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Diabetes - foot ulcers

Diabetic foot ulcer; Ulcer - foot

Description

If you have diabetes, you have an increased chance of developing foot sores, or ulcers, also called diabetic ulcers.

Foot ulcers are a common reason for hospital stays for people with diabetes. It may take weeks or even several months for foot ulcers to heal. Diabetic ulcers are often painless (because of decreased sensation in the feet).

Whether or not you have a foot ulcer, you will need to learn more about taking care of your feet.

What to Expect at Home

Diabetes can damage the nerves and blood vessels in your feet. This damage can cause numbness and reduce feeling in your feet. As a result, your feet are more likely to get injured and may not heal well if they are injured. If you get a blister, you may not notice and it may get worse.

If you have developed an ulcer, follow your health care provider's instructions on how to treat the ulcer. Also follow instructions on how to take care of your feet to prevent ulcers in the future. Use the information below as a reminder.

Debridement

One way to treat an ulcer is debridement. This treatment removes dead skin and tissue. You should never try to do this yourself. A provider, such as a podiatrist, will need to do this to make sure the debridement is done correctly and does not make the injury worse.

Other methods the provider may use to remove dead or infected tissue are:

Taking Pressure Off Your Foot Ulcer

Foot ulcers are partly caused by too much pressure on one part of your foot.

Your provider may ask you to wear special shoes, a brace, or a special cast. You may need to use a wheelchair or crutches until the ulcer has healed. These devices will take the pressure off of the ulcer area. This will help speed healing.

Sometimes putting pressure on the healing ulcer for even a few minutes can reverse the healing that happened the whole rest of the day.

Be sure to wear shoes that do not put a lot of pressure on only one part of your foot.

Wound Care and Dressings

Care for your wound as instructed by your provider. Other instructions may include:

Your provider may use different kinds of dressings to treat your ulcer.

Wet-to-dry dressings are often used first. This process involves applying a wet dressing to your wound. As the dressing dries, it absorbs wound material. When the dressing is removed, some of the tissue comes off with it.

Other types of dressings are:

Keep your dressing and the skin around it dry. Try not to get healthy tissue around your wound too wet from your dressings. This can soften the healthy tissue and cause more foot problems.

When to Call the Doctor

Regular exams with your health care provider are the best way to determine if you are at higher risk of foot ulcers due to your diabetes. Your provider should check your sensation with a tool called a monofilament. Your foot pulses will also be checked.

Call your provider if you have any of these signs and symptoms of infection:

Also call if your foot ulcer is very white, blue, or black.

Related Information

Leg or foot amputation
Type 1 diabetes
Type 2 diabetes
Diabetes and nerve damage
Diabetes
Foot amputation - discharge
Leg amputation - discharge
Leg or foot amputation - dressing change
Phantom limb pain
Diabetes - when you are sick
Diabetes - preventing heart attack and stroke
Diabetes - taking care of your feet
Diabetes tests and checkups
Diabetes and exercise
Diabetes - keeping active
Low blood sugar - self-care
Managing your blood sugar
Type 2 diabetes - what to ask your doctor
Wet-to-dry dressing changes

References

American Diabetes Association. 11. Microvascular complications and foot care: standards of medical care in diabetes-2020. Diabetes Care. 2020;43(Suppl 1):S135-S151. PMID: 31862754 pubmed.ncbi.nlm.nih.gov/31862754/.

Brownlee M, Aiello LP, Sun JK, et al. Complications of diabetes mellitus. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ , eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 37.

National Institute of Diabetes and Digestive and Kidney Disease website. Diabetes and foot problems. www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/foot-problems. Updated January 2017. Accessed June 29, 2020.

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Review Date: 5/13/2020  

Reviewed By: Brent Wisse, MD, board certified in Metabolism/Endocrinology, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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