Ajit Karn
Nerve injury and impaired blood circulation can be complications of diabetes. These conditions can cause skin ulcers on the feet that can rapidly worsen.
The positive news is that diabetes management and foot maintenance can prevent foot ulcers.
When a foot ulcer develops, it is crucial to seek treatment immediately. Most lower leg and foot amputations are initiated by foot ulcers. A non-healing ulcer causes severe tissue and bone injury. It may necessitate the amputation of a toe, a foot, or a portion of a limb.
Some diabetics are at a greater risk than others. Several factors increase the risk of amputation:
- High blood sugar levels
- Smoking
- Nerve damage in the feet (peripheral neuropathy)
- Calluses or corns
- Foot deformities
- Poor blood circulation to the arms and legs (peripheral artery disease)
- A history of foot ulcers
- A past amputation
- Vision problems
- Kidney disease
- High blood pressure, above 140/80 millimeters of mercury (mm Hg)
Here’s how to keep your feet healthy, how to recognize the symptoms that indicate you need to see a doctor, and what to do if you need an amputation.
Preventing foot ulcers
The most effective way to prevent diabetes complications, including foot ulcers, is to manage your diabetes. This includes a healthy diet, regular exercise, regular blood sugar monitoring, and proper medication administration.
Taking care of your feet will prevent complications. It can also ensure that you receive prompt medical care when problems arise. Included in proper foot care are the following:
- Observe your feet every day. Once a day, inspect your feet for ulcers, wounds, fissures, sores, redness, tenderness, or puffiness. Utilize a hand mirror to see the soles of your feet if you have difficulty reaching them. Put the mirror on the floor or ask for assistance if you cannot hold it.
- You should wash your feet daily. Once per day, wash your feet with tepid (not scalding) water. They should be dried tenderly, particularly between the toes. Use a pumice stone to massage the skin in areas prone to calluses.Use talcum powder or cornstarch to keep the tissue between your toenails dry. Apply a hydrating moisturizer or lotion to the tips and soles of your feet to maintain soft skin. Preventing parched skin from developing fissures helps keep bacteria out.
- Do not remove corns and other foot lesions on your own. To prevent skin damage, avoid using a nail file, nail clippers, or scissors on calluses, corns, and warts. Do not use chemical wart removal products. Consult your doctor or a foot specialist (podiatrist) to treat any of these conditions.
- Trim your toenails with attention. Cut your cuticles in a steady line. Utilize an emery board to deburr jagged edges. If you cannot cut your own nails, you should seek assistance.
- Avoid going barefoot. Even around the home, you should not go barefoot in order to protect your feet.
- Use dry, clean undergarments. Socks made of a material that wicks perspiration away from the epidermis should be worn. This consists of cotton and specialty acrylic fibers, but not nylon. Avoid wearing hosiery with restrictive elastic bands. These bands restrict blood flow. Avoid hosiery with seams that could cause skin irritation.
- Purchase shoes that suit properly. Purchase supportive and cushioned footwear for the heel, arch, and ball of the foot. Avoid wearing shoes with a snug fit, high heels, or limited toe boxes. If one foot is larger than the other, purchase larger-sized shoes. Your provider might suggest specially designed footwear. (orthopedic shoes). These shoes conform to the precise contour of your feet, provide cushioning, and ensure that your weight is distributed evenly between both feet.
- Don’t inhale. Smoking makes it more difficult for blood to circulate throughout the body. Additionally, it decreases the quantity of oxygen in the circulation. These issues can worsen incisions and retard the healing process. Consult your provider if you need assistance ceasing smoking.
- Schedule regular foot examinations. Your doctor or podiatrist can examine your feet for indications of nerve injury, poor circulation, and other foot issues. Examine your feet annually, or more frequently if recommended by your doctor.
Signs of trouble
Contact your provider if your feet have:
- Ingrown toenails
- Blisters
- Flesh-colored bumps with dark specks (plantar warts) on the bottoms of your feet
- Athlete’s foot
- An open sore or bleeding
- Swelling
- Redness
- Warmth in one area
- Pain (though you may not feel anything if you have nerve damage)
- Discolored skin
- A foul odor
- An ulcer that lasts longer than 1 to 2 weeks
- An ulcer bigger than 3/4 inch (2 centimeters)
- A sore that doesn’t quickly begin to heal
- An ulcer so deep you can see the bone underneath
Your doctor will examine your foot to diagnose the issue and prescribe a treatment plan.
What if amputation is the only option?
Treatment for foot ulcers is wound-specific. Typically, treatment consists of removing dead tissue or detritus, keeping the wound sanitary, and promoting healing. At least once every 1 to 4 weeks, wounds should be examined.
When the ulcer causes severe tissue loss or a life-threatening infection, amputation may be the only treatment option.
The surgeon will remove diseased tissue while preserving as much healthy tissue as feasible. You will spend a few days in the hospital following surgery. Your lesion may require four to six weeks to heal completely.
In addition to your provider and surgeon, other medical professionals involved in your treatment may include:
- Endocrinologist, a specialist in the treatment of diabetes and other hormone-related disorders.
- A physical therapist, who can assist you in recovering your strength, balance, and coordination. A physical therapist can also instruct you on how to use prosthetic limbs, wheelchairs, and other mobility-enhancing devices.
- An occupational therapist, who specializes in improving routine skills through therapy. This may include instructing you on how to use products that assist with everyday tasks.
- A mental health professional, such as a psychologist or psychiatrist, who can assist you in addressing your emotions regarding the amputation and coping with the reactions of others.
- A social worker, who can help locate services and plan for care transitions.
Even after amputation, it is crucial to adhere to your diabetes treatment regimen. People who have undergone one amputation are at a greater risk of undergoing a second. Eating nutritious foods, getting regular exercise, controlling your blood sugar, and quitting smoking can help you prevent additional complications from diabetes.
