Holton Community Hospital History


What’s that Sore?  Diabetic Foot Ulcer 101





     Diabetic Foot 

Awareness Month

Do you have a sore on your foot that’s been there for a while without improving? If you have diabetes, chances are you’ve developed a diabetic ulcer.

In that case, it’s important to understand what the ulcer is, what caused it, what risks it presents, and how you can treat it.

What’s a diabetic ulcer?
According to the American Podiatric Medical Association, diabetic foot ulcers affect approximately 15 percent of people with diabetes. They’re open sores on the feet from the ankle down. Most develop on the bottom of your feet, particularly under your big toe or the ball of your foot. Typically, ulcers begin with foot injuries, such as cuts or blisters.
These wounds can linger for weeks without improvement. Between 14-24 percent of ulcers end with amputation.
Who’s at risk?
Some individuals face a higher ulcer risk. Native-American, African-American, and Hispanic patients are more likely to develop ulcers, as are men and patients over 60. Additionally, individuals with vision problems, chronic kidney disease, and obesity experience greater risk. Heart disease and high blood sugar also impede your body’s ability to heal and fight infection.
Some behaviors also make foot ulcers more likely to develop. Alcohol consumption, poorly-trimmed toenails, tobacco use, poor hygiene, and wearing poorly-fitted shoes (ones without enough cushioning or room for your toes) can promote ulcer formation.
What causes ulcers?
In addition to high blood pressure and injury, there are other causes of ulcer development and poor healing. In fact, nearly 45 percent of ulcers occur in people with both of these conditions:
  • Diabetic neuropathy: This common complication involves nerve damage in your feet, frequently leading to total sensation loss. This makes it harder for you to notice any scrapes, cracks, or blisters. 
  • Peripheral artery disease (PAD): This condition blocks arteries in your legs, strictly limiting blood flow. Without proper circulation, your body can’t get enough oxygen to the wound for healing.
 Are ulcers life-threatening?
They can be. Without treatment, infectious bacteria can damage and kill your skin and tissues. It can also infect your blood stream or cause a bone infection (osteomyelitis), both of which can lead to sepsis.
If you have PAD, an untreated ulcer can also lead to ischemia where tissue dies, becomes gangrene, potentially leading to death.
What can you do?
Seek treatment as soon as possible. Waiting longer drastically reduces your chances to heal.
Your doctor will prescribe medication to prevent or treat infection and will remove dead skin or tissue (debridement). He or she will tell you to alleviate pressure from your foot by wearing a brace, specialized cast, or using a wheelchair or crutches. Control your blood sugar levels (between 80-130 mg/dL before eating and under 180 mg/dL after eating) and monitor your feet daily for any injuries or changes.


With this knowledge, you can keep track of any lingering wounds on your feet and pursue your best treatment options.