Diabetic Foot Ulcers – If you are diabetic, do not ignore foot ulcers
by admin-blog-kh | April 1, 2021 6:23 pm
Ulcers on the foot of a diabetic[1] person can cause many complications if not detected on early. This condition, called ‘diabetic foot ulcers’ is the cause for gangrene and amputation in a large number of cases, around the world, every year. What are the reasons for diabetic foot ulcers and how to reduce the risk?
Causes of Diabetic Foot Ulcer
In a healthy adult, a cut, laceration, or wound on the feet is attached to an early stage and hence healing is also faster. However, with diabetics, it’s not that simple, for the following reasons:
Peripheral Artery Disease (PAD): Atherosclerosis is a condition in which cholesterol deposits in blood-vessels can harden over time into plaque and narrow, down blood-flow. While this generally occurs in the heart, for a diabetic, this can happen in the blood vessels of the arms and legs too. This causes reduced oxygen supply to the legs and feet. As a result, cuts and wounds in the feet take longer to heal for a diabetic than it does for a healthy adult.
Also Read: How do you identify Peripheral Artery Disease?[2]
Peripheral Neuropathy[3]: The constant, high blood sugar level damages nerves all over the body. When combined with Peripheral Artery Disease, it causes the damage of nerves in the extremities of the body like the forehands, palms, lower legs, and feet. Nerve damage means the person is less sensitive to pain in these areas, so a cut, laceration, or wound is not felt instantly by the diabetic. As a result – there is more chance for ulcers to develop, now.
Structure of the feet: Unlike some other parts of the body where there are many layers of the skin followed by subcutaneous fat, and then the muscles and bones, the structure of the feet is more compact and concise. The underside or soles of the feet have a thin layer of skin and soft tissue. In close proximity to this are the various ligaments, muscles, tendons, and bones of the feet. As a result, an ulcer that is not detected in time can quickly develop into an infection that spreads to the muscles and bones of the feet.
Treatment of Diabetic Foot Ulcer
Due to the above reasons, diabetics may not notice the ulcer, till there is bleeding (on the socks, floor, bed-sheets, or footwear) or a foul smell from the feet. If such a thing happens, the patient should get medical attention from a diabetologist[4], podiatrist, or orthopedic doctor[5] who specializes in diabetes-related foot and ankle ailments, or plastic surgeons[6]/ vascular surgeons[7].
If the ulcers and infection are in an advanced state, the doctor may recommend open surgery to clean and disinfect the tissue
The patient might be advised the following:
Firstly, the doctor will prescribe medicines that will prevent an infection from developing, or spreading if already developed.
Take an MRI of the affected area to check if the infection has spread to the bone
This is followed by debriding – wherein, the wound is carefully cleaned in order to remove dead or decaying skin and tissue
Off-loading, that is, the affected area should not bear any weight or pressure now. To achieve this, the doctor may put a cast around the area, or provide special shoes to be worn by the patient all the time.
Preventive Measures
Given the complications that can arise from a simple cut, laceration wound, or sore in the feet, a diabetic should take preventive measures all the time.
Monitor your blood sugar[8] constantly: Keep your blood sugar at a healthy level all the time to prevent any sores from forming.
Take care of your feet: During a bath or otherwise, wash your feet every day, with warm water and mild soap. Do not use hot water and strong soaps as these can burn your skin and create wounds of their own.
Foot Self-examination: Every day, examine all the sides of your feet thoroughly for any cut, wound, sore, or laceration. Use a hand-mirror for the underside of the feet. You can sit on a chair, fold one leg and rest it on the other thigh to examine thoroughly. If your vision is not very good, take the help of a family member or friend.
Timely medical care: While doing these self-examinations, if you find any cut, or laceration, no matter how minor it is, do not self-medicate. He/she will do the required diagnosis and put you on a course of treatment for quick recovery and rehabilitation.
Cover your feet all the time: It’s important that diabetics cover their feet all the time and should never walk barefoot, not even at home. The possibility of cuts and wounds is high, while the lack of sensation increases the risk. Wear footwear that is comfortable. This way, your feet will not rub against any part of the shoes/sandals.
Do not share footwear with anybody, including family members as you can pick up an infection from them.
Discard old footwear as they may not provide enough cushioning which increases the risk of injury.
Use moisturizers: Dry skin increases the risk of cracked skin and hence open cuts and wounds developing into sores. Rub a moisturizing cream or lotion or petroleum jelly on all sides of the feet, once a day. This will also give you an opportunity to feel any cut, wound, or bump on the feet that is not easily visible.
Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.