Diabetic Foot Ulcers
Diabetic Foot Ulcers
Foot ulcers are a typical consequence of diabetes that isn’t treated with diet, exercise, or insulin therapy. Ulcers are caused by the breakdown of skin tissue, which exposes the layers beneath.
Understanding
Diabetic Foot Ulcers
Diabetic foot ulcers are most frequent located under your big toes and on the balls of your feet, and they can harm the bones in your feet.
Foot ulcers can affect anyone with diabetes, but careful foot care can help avoid them. Diabetic foot ulcers are treated differently depending on the cause.
If you have any concerns about your feet, talk to your doctor to be sure it’s not a serious problem, as infected ulcers can lead to amputation if left untreated.
Identifying symptoms
and diagnosing
diabetic foot ulcers
Identifying symptoms and diagnosing diabetic foot ulcers
Drainage from your foot, which may stain your socks or leak into your shoe, is one of the early indicators of diabetic foot ulcers. Early signs and symptoms include unusual swelling, irritation, redness, and smells in one or both feet.
The black tissue (known as eschar) surrounding a significant foot ulcer is the most noticeable indication. Because there isn’t enough healthy blood flow to the area around the ulcer, this develops.
Around the ulcer, there may be partial or total gangrene, which is tissue death caused by infection. Odorous discharge, discomfort, and numbness are all possible symptoms in this situation.
Foot ulcers can be difficult to detect. Ulcers can sometimes go unnoticed until they are infected.
If you see any skin discolouration, particularly blackened tissue, or if you experience pain around an area that appears calloused or inflamed, consult your doctor.
The Wagner Ulcer Classification System will most likely be used by your doctor to determine the severity of your ulcer on a scale of 0 to 5:
- 0: No open lesions; may have healed lesion
- 1: Superficial ulcer without penetration to deeper layers
- 2: Deeper ulcer, reaching tendon, bone, or joint capsule
- 3: Deeper tissues involved, with abscess, osteomyelitis, or tendonitis
- 4: Gangrene in a portion of forefoot or heel
- 5: Extensive gangrenous involvement of the entire foot
Causes & Risk Factors
Causes & Risk Factors
The following are the most common causes of ulcers in diabetics:
- Poor circulation
- High blood sugar (hyperglycemia)
- Nerve damage
- Irritated or wounded feet
Poor blood circulation is a vascular disorder in which blood does not flow adequately to your feet. Ulcers might also be more difficult to heal if circulation is poor.
Blood sugar control is crucial because high glucose levels might impede the healing of an infected foot ulcer. People with type 2 diabetes and other illnesses often have a more difficult time battling ulcer infections.
Nerve injury is a long-term consequence that might result in a loss of sensation in your feet. Nerve damage can cause tingling and pain. Nerve damage diminishes sensitivity to foot pain and causes ulcers by causing painless sores.
Ulcers are distinguished by drainage from the affected area and, occasionally, a visible bulge that isn’t usually unpleasant.
Risk factors for diabetic foot ulcers
All diabetics are at risk for foot ulcers, which can be caused by a variety of factors. Foot ulcers can be caused by a number of reasons, including:
- Poorly fitted or poor quality shoes
- Poor hygiene (not washing regularly or thoroughly or not drying the feet well after washing)
- Improper trimming of toenails
- Alcohol consumption
- Eye disease from diabetes
- Heart disease
- Kidney disease
- Obesity
- Tobacco use (inhibits blood circulation)
Older males are significantly more likely to get diabetic foot ulcers.
Treating
diabetic foot
ulcers
Treating diabetic foot ulcers
To avoid ulcer pain, stay off your feet. Off-loading is a technique that can help with all types of diabetic foot ulcers. Walking can exacerbate infection and cause an ulcer to grow.
Your doctor may advise you to wear the following products to safeguard your feet:
- Shoes designed for people with diabetes
- Casts
- Foot braces
- Compression wraps
- Shoe inserts to prevent corns and calluses
Debridement, or the removal of dead skin or foreign items that may have caused the ulcer, is a procedure that doctors employ to treat foot ulcers.
Infection is a dangerous consequence of a foot ulcer that must be treated right away. Infections aren’t all treated the same manner.
Tissue from the ulcer’s surrounding area may be sent to a lab to determine which antibiotic will be most effective. Your doctor may perform an X-ray to check for symptoms of bone infection if they suspect a serious infection.
