A Guide To Diabetic Foot Ulcers
Foot Ulcer Prevention
Your health care provider should perform a complete foot exam at least once a year – more often if you have foot problems. Remember to take off your socks and shoes while you wait for your physical examination.
Ask your doctor about Medicare coverage for custom made shoes/inserts.
Call or see your health care provider if you have cuts or breaks in the skin, or have an ingrown nail. Also, tell your health care provider if your foot changes color, shape, or feels different (for example, becomes less sensitive or more painful).
If you have corns or calluses, your health care provider can trim them for you. Your health care provider can also trim your toenails if you cannot do so safely.
Because people with diabetes are more prone to foot problems, a foot care specialist should be on your health care team.
Your health care provider should also give you a list and explain the “dos and don’ts” of foot care.
Most people can prevent any serious foot problem by following some simple steps. So let’s begin taking care of your feet today.
Caring For Your Feet
There are many things you can do to keep your feet healthy. Things you can start doing today:
Take care of your diabetes.
Work with your health care team to keep your blood glucose in your target range.
Check your feet every day.
Look at your bare feet for red spots, cuts, swelling, and blisters. If you cannot see the bottoms of your feet, use a mirror, a selfie stick, or ask someone for help.
Be more active.
Plan your physical activity program with your health care team.
Wash your feet every day.
Dry them carefully, especially between toes. Don’t soak your feet — that can dry your skin.
Keep your skin soft and smooth.
Rub a thin coat of skin lotion over the tops and bottoms of your feet, but never between your toes.
If you can see and reach your toenails, trim them when needed.
Trim your toenails straight across and file the edges with an emery board or nail file.
Wear shoes and socks at all times.
Never walk barefoot. Wear comfortable shoes that fit well and protect your feet. Check inside your shoes before wearing them. Make sure the lining is smooth, and there are no objects inside.
Protect your feet from hot and cold.
Wear shoes at the beach or on hot pavement. Don’t put your feet into hot water. Test water before putting your feet in it just as you would before bathing a baby. Never use hot water bottles, heating pads, or electric blankets. You can burn your feet without realizing it.
Keep the blood flowing to your feet.
Put your feet up when sitting. Wiggle your toes and move your ankles up and down for 5 minutes, two (2) or three (3) times a day. Don’t cross your legs for long periods. Don’t smoke.
Foot Complications
People with diabetes can develop many different foot problems. Even ordinary problems can get worse and lead to serious complications.
Foot problems most often happen when there is nerve damage, also called neuropathy. This can cause tingling, pain (burning or stinging), or weakness in the foot. It can also cause loss of feeling in the foot, so you can injure it and not know it. Poor blood flow or changes in the shape of your feet or toes may also cause problems.
Additional Resources
- Adjunct Methods of the Standard Diabetic Foot Ulceration Therapy
- Hyperbaric oxygen therapy improves health-related quality of life in patients with diabetes and chronic foot ulcer
- Potential benefits of hyperbaric oxygen therapy on atherosclerosis and glycaemic control in patients with diabetic foot
- Effect of hyperbaric oxygen therapy on nerve regeneration in early diabetes
- Systematic Review of the Effectiveness of Hyperbaric Oxygenation Therapy in the Management of Chronic Diabetic Foot Ulcers
- Hyperbaric oxygen treatment of chronic refractory radiation proctitis: a randomized and controlled double-blind crossover trial with long-term follow-up
Diabetic Foot Ulcers
Diabetic Foot Ulcers (DFUs) can be located anywhere on the foot or toes, and they can be a result of something as simple as poorly fitting shoes. Prevention of ulcers is the most effective treatment. Even though some ulcers do not hurt, every ulcer should be seen by your health care provider right away. Simply not treating an ulcer can lead to infection, particularly in the bone, and could eventually lead to the loss of a limb.
If you have a DFU, walking on an ulcer can make it get larger and force the infection deeper into your foot, so it is important to minimize walking on the affected foot. Your health care provider may order or prescribe a special shoe, brace, or cast for you.
What your health care provider will do varies with your ulcer. Your health care provider may order x-rays of your foot to make sure the bone is not infected. Also, the health care provider may culture the wound to find out if the infection is present that requires antibiotics.
An important part of the evaluation of a person with a diabetic foot ulcer is a thorough vascular exam because patients with diabetes have a higher risk of having the peripheral arterial disease. This condition results when circulation to the legs and feet is blocked or narrowed. Poor circulation can cause pain and discoloration in the feet and if severe enough may lead to gangrene and the need for amputation.
See a podiatrist or wound care specialist urgently if a cut, sore, or wound does not heal in a week. Those with a history of diabetic foot ulcers should see a specialist immediately. There are advanced therapies available to treat these wounds.
Of the thousands of therapies available, only these three have evidence of increased wound healing rates:
- Advanced skin substitutes
- Offwading
- Hyperbaric oxygen therapy. (HBOT)
Our Physician wound care specialists at Hyperbaric Physicians of Georgia can help with non-healing ulcers. Your health care provider can refer you to us or you can call us directly for a free consultation.
How do I get treatment?
Patients can be referred by their physicians, or call us directly for a consultation. While patients are undergoing treatment, they remain under the care of the referring physician, who will receive copies of the patient’s treatment documentation. Out of area patients may be referred to an
appropriate local physician at the discretion of the referring physician. To refer a patient, contact any of our locations. Referral forms can be downloaded here.