Diabetic Ulcers and Sores – Everything You Should Know About Diabetes Ulcer Management

If you are a diabetic patient, you are at a bigger risk of having sores and ulcers. There are several reasons why Diabetic patients suffer from sores and ulcers. Read this blog to know about diabetic ulcers and sores.

Ulcers are referred to as open sores on the skin that do not heal in the way they should. Very often, it occurs on the hands and legs, but it can also occur on other parts of the body like the stomach.

One of the main reasons why Diabetic patients suffer from ulcers and sores are high blood sugar levels as it damages the nerves and blood vessels. It lessens the blood flow especially in the hands, feet, and limbs which makes it harder for the sores to heal, making the body prone to other infections too.

In many cases, Diabetes leads to a condition known as Peripheral Arterial Disease (PAD) which reduces the flow of blood in the legs and feet. As the nerves get damaged, it becomes harder for a person to feel the pain or other symptoms of ulcers.

Ulcers are dangerous as they can lead to serious infections and in some cases, they can also cause Gangrene, a condition in which the tissue dies.

Summary

Diabetic ulcers are the open sores on the skin which usually occur on the hands and legs. The main cause of this complication is high amounts of sugar in the bloodstream of the patient. This damages the nerves and blood vessels in the legs and hands resulting in inadequate blood flow to the parts. It may cause serious infection and hence, it is highly recommended to see a doctor if you notice any unusual thing on your skin.

Diabetic Ulcer Symptoms

The first sign of foot ulcers that patients face is drainage coming out of your foot, which is noticed in the form of sock strain or in the shoes. Here are a few more symptoms you may notice early in the disease –

  • Unusual swelling
  • Odour from one or both feet
  • Irritation
  • Redness

If the problem has already gotten serious, the most visible sign is black tissue, also known as eschar, around the ulcer. It happens because there is not a healthy blood flow around the area surrounding the ulcer.

diabetic ulcers

You can also see partial or complete gangrene, which means that the tissue around the ulcer has died owing to the infection. It results in odorous discharge and pain from the ulcer and can also cause numbness.

Foot ulcer symptoms are not always evident as sometimes, you may not see a single sign of it till it gets infected.

You should stay in constant touch with your doctor and report if there is any skin discoloration, like tissue has turned black, or feel some sort of pain around the area which looks callused or irritated.

Summary

The normal symptoms of dibetic ulcers include unusual swelling, odour from one of both feet, redness and irritation, but there can be more severe symptoms as well, like black tissue, gangrene and complete numbness.

Diagnosis of Diabetic Ulcers

Your doctor may ascertain the severity of your ulcer on the scale of 0-5, through the Wagner Ulcer Classification System:

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

To make sure ulcers are gone in some time you need to obtain healing as early as possible. The faster the healing, the lesser the chances for an infection.

Key factors in the treatment of diabetic foot ulcers are:

  • Prevention of infection
  • Keep pressure off the foot
  • Debridement: Removes tissue and dead skin
  • Apply medications to the ulcers
  • Keep blood glucose level under control

Not all ulcers cause infection. If your podiatrist, however, diagnoses an infection, a treatment sequence of antibiotics, wound care and hospitalisation will be necessary.

To keep ulcer infections at bay, you must:

  • Keep blood sugar levels under control
  • Keep the ulcers clean and covered
  • Cleanse the wound daily
  • Avoid walking barefoot

Wear only comfortable footwear or the ulcers will take a long time to heal.

Perfect physical balance will help older people to avoid life threatening complications of falling. Wear a selected type of shoes or footwear to maintain the balance.

Try finding sport specific shoes as it will help you play. Buy the best sport shoe to avoid pain and other troubles.

Buy comfortable flip flops to avoid foot pain and other flip flop fiascos.

Try wearing supportive running shoes which will help you ease the pain and make you comfortable if you have developed diabetic ulcers.

Summary

The doctors usually diagnose diabetic ulcers and sores through Wagner Ulcer Classification System, in which they rate the severity of the ulcer from 0 to 5. As these ulcers can potentially cause serious infection, it is much necessary to address the problem as early as possible.

