More than 537 million patients worldwide have diabetes, and foot ulcers represent one of the most dangerous complications of this condition. These ulcers are present in 15 percent of all diabetic patients, and around 25 percent of them may result in amputation if they are not treated. Since such ulcers are frequently not noticed until they turn severe, it is important to get diabetic foot management in time.
What is a diabetic foot ulcer?
A diabetic foot ulcer is an open sore that normally appears at the big toe or ball of the foot. They are caused by insufficient circulation, nerve, or persistent pressure. Ulcers can deteriorate when untreated and reveal tendons or even bone. Diabetic foot ulcer management is therefore important to avoid the complications, particularly in long-term diabetes.
Common Causes of Foot Ulcers
Severe blood sugar levels destroy nerve structures, resulting in numb feet. This is known as peripheral neuropathy, and patients have an inability to feel injuries. Minor cuts, burns or blisters could be ignored and lead to ulcers.
Moreover, the process of healing is slow because of poor circulation due to constricted blood vessels. This makes simple wounds hard to heal. The immune response is also weakened by hyperglycemia, causing illnesses to multiply fast.
How to recognise early symptoms?
Once the symptoms become present, early assessment can avoid further progression to gangrene or infection of the bones.
- Persistent foot swelling
- Skin discolouration or redness
- Socks or shoe drainage
- Pain, numbness or tingling
- Foul-smelling discharge
- Blackened skin or tissue (eschar)
- Temperature differences between feet
Classification of Foot Ulcers
The Wagner ulcer Classification System is a system that doctors use to grade ulcer severity. The stage differentiation enables specific diabetic foot care and aids in adequate treatment planning.
- Grade 0: There are no ulcers, but the skin is at risk.
- Grade 1: Ulcer that is superficial and affects the skin only
- Grade 2: Deep ulcer reaching the tendon or joint capsule
- Grade 3: Deep ulcer with bone involvement or abscess
- Grade 4: Partial foot gangrene
- Grade 5: Extensive gangrene affecting the entire foot
How to Prevent Foot Ulcers?
People with diabetes should adopt daily foot care routines to minimise the risk. In addition, managing blood sugar levels consistently can reduce nerve and vascular damage, which are primary risk factors.
- Wash feet daily with warm (not hot) water
- Dry thoroughly, especially between toes
- Moisturise feet, avoiding toe spaces
- Trim nails straight across
- Wear cushioned, well-fitting shoes
- Inspect feet daily for cuts, blisters, or swelling
- Avoid walking barefoot indoors or outdoors
Treatment Strategies
In case of ulcer development, early treatment prevents serious consequences. Some of the strategies used in effective diabetic foot ulcer management are as follows:
- Offloading Pressure
It is important to reduce weight on the troublesome foot. To alleviate pressure, doctors prescribe bed rest, custom-designed shoes, braces or total contact casts.
- Wound Care
Wound healing is aided by cleaning and applying topical antibiotics or frequent dressing changes. Special dressing, such as calcium alginate, absorbs drainage and combats bacteria.
- Debridement
The dead tissue impairs the healing process and exposes a person to infections. Physicians use aseptic instruments to cut away dead skin and encourage the growth of healthy tissue.
- Infection Control
Antibiotics, whether oral or intravenous, are necessary in infected ulcers. Treatment is based on lab results and wound culture.
- Improving Circulation
Interventional radiologists can also conduct angioplasty to promote blood flow. This enhances the recovery and deterioration of tissues.
Various Advanced Treatments
The majority of diabetic foot ulcers can be cured non-surgically when treated in the early stages. Some situations might necessitate:
- Skin grafting is performed through synthetic skin or donor skin.
- Hyperbaric oxygen boosts the supply of oxygen to wounds.
- Foot surgeries, such as bunion surgeries or hammertoe surgeries.
- Amputation is the final resort in case of a life-threatening spread of infection.
Managing Risk Factors
Several lifestyle factors increase the likelihood of foot ulcers:
- Wearing tight or poorly made shoes
- Not washing or drying feet daily
- Improper nail trimming
- Smoking or tobacco use
- Obesity and physical inactivity
- Excessive alcohol consumption
- Existing eye, kidney, or heart disease
Additional Tips for Long-Term Diabetic Foot Management
Regular Foot Exams
To determine sensory loss, a physician might resort to aids such as a monofilament test. In case of previous ulcers, you are advised to visit Dr. Gangwani’s Vascular Clinic more regularly.
Control Your A1c Levels
The Haemoglobin A1c measures your long-term average blood sugar. An A1c below 7 will reduce foot complications and improve foot health.
Manage Comorbid Conditions
Circulation and healing are affected by high blood pressure, high cholesterol, and kidney disease. Management of these conditions will ease the load on the body and enhance foot health.
Practice Proper Wound Dressing Techniques
Clean and dress your ulcer according to the instructions of your provider. Avoid using harsh antiseptics unless prescribed, as they may damage healthy tissue. Use non-stick dressings to avoid skin trauma when changing them.
Final Thoughts
With daily diabetic foot management and timely medical intervention, you can prevent minor foot injuries from turning into life-altering complications. If you’re looking for treatment options for diabetic foot ulcers, book an appointment with Dr. Gaurav Gangwani.
