DIABETIC FOOT ULCERS

What is a diabetic foot ulcer?

Diabetes mellitus is a condition in which the body does not make enough insulin. Patients who suffer from diabetes are at risk of developing problems with their feet, causing a diabetic foot ulcer. If a patient has diabetes, injuries to the feet are often slow to heal, and can quickly become infected

How is it caused?

Diabetic foot ulcers are a serious complication of the disease, and can be divided into two groups:

• Patients who have nerve damage (neuropathy) in the feet and legs, which results in a loss of feeling and changes to the foot shape often causing an abnormal walking pattern
• Patients who have a restricted blood supply (ischaemia) to their feet and legs, resulting in cold and painful feet.

In some patients, both nerve damage and restricted blood supply can occur together (neuroischaemia).

 

Who is at risk?

You are at greater risk of developing diabetic foot ulcers if you have poorly controlled diabetes, you smoke, are overweight, or have a history of heart disease. All of these factors can reduce or affect your blood supply.

What treatment will I receive?

The treatment you will receive will depend on the results of your assessment at your first visit. Your assessment is likely to include:

• Taking a full medical history from you
• Assessment of the blood supply in your legs by completing a Doppler examination, which we can do in clinic
• If necessary, undertake a scan (duplex examination) of your leg that is undertaken in an X ray Department.
• An examination of your footwear.

You may also need assessment by an orthotist (a healthcare professional who specialises in footwear for people with foot problems and foot ulcers) for appropriate footwear, and you may need nail and hard skin treatment from a chiropodist/podiatrist.

Treating your diabetic foot ulcer will involve a number of healthcare professionals. Our main aim is to prevent foot problems from developing, but if you have an ulcer prompt action will be needed to prevent further complications. Appropriate dressings will be applied to your ulcer to promote healing and prevent infection. 

What can I do to aid healing and prevent recurrence?

There are a range of actions you can take, including:

• Reduce your weight (seek advice from your GP if needed)
• Maintain a healthy nutritiional balanced diet
• Stop smoking
• Wash feet daily in warm water. Dry well between toes.
• Apply moisturising cream, avoiding the area between toes
• Examine feet daily for any cuts or blisters.
• Toenails should be cut to the shape of your toes.
• Ensure shoes fit well.
• Try to avoid injuries, especially to lower limbs. Wear loose socks and keep feet warm.
• Try not to walk barefoot.