Treatment of Diabetic Ulcer & Sores

The most important thing a patient must keep in mind is to notice the change in the skin as it may cause other problems. It is advised to consult the doctor on an immediate basis.

There is a possibility that your doctor might ask you to undergo a procedure known as Debridement, in which unhealthy tissue from the wound is being removed.  It will also help ulcers or sores from getting infected and becoming big in size.

Some of the steps you must follow are:

  • Keep It Clean: Use mild soaps and water unless your doctor suggests you some particular cleanser. Do not use hydrogen peroxide as it could reduce healing and increases your odds of getting infected.
  • Cover It: Your health practitioner will suggest to you some specific bandaging steps. Yes, you might have heard about ‘air out’ wounds as wounds when kept open get healed but experts advise putting bandages on the wounds as it reduces the odds of getting infected.
  • Do Not Pressure: Keeping pressure off the ulcers means you need to wear crutches, special footwear that is very comfortable as reducing pressure will help ulcers to heal faster.
  • Medications: Always use topical medicines that are suggested by your doctor. These topical medications can be saline, skin substitute, growth factors.
  • Blood Sugar Under Control: Maintaining a balance of blood sugar helps in reducing the risks of ulcers, sores, and other problems. Also, keeping blood sugar levels balanced helps in healing existing ulcers.

Summary

 Usually, doctors have to perform a Debridement procedure to help you get rid of the ulcers. In this procedure unhealthy tissue from the wound is removed which will also help ulcers or sores from getting infected and becoming big in size. The doctor might ask you to follow some instructions to improve the results like keeping the area clean, not putting pressure on it, taking medications on time, keeping blood sugar under control, etc.

How Can Diabetic Ulcers Be Prevented?

Well, there are a lot of things that you can do to reduce the chances of ulcers at first. Have a look at the options –

  •  Keep Blood Sugar Levels In Check: The best thing you can do is to keep blood sugar levels under control as it will help in preventing small cuts and sores from developing into ulcers. In case, you are unable to keep blood sugar levels under control, tell your doctor. Changes to your lifestyle and medication will keep your blood sugar levels from getting too high, which eventually will reduce the chance of getting sores or ulcers.
  • Pay Attention To Your Feet: Keep a regular check on your body, especially on your feet. Look for blisters, cracks, cuts, redness, white spots, discoloration, or other changes. Even if you feel more warmth or cold than usual, then pay attention as it could be a sign of sore or ulcer.
  • Do Not Smoke: Smoking damages blood vessels and decreases blood flow which slows down the procedure of healing. Excessive smoking also raises the risk of ulcers.
  • Do Not Walk Barefoot: While walking barefoot increases the chance of injuries in the toes and foot which can lead to the chance of serious problems.

Once the ulcer is noticed, the patient must go and see podiatric medical care on an immediate basis. Foot ulcers should be treated to reduce the risk of infection, improve function and reduce health care costs.

Summary

The best way to keep diabetic ulcers at bay is to keep your blood sugar levels under control through exercise, balanced diet and medications. The other ways include keeping a close eye on any changes in the look or feel of your feet, quit smoking and not walking barefoot.

Risk Factors Of Diabetes Ulcers

Diabetic sores and ulcers are basically the result of diabetes. Hence, analysing the risk factors of diabetes and keeping them at bay is very critical. Have a look at the risk factors of diabetes:

  • Genetic
  • Age factor (People above 45 years of age are highly at risk)
  • Family (If your mother, brother is suffering from diabetes then there are high chances that you can suffer from Diabetes)
  • Prediabetic
  • Heart and blood vessel disease
  • High blood pressure
  • Obesity
  • Low good cholesterol
  • Depression
  • Gestational diabetes
  • PCOS
  • No physical activity
  • Excessive smoking
  • Irregular sleep pattern
  • Stress

Summary

As ulcers and sores are a complication of diabetes, the ideal way to prevent them is keeping your diabetes under control. Hence, analysing the risk factors like extra weight, depression, no physical activity, irregular sleep patterns, heart and blood vessel disease, etc and addressing them quickly are the best options you can choose to reduce your risk of getting sores and ulcers.

