Diabetic Foot Ulcers - Complications & Treatment

Having to live with diabetes means adjusting to a new lifestyle. People who manage diabetes mellitus know that this metabolic disease causes high blood sugar. With this condition, your body doesn’t make enough insulin. Or it doesn’t properly use the insulin that it’s already there. And this eventually results in different health issues if not treated in time. 

Any person with diabetes needs to understand all the complications of high blood sugar. The longer it’s left untreated, the higher it gets, the greater the risks for serious health problems. 

Some of the most common complications caused by diabetes are: 

• Cardiovascular disease
• Nerve damage (neuropathy)
• Diabetic foot and foot infections and sores
• Kidney damage (nephropathy)
• Eye damage (retinopathy)
• Skin conditions
• Hearing impairment
• Alzheimer's disease
• Depression
• Gastroparesis

This article will detail diabetic foot ulcers, their causes, and the possible treatment and prevention methods. 

What Are Diabetic Foot Ulcers?

Diabetic foot ulcers are one of the most common complications of poorly managed diabetes. They’re usually located underneath the big toes and on the heels. But their location can differ. It mostly depends on how you lean on your foot and what part of the skin has been exposed to constant irritation. Some of the usual diabetic foot ulcer symptoms include swelling, redness, sores, and cracks.  

There are three most common types of foot ulcers:

• Arterial
• Neurotrophic
• Venous stasis ulcers

The ulcer’s location defines each of these three types and how it looks.

Diabetic foot ulcer stages can be classified into six groups according to the Wagner classification chart. 

The foot ulcer stages are:

• Grade 0 - skin is still intact.
• Grade 1 - Superficial changes on the skin.
• Grade 2 - Deeper wounds.
• Grade 3 - Deep abscess formation.
• Grade 4 - Partial gangrene.
• Grade 5 - Extensive gangrene.

By looking at pictures of diabetic foot ulcers, you could compare to see if they match any wounds on your feet. However, it’s highly recommended to visit a doctor in this case who’ll offer the best possible treatment. An early-stage diabetic foot ulcer can only be detected through regular foot inspection. 

What Causes Diabetic Foot Ulcers?

Diabetic foot ulcers form due to skin breaking down, exposing layers underneath. They are usually caused by high blood sugar, poor circulation, nerve damage, and damaged foot skin. 

High blood levels and poor blood circulation could slow down the healing process of an infected ulcer. That’s why if you’re managing diabetes, it’s essential to minimize the level of damage done to your feet and any other part of your body.

Nerve damage leads to the loss of feeling in your feet and hands. That makes it harder for you to detect new wounds, increasing the risk of infection.

Dry and damaged skin on the feet is normal with diabetics, and it’s more prone to cracking and open wounds. 

Diabetic Foot Ulcer Treatment

After you’re diagnosed with a diabetic foot ulcer, the first thing that you should do is avoid walking or standing as much as you can. Any additional pressure on the wound can cause further complications. 

If the ulcer isn’t in its early stages, the doctor will do everything to prevent further infection. The first step would be to disinfect the skin around the ulcer. Then, your doctor will probably suggest enzyme treatments and foot baths to prevent the infection from spreading. 

Every foot ulcer differs, so not everyone gets the same treatment. There are various ways in which doctors treat diabetic foot ulcers. 

1. Medicine: One of the possible ways to treat an ulcer is with medicine. The doctor may prescribe anti-clotting medication, antibiotics, or antiplatelets. Your treatment will depend on the lab results and the level of infection in the wound. 
2. Topical Treatments: A diabetic foot ulcer can also be treated with different topical treatments. Various creams, gels, and solutions will protect the wound and help it heal faster. These topical treatments vary, including PHMB gel, iodine, medical-grade honey, and silver sulphadiazine. 
3. Pressure Reduction and Weight Management: Managing external pressure on the foot and body weight is crucial in treating and preventing diabetic foot ulcers. Reducing pressure involves using special footwear, orthotic devices, or casts to redistribute weight away from the ulcerated area, minimizing further trauma and irritation. Simultaneously, weight loss plays a significant role, as excess body weight increases pressure on the feet, particularly in areas prone to ulceration, which can hinder the healing process of existing ulcers and potentially lead to new ones. Effective weight management through a balanced diet and regular physical activity reduces the stress on the feet, improves blood sugar control, cardiovascular health, and reduces inflammation. Together, these strategies are essential in managing diabetes and its complications, including foot ulcers, by addressing the direct and indirect factors contributing to their development and healing.
4. Debridement: Debridement is crucial in removing dead, damaged, or infected tissue from the ulcer. This process is essential because it clears the tissue that hinders healing and can harbor bacteria, leading to infection. By removing this tissue, debridement helps to improve the healing environment of the ulcer, reduces the risk of infection, and can also help in better assessing the depth and severity of the ulcer.
5. Surgery: Later stages of a foot ulcer might require an urgent surgical procedure. Procedures such as this one might seem frightening. But they are necessary to prevent further infection or even possible amputation. The surgeon operates on the ulcer by removing foot deformities or shaving down the bone. It’s improbable that you’ll need surgery if you see your doctor in time. 
6. Blood Sugar Management: Effective blood glucose management is crucial in treating diabetic foot ulcers. High blood sugar levels can impair the body's ability to heal and fight infections, critical aspects of recovering from a foot ulcer. Keeping blood sugar within a target range helps to promote better circulation and nerve function, both of which are essential for wound healing. Consistent blood sugar management can also prevent the progression of complications that contribute to the development of foot ulcers, such as neuropathy (nerve damage) and peripheral artery disease.
7. Alcohol and Tobacco Use: The use of alcohol and tobacco can significantly hinder the healing process of diabetic foot ulcers. Smoking, in particular, impairs blood circulation, reducing the amount of oxygen and nutrients that reach the wound, thereby slowing down the healing process. Alcohol can also have detrimental effects, including poor blood sugar control and a reduced immune response. Both alcohol and tobacco use can exacerbate complications associated with diabetes, such as nerve damage and cardiovascular problems, further complicating the healing of foot ulcers. Therefore, reducing or eliminating alcohol and tobacco consumption is recommended as part of a comprehensive approach to treating diabetic foot ulcers.
8. Prevention: Proper management of your diabetic foot can prevent ulcers in the first place. Even though this isn’t a treatment per se, it can be more useful than anything else. The best way to deal with ulcers is not to allow them to appear. Adapting to a new and improved lifestyle is the only way to achieve this. Start with a thorough inspection of your feet daily. Look for cracks or wounds that might get infected. Also, don’t forget to dry your feet after every shower properly. Use a clean, dry towel and pay attention to the space between the toes. Moreover, moisturize your skin regularly to prevent it from breaking. Wearing proper footwear and diabetic socks outdoors and indoors is essential. Specialized socks for diabetics and shoes improve circulation, protect your feet, and keep them warm. Lastly, include daily exercise in your schedule. Physical activity improves blood circulation and can keep your weight in check. The less weight you have, the less pressure your feet endure. All you need is 30 minutes of physical activity every day. You’ll start feeling the benefits of this new lifestyle very soon.
   
    

Let Us Help You

Preventive care of diabetic feet has proven to be the most successful way of keeping your feet healthy. Wearing specialized warm socks for people with diabetes has many benefits. It will improve blood circulation and protect your feet from scarring and infections. 

Viasox offers many different options. For any additional questions or feedback, you’re welcome to contact us anytime! We’re looking forward to hearing from you!