Issue 5 Stories
Health Matters

Diabetic Foot Ulcers: Prevention and Treatment

Diabetic foot ulcers are among the most common complications of diabetes. These nonhealing or difficult-to-heal open sores are often found on the bottom of the feet, but they can occur anywhere on the lower legs or feet. The sores can become infected, making them even harder to heal, and possibly leading to gangrene and eventual amputation of the foot or lower leg. In the United States, in fact, diabetes is the leading cause of nontraumatic foot and lower-leg amputations, according to the American Podiatric Medical Association.

Why do foot ulcers occur?

Over time, diabetes can affect the nerves, resulting in diabetic neuropathy, which often causes numbness in the feet. This condition, along with poor circulation, friction from calluses, poorly fitting shoes, and other cuts or abrasions, can cause foot ulcers. High blood sugar (glucose) and circulation problems that may accompany diabetes often make it difficult for foot ulcers to heal.

How are foot ulcers treated?

The goal in treating diabetic foot ulcers is to get them to heal quickly, in order to avoid infection. A wound care specialist or podiatrist (foot specialist) may use any of the following treatments, as needed:

•   Debridement, during which dead skin in or around the wound is removed to promote healing of the healthy tissue

•   Off-loading, which involves taking pressure off the wound—often accomplished by having the patient wear a brace, cast or some type of specialized foot gear

•   Grafting, which involves the use of cellular or tissue-based products to help speed healing

•   Hyperbaric oxygen therapy to promote healing of the wound from the inside out

•   Frequent changing of bandagesand the use of medications to lessen the risk of infection

How can I avoid diabetic foot ulcers?

If you have diabetes, you are likely at increased risk for foot ulcers and amputation. You can help prevent foot ulcers by always wearing shoes and carefully checking your feet at least once a day. Use a mirror to help you examine the tops, sides and bottoms of both feet, and be sure to check between the toes and examine the areas surrounding your toenails. Note any cuts, abrasions, ingrown toenails, blisters, calluses, bruises, cracked skin, discolored areas, or numbness or tingling, and see your doctor or a podiatrist if you find any areas of concern. Have a healthcare professional check your feet regularly, as well.

In addition to self-examination, do the following:

•    Wash and dry your feet daily, using lukewarm water instead of hot water.

•    Avoid walking barefoot or in your socks in any area where you could step on objects that could cut or bruise your feet.

•    Don’t wear the same shoes two days in a row; instead, rotate between two or three pairs, and change your socks at least once daily. Wear only shoes that fit your feet comfortably.

•    Wear padded socks for extra protection, and check inside your shoes for sharp seams or edges.

•    Walk as much as you can to increase circulation and help you lose weight.

In addition, work closely with your healthcare provider to manage your diabetes and keep your blood sugar under control.

Both Sentara Blue Ridge Region hospitals offer specialized wound care in their Wound Healing Centers. For more information, call:

Sentara Martha Jefferson Hospital: 434-654-8570

Sentara RMH Medical Center: 540-689-2100

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