Author: Dr. Gordon Slater
Diabetic ulcers are a concerning complication of diabetes that can cause grave health complications and, in the worst cases, amputation. In this article, we take a closer look at this diabetic complication, examining the causes, risk factors, treatment options, and preventive measures.
What Are Diabetic Ulcers?
Diabetic ulcers, or diabetic foot ulcers, are open sores or wounds that occur most commonly on the feet or lower extremities in those with diabetes. These ulcers are a common but serious diabetes complication and can lead to severe medical issues if not properly managed.
What Causes Diabetic Ulcers?
Diabetic ulcers typically develop due to a combination of factors. One primary contributor is peripheral neuropathy, a form of nerve damage resulting from prolonged exposure to high blood sugar levels. This condition leads to decreased sensation in the feet, making it challenging for individuals to detect pain or discomfort caused by injuries or pressure points.
Another factor is poor circulation, a common consequence of diabetes. Poor blood circulation reduces the body's capacity to transport oxygen and essential nutrients to the affected areas, impairing the body's natural healing processes.
In some cases, where those with diabetes have foot deformities, develop pressure points, or get a small cut or blister, the combination of nerve damage and reduced blood flow can create an environment where infections thrive, ultimately increasing the risk of ulceration.
Signs and Symptoms of Diabetic Ulcers
Signs and symptoms of diabetic ulcers may include:
● Open sores or wounds on the feet, typically on the bottom or sides.
● Swelling and redness around the wound
● Drainage or pus from the wound
● A foul odor from the wound
● Black tissue at the ulcer site
● Increased warmth or coolness of the affected area.
● Fever, if the ulcer is infected
● Pain or numbness, although it may not be felt due to neuropathy.
Who Is at Risk of Developing Diabetic Ulcers?
People with diabetes, predominantly those with poorly controlled blood sugar levels, are at the highest risk of developing diabetic ulcers. Other risk factors include
● A history of foot ulcers or amputations
● Long-duration diabetes
● Peripheral neuropathy
● Poorly fitting footwear
● Smoking
● Alcohol abuse
● Kidney disease
How Do You Treat Diabetic Ulcers?
Treatment for diabetic ulcers depends on the severity of the condition, typically involving a multidisciplinary approach, which may include:
● Regular cleaning and dressing changes
● Reducing pressure on the ulcer through special footwear, casts, or braces.
● Antibiotics if an infection is present.
● Maintaining optimal blood glucose levels
● Removal of infected or dead tissue from the ulcer
● Vascular interventions such as angioplasty or revascularization to improve blood flow
● Hyperbaric oxygen therapy to help wound healing.
● Surgery for extensive ulcers, those with deep tissue involvement, or bone infections.
How to Prevent Diabetic Ulcers?
Preventing diabetic ulcers involves a series of proactive steps. First and foremost, maintaining healthy blood glucose levels is crucial in reducing the risk of neuropathy and poor circulation.
Additionally, those with diabetes need to take meticulous care of their feed, cleaning and checking them daily for any redness, pain, swelling, or injury in order to detect issues at their earliest stage. Additionally, proper footwear is important. Wearing well-fitting and supportive shoes is key to preventing pressure points, and for some, diabetic shoes may be recommended.
Moreover, smoking cessation and limiting alcohol consumption can help improve blood circulation and reduce the likelihood of neuropathy. These lifestyle changes as well as regular foot examinations by a healthcare professional, are especially helpful for those with a history of ulcers.
Conclusion
Diabetic ulcers are a common but serious complication of diabetes that develops because of a combination of neuropathy, poor circulation, and other risk factors. Yet, it is also preventable. Those with diabetes can take proactive measures such as regular foot care and blood sugar control to reduce the likelihood of ulcers.
If you or a loved one is living with diabetes, consult an experienced healthcare professional regularly to check for the development of such ulcers. If ulcers are present, they can offer immediate treatment to prevent further complications, including infection and amputation, for the best health outcomes.