How To Prevent Diabetic Foot Ulcers

A lesser-discussed aspect of diabetes is the risk of developing foot ulcers.

It’s a common complication among diabetic patients who face challenges when adjusting to a controlled diet, exercise, and medication treatment.

But how serious are diabetic foot ulcers, and how do you prevent them? Let’s discuss!

The Link Between Diabetes And Foot Ulcers

The connection between diabetes and foot ulcers is fairly direct.

Around 19–34% of diabetic patients develop foot ulcers, and most of them develop symptoms of it. Being diabetic makes you more prone to developing sores, wounds, or ulcers.

Diabetic foot ulcers usually develop in the toes and balls of the feet all the way to the bones, hands, and skin folds on the stomach. They are open sores or wounds that don’t heal the way they should.

Here’s why:

People with diabetes often have high blood sugar or glucose levels which can damage nerves and blood vessels. Damaged blood vessels lead to decreased blood flow, especially to your hands, feet, and other limbs, making it harder to heal sores, ulcers, and cuts. Those with diabetes are also prone to peripheral arterial disease (PAD), decreasing blood flow to the limbs. The damaged nerve condition makes it hard for people with diabetes to feel pain and other ulcer symptoms. So, people with diabetes cannot treat minor wounds in time and prevent them from developing into ulcers.

According to the International Diabetes Federation,

• An estimate of 9.1–26.1 million people develops diabetic foot ulcers annually.
• People with diabetic foot ulcers were reported to have a 2.5-fold increased risk of death compared to those diabetic patients without foot wounds.
• Treatment of diabetic foot ulcers accounts for at least one-third of the total cost of diabetic care.
• Subsequent foot ulcers are common with a recurrence rate of 40% in diabetic patients within 1 year.

People with diabetes need to be careful about foot complications as they potentially lead to loss of limbs and even life. Diabetic foot ulcers are a dangerous condition that can lead to severe infections and gangrene. In the most critical cases, the only treatment option left for doctors is to amputate the affected areas.

Here are a few glaring statistics on the dangers of diabetic foot ulcers:

• The development of foot ulcers precedes nearly 85% of amputations.
• As per the American Diabetes Association, every 30 seconds, a patient’s limb is lost due to diabetic-related foot complications.
• According to the American Academy of Family Physicians, people with diabetes are 15 to 46 times more likely to require lower-leg amputation compared to those without the condition.
• This limb loss leads to both severe clinical and psychological consequences including a five-year mortality rate of 50%.
• This five-year mortality rate of 50% is higher than breast cancer in women, and prostate cancer in men.

Current efforts include raising public awareness about diabetic foot ulcers, improving our understanding of optimal professional care, and the persistence of diabetic foot complications despite treatment.

It’s crucial for you to be aware of the high-risk diabetic foot ulcers, learn preventive measures, and identify early symptoms to get treated immediately.

Research proves that diabetic foot ulcers are a preventable condition.

Best Tips For The Prevention Of Diabetic Foot Ulcers

The best treatment for diabetic foot ulcers is prevention. It’s actually one of the easiest, inexpensive, and most effective measures that you can take to tackle diabetic foot ulcers.

Here’s how you can prevent the onset of diabetic foot ulcers.

1. Check Your Feet Daily

It’s the topmost recommended practice suggested by physicians.

Since ulcers are highly prevalent, a careful and daily inspection of the diabetic foot is of utmost importance.

Watch out for any cuts, blisters, scratches, cracks, bruises, skin tears, ingrown toenails, corns, calluses, redness, swelling, white spots, open wounds, sores, and ulcers. You may not feel any pain, so it is important to pay attention to minute details. If you’re feeling more warm or cold than usual as it may be a telltale sign that you have an open wound.

Sometimes you may not feel anything at all, so it’s necessary to inspect your feet daily, especially between your toes and the soles of your feet. You can use a mirror to look for any signs of abnormalities.

A few don’ts:

• Under any circumstance, do not attempt to remove corns or calluses by yourself.
• Avoid experimenting with your nails and tampering with it, especially if you have high blood sugar. It’s best to keep your nails trimmed and in plain round style.

If you notice any abnormality, contact your family physician immediately as early detection can avoid health problems.

2. Wash And Dry Your Feet Daily

Wash your feet at least once daily, with gentle soap and water. Dry thoroughly, paying attention to the area between your toes.

Note that the water you use to rinse your feet should be below 100° Fahrenheit to prevent burning. If you’re a diabetic patient with sensory neuropathy, avoid heating pads, or warming your body or feet with hot water bottles, a space heater, or a spa. Do not place your feet next to the heater during winter.

