How to Support Your Loved Ones with Diabetes

Diabetes Support

Receiving a diabetes diagnosis and learning to manage the condition can be difficult. Handling it alone can be very tough, but there’s a great deal you can do to support your loved ones and help them keep their diabetes under control.

In fact, the level of support you offer your family member or friend with diabetes is one of the best predictors of how well he or she will be able to handle the diagnosis.

Try these strategies to maximize the level of support you provide:

  1. Learn about diabetes. Study up on the condition, its symptoms, and complications. Encourage your loved one to do the same.
  2. Know the symptoms. Learn to recognize the symptoms of both high and low blood sugar — not only can they cause cranky moods, but they can also be harmful. High blood sugar causes frequent urination, extreme thirst, blurry vision, and fatigue. Low blood sugar symptoms include fatigue, frequent yawning, an inability to think or speak clearly, loss of muscle coordination, sweating, seizures, twitching, feeling like they’ll pass out, becoming pale, and losing consciousness.
  3. Let your loved one know you understand what he or she is experiencing. But, be careful that you don’t enable them, letting them use their diagnosis as an excuse for not taking care of themselves.
  4. Make healthy food choices. Eat healthy meals together and avoid the foods your loved one shouldn’t eat. Choose foods low in fat, cholesterol, salt, and sugar. Opt for fresh fruits, vegetables, whole grains, lean meats, and fish.
  5. Walk, jog, bicycle, swim, or dance with your loved one to encourage the right level of physical activity.

 

Advanced Diabetes

If your loved one’s condition is complicated or advanced, you might need additional help. Be sure to provide him or her the right level of diabetes support. In those situations, consider an at-home nurse or rehabilitation program. Not only can these healthcare providers help monitor your loved one, but they can also answer questions about diabetes.  In addition, they offer recovery services and can help manage wound dressings. With their assistance, you could be better positioned to offer much-needed emotional support.

Ultimately, if you’re part of your loved one’s diabetes support system, it’s important for you to listen to and identify the best ways to meet his or her needs. Make sure you maintain reasonable expectations about their abilities to control their blood glucose levels. There will be instances when their levels will change unexpectedly. Keep sugary candy on hand for instances when severe symptoms suddenly appear.

Overall, remember controlling blood glucose levels can be complex;  you should avoid blaming your loved one if he or she struggles to control the condition. Contact the Amputation Prevention Centers of America for more information on how you can help your loved ones with diabetes support.

What is Peripheral Neuropathy?

Peripheral Neuropathy

Do you have numbness, tingling, or constant pain in your feet and legs? It is worse overnight? Is it hard to feel temperature with your feet, but they’re still hyper-sensitive to touch? If you answered yes, you could have peripheral neuropathy.

And, if you have diabetes, it’s critically important to understand this condition.

What Is It Peripheral Neuropathy?

Peripheral neuropathy is loss of feeling mainly in your legs and feet, but it can spread to your arms and hands.

It affects between 60 percent to 70 percent of people with diabetes, according to the National Institutes of Health, and it worsens at night. It impacts people differently, however. Some feel tingling. Others feel pain or numbness. But, overall, changes appear slowly as people age.

Caused by chronically high blood sugar levels (130 mg/dL before eating; >180 mg/dL after eating), peripheral neuropathy damages nerves, making it harder for messages to travel between your brain and your extremities. It can be particularly dangerous because you might not know you’ve developed an ulcer. Left untreated, ulcers can get infected, potentially leading to amputation or death.

Symptoms

Initially, you can develop numbness; tingling; a prickly pins-and-needles feeling; a burning or cold sensation; pinching; buzzing; or sharp, deep stabbing pains. However, as peripheral neuropathy progresses, these signs are also possible:

  • Touch sensitivity: Your toes, feet, legs, and hands can become overly responsive.
  • Muscle weakness: Nerve damage weakens your muscles, making it harder for you to walk or grab things.
  • Balance problems: Numbness in your feet can make you unsteady and uncoordinated.

Peripheral neuropathy can also cause digestive system, urinary tract, blood vessel, and heart problems.