Prevention Of Diabetes

Diabetes is a lifestyle disease that is very common in India and the number of patients of Diabetes is increasing with each passing day. To prevent this disease, all you need to do is to bring some changes in your lifestyle. These changes include:

  • Weight loss: It is advised to lose weight as losing 8 to 10 percent of weight might help in reducing the chances of suffering from Type-2 Diabetes.
  • Stay Active: Brisk walking for at least 30 to 45 minutes lessens your chances of getting ill.
  • Eat A Balanced Diet: Avoiding processed carbs, sugary drinks and saturated and trans fats can help you immensely. Limiting consumption of red and processed meats also helps.
  • Quit Smoking: Stop smoking as smoking plays worst in patients suffering from Diabetes. Try taking the help of a therapist and quit smoking as early as possible.

To keep your diabetes under control, it is very important to maintain a proper diet plan. For this you need to:

  • Follow a schedule for meals
  • Eat a small amount of your meal
  • Consume more fibrous foods such as fruits, whole grains, etc
  • Use healthy cooking oils

In some cases, a health practitioner advises the patient to see a dietitian, who can help you with:

  • Identifying healthy choice food
  • Well balanced and nutritional meals
  • Healthy habit change
  • Perfect amount of carbs that will help in keeping blood sugar levels stable

Staying fit and performing exercise on a regular basis helps in managing diabetes. It is advised to take suggestions from your health practitioner before starting or changing your exercise:

  • Aerobics: It is a good way to keep yourself healthy. It is suggested that an adult should perform moderate aerobic exercise for five days or 150 minutes a week. Whereas, children must do aerobics for 60 minutes daily.
  • Resistance Exercise. It includes weight lifting, yoga, and calisthenics that help in increasing stamina, strength, and endurance. If a patient is an adult then he might perform two to three sessions each week while children should keep themselves engaged for three to four days.

Summary

The best ways to prevent diabetes in the first place are weight loss, having a balanced diet throughout the day, staying active and quitting smoking. You can also keep yourself fit by indulging in aerobics and resistance exercises as per the recommendation of your doctor.

Takeaway

Diabetic ulcers and sores are a very serious complication of diabetes and people usually ignore it until it gets worse. Hence, it is highly recommended to keep your blood sugar levels under control and keep checking your feet for any sort of unusual signs and symptoms so that it can be addressed on time.

FAQs:

Is Vaseline good for diabetic feet?

Yes, doctors recommend using unscented lotion or petroleum jelly (vaseline) on your feet if you have a foot ulcer. Diabetes is also known to cause very dry skin which may lead to cracking and other issues as well. But it is completely prohibited to use vaseline between your toes.

What does the beginning of a foot ulcer look like?

Generally, the first sign of foot ulcers is a red sore found on the ball of the foot or under the big toe. If this sore remains untreated, it may get infected and you will see pus and smell bad odour. Leaving it untreated, may lead to development of gangrene and cause amputation.

How long does a diabetic ulcer take to heal?

A diabetic foot ulcer may occur because of numerous reasons including neuropathy, peripheral ischemia, or both. Given the proper treatment and care, ulcers may take up to a few months to heal. But unfortunately, one-third of the ulcers never ever heal completely because of amputation.

What does diabetic foot sores look like?

A foot ulcer resembles a red carter in the skin. Usually, it occurs on the side or bottom of the foot, and it may appear on the tip of the toe as well. You may also see a border of thickened callused skin surrounding the round carter.

How do you treat diabetic sores?

Doctors recommend washing the affected area with soap and water on a daily basis. Keeping the area dry after every wash and applying an antibiotic ointment are also a great way to get rid of this problem. Keeping pressure off the affected body part is also a very highly recommended idea for quick healing.

References:

  1. https://www.healthline.com/health/diabetic-foot-pain-and-ulcers-causes-treatments
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3508111/
  3. https://surgery.ucsf.edu/conditions–procedures/diabetic-foot-ulcers.aspx
  4. https://www.podimetrics.com/publications/Armstrong%202017%20Diabetic%20Foot%20Ulcers%20and%20their%20Recurrence.pdf

 

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