Use a physician-recommended skin moisturizer and stay away from irritating topical agents.

3. Wear Appropriate Footwear

The right footwear is essential as ill-fitting shoes can increase the chances of blister formation.

Your feet size can alter based on your health. Wear shoes with half an inch of space between your toes and the shoe tip, so your feet get the required arch support.

Avoid walking barefoot and risk being injured. If you have diabetic neuropathy, wear proper footwear with an enclosed frontal part both indoors and outdoors.

Sandals and high heels are not diabetic-friendly footwear, as they can put excess stress on, irritate, and scrape your foot.

Wear a clean, dry pair of socks without tight elastic bands, as it can restrict the required blood flow to your feet. Change your socks frequently.

Also, make it a regular practice to check the insides of your shoes for any sharp objects that can injure your feet, before you wear them.

Since foot ulcers can return even after treatment, your doctor might recommend custom shoes designed for people with diabetes.

4. Keep Your Blood Sugar In Control By Following A Healthy Lifestyle

Uncontrolled glucose or sugar levels often cause a loss of sensation in the feet, making your sores go unnoticed. It leads to various foot complications, including diabetic foot ulcers, and prevents wound healing.

The Diabetes Control and Complications Trial Research Group study proved good glycemic control could prevent and reduce various diabetes complications, including nephropathy, neuropathy, and retinopathy.

The first step towards keeping your blood sugar under control is to monitor it daily and try to stay in the normal range. You can achieve this objective by following a healthy lifestyle that includes regular exercise and a nutritious diet.

Various studies have proven the effectiveness of exercise and physical activity against the complications of diabetic foot. The research found patients who exercised had a lower annual incidence of diabetic foot ulcers than those who didn’t.

Being overweight puts additional stress on your feet, which can cause friction while wearing shoes and lead to bites. Plan a balanced diet with lean protein, high fiber, less saturated fats, and the right nutrients for your body.

Habits such as smoking and alcohol consumption can prevent the healing process of diabetic foot ulcers and raise your risk of amputation. These habits may also affect your heart health. One possible outcome is restricted blood flow to your legs.

Consult your doctor regularly and get your sugar levels tested. Discuss medication and lifestyle changes that you need to make to control your blood sugar levels, and follow your doctor’s advice.

5. Schedule Regular Medical Checkups

Irrespective of whether your blood sugar levels are under control, you must visit your doctor regularly especially if you have neuropathy. In which case, you may not feel the damage to your feet and skin.

Your doctor can also check if you are at high risk for developing a foot ulcer and suggest a suitable prevention plan for you. They can also examine you for any altered sensations and cardiovascular diseases.

According to the 2019 guidelines of the International Working Group on the Diabetic Foot (IWGDF) on the assessment of diabetic foot ulcers:

“An individual with diabetes who is at very low risk for foot ulceration (IWGDF risk 0) should, to assess the subsequent risk for ulcers, be examined annually for signs or symptoms of protective sensation loss and peripheral artery disease.

A patient with diabetes who has protective sensation loss or peripheral artery disease (IWGDF risk 1–3) should undergo a more comprehensive examination, with the following taken into account: history, vascular status, skin, bone/joint, protective sensation loss, footwear, poor foot hygiene, physical limitations that may hinder self-care of the feet (e.g., problems with visual acuity, obesity), and foot care knowledge.”

The key to preventing diabetic foot ulcers and their complications such as amputation is early detection and medical intervention. An estimated 85% of diabetic foot ulcers are reported to be preventable with the right preventive treatment.

Final Thoughts

Diabetic patients can get foot ulcers. But good foot care and diabetes management can keep diabetic foot ulcers at bay. Our tips for preventing diabetic foot ulcers should help you stay safe and healthy.

Having said that, please get in touch with your doctor immediately if you experience any warning symptoms such as fever, redness, swelling, numbness, darkened flesh, or pus from your wound. Prompt medical evaluation and treatment can prevent severe complications of diabetic foot ulcers, including infection, abscesses, and amputation.

Stay educated about diabetic foot ulcers, and stay safe with our effective prevention strategies.

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(Disclaimer: We routinely draw upon public health resources to inform our write-ups. Information in this article may be drawn up from multiple public health sources, including:

• Centers for Disease Control & Prevention
• Medline Plus
• National Institutes of Health
• American Medical Association
• American Association of Family Physicians
• Mayo Clinic
• Family Doctor