Treatment Options

There’s no cure for peripheral neuropathy, but you can minimize your discomfort. Talk with your doctor about these options.

  • Braces: Hand and foot braces can reduce physical disability and pain. Orthopedic shoes can improve your gait and help prevent foot injuries. Splints can also alleviate carpal tunnel symptoms.
  • Complementary techniques: In some cases, acupuncture, massage, herbal medication, and cognitive or behavioral training can lessen neurological pain.
  • Medication: Some drugs approved for chronic neuropathic pain can provide relief. Discuss effective medications with your doctor.
  • Transcutaneous electrical nerve stimulation: This treatment delivers gentle electrical currents to painful sites via electrodes attached to the skin. Some studies show it improves peripheral neuropathy.

Protecting Your Feet

If you have peripheral neuropathy, take steps to prevent ulcers or sores on your feet. Follow these tips to avoid potentially serious wounds.

  • Check your feet daily for blisters, sores, or ulcers.
  • Keep your feet clean and dry.
  • Trim your toenails carefully. Cut them straight across, filing down sharp edges.
  • Wear clean, dry socks.
  • Wear cushioned shoes with enough space for your toes.

When to See Your Doctor

There will be times you’ll need to consult your doctor. Schedule an appointment if you see any of these changes if:

  • you have any non-healing cut or sore on your foot.
  • burning, itching, tingling, weakness, or the pain in your hands or feet interferes with your daily activities or sleep.
  • you see changes to your digestion, urination, or sexual function.
  • you experience dizziness.

Overall, knowing how to identify and what to expect from peripheral neuropathy can help you manage the condition.

Contact the Amputation Prevention Centers of America for more information.

Preventing and Treating Foot Ulcers | Amputation Prevention Centers

Treating Foot Ulcers
With foot ulcers occurring in approximately 15 percent of patients with diabetes. Preventing and treating foot ulcers when they occur can be an important part of your health routine.

In addition to foot ulcers, if you have diabetes, your risk of amputation is 28 times higher than someone without the condition. Consequently, successfully avoiding foot ulcers or ensuring prompt healing can help you avoid the problem.

Preventing Foot Ulcers

Staving off a foot ulcer is the most beneficial option. To ward them off, follow these steps:

  1. Manage blood sugar: Before eating keep your blood sugar at 80-130 mg/dL before meals and under 180 mg/dL after. A healthy blood sugar level encourages faster healing.
  2. Pamper your feetConduct daily foot inspections, using a mirror to see the bottoms of your feet, if necessary. Look for cracks, cuts, blisters, and other signs of wounds. Wash your feet daily with mild soap and warm water. Dry thoroughly, especially between your toes, and apply talcum powder to deter blisters.
  3. Pick the right shoes: Select shoes that are tight enough to keep fabric from rubbing your skin, causing an ulcer. But, choose ones loose enough to not crowd your toes and be comfortable. If you need them, choose orthopedic shoes that can be custom fitted to the size, shape, and contours of your feet.
  4. Don’t light up: Don’t smoke. It reduces your circulation, making your blood flow problems worse. It can also decrease the feeling in your feet.
  5. See your doctor: Have a foot exam at least once a year to inspect your feet for circulatory issues, early signs of nerve damage, or other foot problems.

 

Treating Foot Ulcers

If you do develop a foot ulcer, there are therapeutic options available. Discuss the best tactic with your doctor.

  1. Debridement: This is the surgical removal of unhealthy tissue and bacteria from the wound in order to promote healing.
  2. Hyperbaric Oxygen Therapy (HBOT): HBOT works by delivering 100% pure oxygen to a patient through increased atmospheric pressure in a large, clear, acrylic chamber. This increased oxygen absorption enhances the body’s ability to heal.
  3. Living Cellular Skin Substitute: This therapy consists of the application of products made of living cells and proteins that can, over time, stimulate wound healing.

Within 4 weeks, if you haven’t healed — or if you have developed a bone infection — consult your doctor.