Infection of a foot ulcer can be avoided by using the following methods:
- Footbaths
- Disinfecting the skin around an ulcer
- Keeping the ulcer dry with frequent dressing changes
- Enzyme treatments
- Dressings containing calcium alginates to inhibit bacterial growth
Medications
If your ulcer infection persists despite preventive or anti-pressure treatments, your doctor may prescribe antibiotics, antiplatelets, or anticlotting medications.
Many of these antibiotics target bacteria like Staphylococcus aureus, which causes staph infections, and ß-haemolytic Streptococcus, which lives in your intestines.
Consult your doctor about any other health conditions you may have, such as HIV or liver disease, that could raise your risk of infection by these hazardous bacteria.
Surgical procedures
Your doctor may advise you to get your ulcers surgically treated. By shaving down the bone or eliminating foot deformities like bunions or hammertoes, a surgeon can help relieve pressure around your ulcer.
Your ulcer is unlikely to require surgery. If no other treatment options work, surgery may be necessary to keep your ulcer from worsening or leading to amputation.
Alternative and Complementary therapies used
when treating Diabetic Ulcers patients
Hyperbaric oxygen therapy
Studies have shown that hyperbaric oxygen therapy could be used as a therapeutic intervention for type 2 diabetes. Hyperbaric oxygen along with other wound therapies can decrease wound healing time for chronic wounds that would otherwise go unhealed.
Cryotherapy
It has been proven in studies that cooling the foot with Cryotherapy prevents neuropathic diabetic foot wounds.
Ozone therapy
Ozone therapy can optimise cellular metabolism and, because of its antioxidant and antibacterial effects, can help the better healing of diabetic foot ulcers.
Red Light Therapy
Infrared Sauna therapy
Infrared sauna therapy has been proven to help detoxify and heal diabetic foot ulcers.
Hyperbaric oxygen therapy
Studies have shown that hyperbaric oxygen therapy could be used as a therapeutic intervention for type 2 diabetes. Hyperbaric oxygen along with other wound therapies can decrease wound healing time for chronic wounds and diabetic foot ulcers that would otherwise go unhealed.
Cryotherapy
It has been proven in studies that cooling the foot with Cryotherapy prevents neuropathic diabetic foot wounds.
Ozone therapy
Ozone therapy can optimise cellular metabolism and, because of its antioxidant and antibacterial effects, can help the better healing of diabetic foot ulcers.
Red Light Therapy
Infrared Sauna therapy
Infrared sauna therapy has been proven to help detoxify and heal diabetic foot ulcers.
Prevention tips
Prevention tips
More than half of diabetic foot ulcers become infected, according to a review report published in the New England Journal of Medicine in 2017. In persons with diabetes, about 20% of moderate to severe foot infections result in amputation. The importance of preventive care cannot be overstated.
Maintain a close eye on your blood glucose levels since when your blood sugar is stable, your chances of developing diabetes problems are reduced. You can also assist prevent foot troubles by doing the following:
- Washing your feet every day
- Keeping toenails adequately trimmed, but not too short
- Keeping your feet dry and moisturized
- Changing your socks frequently
- Seeing a podiatrist for corn and callus removal
- Wearing proper-fitting shoes
Foot ulcers might reappear after being treated. If the region is inflamed again, scar tissue can get infected, so your GP may advise you to wear shoes developed specifically for diabetics to prevent diabetic foot ulcers from reoccurring.
Diabetic Ulcers
Statistics
Diabetic Ulcers Statistics
According to a new study by Diabetes UK, there were 26,378 lower limb amputations connected to diabetes and in particular Diabetic Foot Ulcers in England from 2014 to 2017, up 19.4 percent from 2010 to 2013.
When to see the GP
When to see the GP
If you notice blackened flesh around an area of numbness, you may have an infected foot ulcer. See your doctor immediately. Ulcers can lead to abscesses and spread to other parts of your feet and legs if left untreated.
Ulcers can sometimes only be treated at this point with surgery, amputation, or synthetic skin substitutes to replace lost skin.
Diabetic Foot Ulcers Summary
Diabetic Foot Ulcers Summary
Diabetic Foot ulcers are curable if diagnosed early. If you get a sore on your foot, see a doctor straight once, as the risk of infection grows the longer you wait. Amputations may be required if infections are not managed.
Stay off your feet and stick to your treatment plan while your ulcers heal. It can take several weeks for diabetic foot ulcers to heal.
If your blood sugar is high and steady pressure is applied to the ulcer, it may take longer for it to heal.
The most efficient strategy to allow your foot ulcers to heal is to maintain a diet that lets you fulfil your glycemic targets while also off-loading pressure from your feet.
After an ulcer has healed, persistent preventive care can help you avoid a recurrence.
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