can become serious issues because of lost protective sensation.
Treatment Options
1. Pressure Relief
The most critical part of the treatment is the relief of pressure from the wound, which the medical professionals call “off-loading.” This may include the use of specialized diabetic shoes that redistribute pressure away from the ulcer site.
Some patients will need custom inserts made to the exact contours of their feet, while others may need more aggressive interventions such as special casts or even temporary use of crutches or wheelchairs. The secret is to allow the wound to heal without the constant stress of walking and standing.
2. Wound Care Essentials
Effective wound care is the foundation of successful ulcer treatment. This begins with routine cleaning with sterile solutions to remove any debris and bacteria.
Often, professional debridement—where a healthcare provider carefully removes dead tissue—is necessary to promote healing. The wound needs to be maintained in an environment accurately calibrated to be moist enough to promote healing but not overly saturated so as not to cause tissue destruction.
Modern wound dressings are carefully designed for these requirements to be met for optimal healing.
3. Infection Management
Infection can significantly complicate the treatment of ulcers, so its control is a serious concern when it occurs. Your doctor will likely obtain cultures to specifically identify bacteria at play enabling a targeted antibiotic therapy plan.
Some patients may require antimicrobial dressings specific to killing the bacteria that are residing in the wound. Monitoring is necessary to ensure that infection is responding to antibiotic therapy, but if healing is not happening as expected further diagnostic tests may be necessary.
4. Advanced Treatment Technologies
Modern medicine has revealed amazing advances in the treatment of diabetic foot ulcers. One of the most exciting areas in these directions is tissue engineering treatment.
Available products include temporary skin substitutes such as Dermagraft® and Apligraf, which provide the wound with the necessary biological elements needed to heal. Growth factor therapy stimulates the native healing ability of the body, while stem cell treatments and platelet-rich plasma therapy harness the body’s own resources for repair. These sophisticated treatments are proven to have enhanced healing rates.
5. Surgical Interventions
Sometimes, surgical intervention is required to encourage healing. This could be removing infected bone, or correcting foot deformities that cause ulcers, or improving distal blood flow supply.
Partial amputation in severe cases might be necessary where other treatments have failed and the infection can be contained to preserve the rest of the limb. In reality, most patients today can be treated without such extreme maneuvers with early intervention and proper care.
Prevention: The Foundation of Foot Health
Prevention is easier than treatment and includes a comprehensive daily routine of foot care. The feet should be washed thoroughly in warm, not hot, water. Drying of the feet, especially between the toes, must be scrupulous, and checking regularly for changes or injury is recommended.
Moisturizer prevents cracking but should not be applied between the toes since moisture can lead to fungal infections. Clean dry socks and well-fitting shoes protect the feet from many forms of damage.
Blood sugar management plays a crucial role in prevention. Research demonstrates that each 1% reduction in HbA1c (a measure of blood sugar control) reduces complication risks by 21%. This makes regular blood sugar monitoring and management an essential part of preventing foot ulcers.
Recovery and Long-term Outlook
The healing journey for diabetic foot ulcers typically spans 3-6 months, though this timeline can vary significantly based on several factors. Your blood sugar control, adherence to treatment instructions, overall health status, and the quality of wound care all influence healing speed.
Don’t let a diabetic foot ulcer take away your mobility and the quality of your life. At ProFoot Doctors, we have a team of podiatrists offering the most comprehensive care using the most advanced treatment options available. We understand the intricacies of diabetic foot care and work closely with each patient to develop an effective treatment plan.
This method combines the latest treatment therapies with educational programs and preventive services to allow for healthy feet well into life. Contact us now to schedule an appointment and get started on your path toward recovery. Your feet deserve high-quality care, and we’re ready to provide that.