Be aware, foot ulcers can start small with a callus or a blister. Be sure the keep your weight off the affected foot as much as possible to avoid any worsening of your ulcer. Be vigilant. The soft tissue of your foot is susceptible to infection, so any problems can spread to muscle and bone quickly. If you notice any changes or problems, contact your doctor. Delayed treatment can slow down healing and even lead to amputation.

Contact the Amputation Prevention Centers of America for more information on preventing and treating foot ulcers.

Why Your Peripheral Neuropathy Feels Worse at Night

Peripheral Neuropathy

The pain, tingling, and burning sensations from diabetic peripheral neuropathy can be debilitating any time of day. But, for some people, these uncomfortable sensations get particularly worse at night, especially when they’re trying to sleep.

If you’re in this category, you might have been told you’re imagining it. But, recent research from the Comprehensive Pain Center at Oregon Health & Sciences University indicates more acute pain at night isn’t in your head. In a study of nearly 650 participants, investigators found patients with diabetic peripheral neuropathy — regardless of age, gender, or other health conditions — reported feeling the most significant pain between 11pm and 8am.

Next time you feel your peripheral neuropathy pain intensifying at night, consider these possible causes. In some cases, you can try to get the discomfort under control.

  1. Fewer distractions: At night, there’s less to take your mind off your pain — no chores, no errands, and no talking as you try to drift off to sleep. That’s when your mind and body become more aware of your surroundings. You notice your pain more, making sleep elusive.

To combat that heightened awareness, try to focus on something you enjoy to take your mind off what you’re feeling.

  1. Cooler temperatures: With peripheral neuropathy, according to Loma Linda University Health, your feet will be far more sensitive to cooler air. As temperatures drop at night, your peripheral nerves can begin to tingle more, and you’ll feel more burning or sharp pains. Your heart rate also slows when you’re colder, slowing your blood and increasing painful sensations.

If you can handle the touch on your feet, wrap up in blankets to warm up.

  1. Stress/Fatigue: Sometimes, physical stress and exertion can increase your nerve pain as your body begins to relax at the end of the day. Vigorous exercise and the soreness that accompanies it can contribute to more night-time nerve pain.

Be sure you alternate your exercise routines so you’re not over-taxing your body, and pay attention to when you need to take a break from exercise and let your body rest.

  1. Medication: Even though your medication might work well during the day, keeping you mostly free from pain, it eventually wears off. This typically happens at night, according to the Innovations Stem Cell Center. When you’ve been comfortable all day, you’ll notice the pain much more when it starts to creep back in.

 

Try these strategies to stay comfortable at night if your have peripheral neuropathy pain:

  • Control your blood sugar. Work to keep your levels between 80-130 mg/dL before eating and under 180 mg/dL after meals.
  • Soak your feet in a warm bath to relax your nerves at night. Be sure to check the water temperature to avoid burning your feet.
  • Exercise regularly. It increases blood flow and oxygen to your feet, reducing pain. Listen to your body, though, and take breaks when needed.

Contact Amputation Prevention Centers of America if you have questions.

Protect Yourself from Charcot Foot

Charcot Foot

If you have diabetes, you face the possibility of developing many foot problems, including ulcers, non-healing sores, and even amputation. But, there’s another condition you should know about and watch out for: Charcot foot.

Also called Charcot arthropathy, this condition weakens the bones in the feet of people who have peripheral neuropathy. It also attacks the joints and soft tissues. Over time, it can cause painful sores and actually change the shape of your foot.

Why does Charcot foot happen?

Your bones naturally lose calcium when injured, and, according to the Cleveland Clinic, that makes the bones weaker and more susceptible to further damage. The numbness from peripheral neuropathy increases the danger. If you can’t feel a sprain, a break, or an infected or lingering sore, you’re more likely to continue walking on your foot normally. In some cases, slow healing from a foot surgery can be responsible.

What happens?

Prompted by injury that often doesn’t get timely treatment, your bones lose the calcium that keeps them strong. At that point, your foot can start to lose its shape, and your arch can drop below your toes or heel. Doctors often call this “rocker bottom.”

