Approximately 15% of people with diabetes suffer from foot ulcers, according to the American Podiatric Medical Association. This dangerous condition is a threat to all diabetes patients, but learning about foot ulcers and taking preventative care measures can decrease your risk.
Foot complications lead to the highest percent of hospital visits for diabetics. And foot ulcers are the most common foot injury that results in amputation. Fortunately, the United States National Diabetes Advisory Board reports that early detection and treatment may prevent up to 85% of amputations.
The severity of your diabetes will affect the likelihood of developing a foot ulcer. This is true, of course, of all diabetes side effects and complications, but what exactly are the triggers that make patients more prone to foot ulcers?
Neuropathyis a complication associated with a number of medical conditions including diabetes. The condition makes diabetics more susceptible to foot injuries that can lead to ulcers. In general, neuropathy refers to nerve damage. Diabetes patients suffer from peripheral neuropathy, which is technically defined as nerve damage outside of the brain and spinal cord. It affects extremity nerves such as those in the legs and feet.
Up to 50% of people with neuropathy due to diabetes do not have symptoms. This may not sound so bad: you’re pain-free and your lifestyle is unaffected; but it’s a real danger if you receive a injury that goes undetected due to lack of sensation in your foot. In fact, some patients realize that they have foot injuries (even ulcers) only by seeing blood from the open wound on their socks.
If blood vessels in the feet are damaged, tissue damage may occur. This is caused by loss of blood circulation to the feet, known as peripheral arterial disease (PAD) and is a problem faced by one third of diabetics over the age of 50. Circulation problems not only cause nerve damage, but also results in slow healing.
Physical changes that damage the feet are another concern for diabetics. It’s not uncommon to develop calluses on the ball pad or heel under the foot. The real danger is that callus skin can break down to form an ulcer, which often goes undetected because it is hidden under the calloused skin.
Nerve damage can cause changes to the shape of your feet and cause foot structural deformities. Proper fitting and comfortable shoes are a vital part of preventing calluses, bunions, and other foot and toe defacements that can result in ulcers. Treatment of calluses should be handled by a medical professional.
Foot Ulcer Prevention
In addition to the routine care patients take to manage diabetes, there are specific precautions that will minimize the risk of developing a foot ulcer.
Broken skin wounds have a high likelihood of developing into foot ulcers. These painful injuries can lead to very serious problems. Foot exams should be a routine part of your medical checkups. Speak to your doctor about how frequently you need to schedule your office visits and what to look for on your own feet in between visits.
In addition to checking your feet, you should develop routine personal foot care habits that prevent wounds and reduce the risk of infection.
- Toenail trimming and pedicure procedures should be handled with care and only with the proper sterilized
- Keep your feet clean and nourished. The nerves that control moisture by producing oils in your feet may not work properly. Dryness can result in cracked open skin. The American Diabetes Association ( http://www.diabetes.org/) recommends applying a thin coat of petroleum jelly or unscented hand cream on your feet after bathing to seal in moisture. Other tips they recommend: don’t put oil or cream between your toes (extra moisture can cause infection) and don’t soak your feet, which can backfire and cause dry skin.
- Wear the correct shoes. Poor fitting and poor quality shoes can cause or exacerbate diabetic foot ulcers. We’ve already discussed the dangers associated with developing blisters, calluses or bunions. We recommend shoes that are specifically designed to address diabetic foot care.
Preventative care is key. But sometimes no matter how careful you are, stuff happens, and you or your doctor will find that you have a wound. Hopefully your foot care routine will allow you to detect your injury early on. Consistent and frequent medical exams will provide early detection, which will have a profound impact on your quality of life.
If you develop a foot injury, your concerns shift to infection prevention. And if you are diagnosed with a foot ulcer, your doctor will help you best treat it to heal quickly and to prevent the possibility recurrence. What care should you take to speed up your recovery if you’re afflicted with a foot ulcer?
- Keep pressure off your foot to allow it to heal.
- Never walk barefoot.
- Keep your wound area clean and covered with a saline dressing (or dressed as advised by your doctor).
- Always wear the right shoes to prevent a healing or a healed ulcer from returning. Once healed, scarred skin is sensitive and must be treated with care to prevent a recurrence.
There’s more information on the importance of functional footwear for diabetics in our blog How to Protect Diabetic Feet.