A diabetic foot ulcer is an open wound commonly located at the base of the foot, caused by areas of pressure. Diabetic foot ulcers affect approximately 15 percent of patients with diabetes. People with diabetes are often affected by foot ulcers if they have neuropathy, or nerve pain.
Foot ulcers form when skin tissue breaks down and causes exposure of subcutaneous tissue, tendon, muscle and bone. If it is not treated quickly, it can get infected and even lead to lower-extremity amputation. Most patients with diabetes tend to develop foot ulcers. There are several factors that could lead to a diabetic foot ulcer.
Poor circulation from vascular disease leads to inefficient blood flow to the feet. It can also lead to foot ulcers and difficulty healing. Diabetic patients can develop neuropathy after many years. Neuropathy is an inability to feel foot pain due to nerve damage, which is caused by increased blood sugar levels. This can also lead to a diabetic foot ulcer. High glucose levels can slow down the healing process, which could lead to infection. Other causes of foot ulcers include:
The best-known risk factors include diabetic neuropathy, foot deformities and peripheral arterial disease. A cautious physical examination, followed by monofilament testing for neuropathy and non-invasive testing for blood vessel inadequacy, helps a diabetic foot doctor identify patients susceptible to foot ulcers, and who already have ulcers or other foot problems.
Proper education regarding foot hygiene, nail care, diabetic foot care and diabetic shoes are significant to reduce the risk of sustaining an injury that could lead to the formation of foot ulcers. Foot ulcerations can cause soft tissue infection or bone infection which can lead to amputation. The risk of lower extremity amputations is 15 to 46 times higher in diabetic patients than in people who don’t have diabetes mellitus. The risk factors of diabetic foot ulcers include:
The signs of diabetic foot ulcers are not always obvious, especially in the early stages. You may not see any signs until the ulcer has become infected. You may not feel any pain due to nerve damage and this will prevent you from knowing that you have foot ulcers. However, you need to be very observant and take notice of every little change that takes place on your foot.
Symptoms of diabetic foot ulcers include:
When diagnosing a diabetic foot ulcer, your foot doctor will conduct a thorough physical examination of your foot to evaluate for any signs of pre-ulcerative lesions, circulation issues, or nerve damage. Your foot doctor will ask you some health-related questions such as the type of shoes you normally wear and how you keep your feet clean and healthy.
You may be asked to stand and walk so we can assess the weight of your body and the pressure on your feet. If you limp, this may indicate structural damage. Further imaging and diagnostic testing may be required to evaluate the extent of wound/bone infection. You may undergo tests that include:
Blood tests – A blood test allows your diabetic foot doctor to screen for infections. If the ulcer is reddish in color, swollen or you feel warm around the area, a blood test may also be conducted.
MRI scans – MRI scans are done so that your doctor can know the extent of damage caused by the ulcer. It shows the bones and reveals any inflammations that may have occurred.
X-rays – You may undergo an X-ray so that your doctor can examine the internal bones and tendons for any infection or damages. Changes in the alignment of bones, loss of bone mass, weakened bones and fractures may occur. Early detections of any of these conditions help to prevent a worse case of amputations.
CT Scan – You may also undergo a CT scan to check and examine internal organs and bones.
Bacterial cultures – Your foot doctor may take a sample of the ulcer with a cotton bud or any other thin medical instruments to check for bacteria.
Diabetic foot ulcers should be treated at an early stage to prevent the ulcer from getting infected and progressing. The key factors for appropriate treatment of diabetic foot ulcer are:
Do you have a diabetic foot ulcer? Schedule an appointment with Graff Foot Ankle and Wound Care today. Call (972) 403-7733 or use our convenient Request an Appointment form to schedule your visit.
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June 17, 2022
By Dr Graff
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