Diabetic Foot Ulceration

Diabetes is becoming more common in our society. According to the National Diabetes Statistics Report,

almost 30 million Americans in 2012 had diabetes. Diabetes can have a huge impact on your foot health.

Long-term poor blood sugar control can affect the vascular system in your foot by damaging the blood

vessels. This can decrease your ability to heal any injury or ulcer to your foot.

Another complication of uncontrolled diabetes is peripheral neuropathy. This decrease in sensation can

prevent a patient from detecting trauma or increased pressure to the foot. As a result an ulcer can

develop and worsen before you realize there is a problem. Ulcers can be treated conservatively (non surgically) however

sometimes they require surgical intervention in order to heal. Below is a case of patient treated and healed

with strictly conservative treatment.

A patient presented to my office with a diabetic foot ulceration that had been present for 18 months

without much progress in healing (see picture below).

Diabetic foot ulcer

The patient was treated with strict conservative care which included daily dressing changes, the patient

being non-weight bearing the foot with a knee scooter, and debridements of the excess callous build

up.

In just 3 weeks the patient’s ulcer had improved by 87.9%.

Diabetic foot ulcer visit 2

And just 7 weeks after starting treatment, the patient is now healed (see pic below).

Diabetic foot ulcer 3

With good conservative care by both the patient and physician, a diabetic foot ulcer can be healed. This

patient wished to avoid surgery and therefore had excellent compliance to the treatment plan. He will

be placed in custom orthotics to help offload the area and continue to follow up with me to ensure that

the ulcer does not recur.

Here are a few tips to help diminish the development of a diabetic foot ulceration.

 Maintain consistent good blood sugar levels. This will help prevent development of vascular

disease and peripheral neuropathy

 Check your feet daily. This will allow you to catch a small problem (like a cut or callous) before it

becomes a big problem (like a diabetic foot ulceration).

 If you do have peripheral neuropathy, never walk barefoot. This can keep you from stepping on

things without your knowledge that could progress to an ulceration.

 See your doctor once a year for a foot check. At this appointment your sensation, pulses, and

skin can be checked for any potential problems.