Additionally, your toes might curl, and your ankle can become twisted and unsteady. Any misshapen bones can also press against your shoes, creating new sores that can also get infected and lead to amputation.

What to look for?

Diagnosing Charcot foot can be difficult, according to a study published in American Family Physician, because it mimics other conditions, including cellulitis and blood clots. Initial X-rays and lab tests can also often look normal.

However, there are some symptoms, other than the fallen arch, that can make you suspect Charcot foot. If your foot becomes reddish, warm to the touch, or swollen, talk with you doctor. You should also be concerned if you have instability in your ankle, any misalignment of the bones that form the joint, or a strong pulse in your foot.

Can you prevent it?

Yes, you can do things to potentially side-step Charcot foot. Follow this list for better foot health:

  1. Get regular check-ups with a foot doctor who has experience treating diabetic foot problems.
  2. Check your feet daily for swelling, redness, warm spots, and sores. Check between your toes, too.
  3. Wash your feet daily, and dry them thoroughly.
  4. Always wear socks and shoes.
  5. Keep your blood sugar levels under control — between 80-130 mg/dL before eating, under 180 mg/dL after.
  6. Take extra care to avoid injury, particularly while exercising.

 
Overall, if you begin to see these changes in your feet — especially if your foot begins to change shape — contact your doctor immediately. Any delays can result in further damage to your foot that could lead to infection or amputation.

For questions, please contact Amputation Prevention Centers of America.

Diabetic Amputation & Neuropathy — Is It Inevitable?

Diabetic Amputation
Diabetic neuropathy — nerve damage caused by high blood glucose levels — affects between 60 percent and 70 percent of individuals with diabetes. If you have it, your diabetic amputation risk will be higher. In fact, more than 50 percent of all amputations annually are associated with diabetes.

According to the National Institutes of Health, approximately 86,000 people undergo foot amputations yearly. But, you can reduce your likelihood if you understand the role neuropathy frequently plays in amputations.

How Neuropathy Causes Problems

The nerve damage and reduced sensations in your feet make it far easier for you to sustain injuries and get infections. Because you can’t notice any discomfort, ulcers, infections, and gangrene can develop easily, and poor circulation makes it harder for you to heal.

If the infection can’t be controlled or the wound won’t heal, amputation is a likely outcome to remove dead tissue. Of the roughly 15 percent of all diabetics who develop a foot ulcer, 24 percent will face amputation.

In some cases only toes or parts of the foot are removed to salvage as much healthy tissues as possible. But, if the infection has spread, doctors might have to remove the entire foot or leg. Amputations require several nights in the hospital and up to 8 weeks of recovery time. Prostheses, assistive devices, and home adaptations can help with rehabilitation.

Ways to Reduce Risk for Diabetic Amputation & Neuropathy

You can reduce your chances for developing an injury that ends in amputation.  Following these suggestions can help keep your feet in tact:

  1. Don’t smoke. It constricts the blood vessels, decreasing circulation.
  2. Get routine foot check-ups. Examine your feet daily, using a mirror to see them if needed. Have a medical provider check them regularly, as well.
  3. Control your blood sugar. Keep your levels between 70-130 mg/dL before eating and under 180 mg/dL after meals.
  4. Eat healthy. Choose lean meats, fruits, vegetables, fiber, and whole grains. Avoid sugared juices and sodas.
  5. Get at least 30 minutes daily. Swimming and walking are good options.
  6. Practice good foot care. Wash and dry your feet thoroughly every day, putting cornstarch between your toes to minimize moisture. Keep your toenails trimmed short. Apply a thin layer of petroleum jelly to your feet to reduce cracking. And, wear well-fitting, closed-toe shoes and dry socks without elastic at all times.
  7. Don’t remove warts or callouses with scrapers or scissors. It can leave your feet open to infection.
  8. Keep moving. Wiggle your toes and twist your ankles several times a day.

 

When to Talk With Your Doctor

Even if you follow these tips, problems could still arise. See your doctor if you have any of these issues: fungal infections, splinters, ingrown toenails, corns, bunions, callouses, plantar warts, chilblains, hammertoes, dry skin, gout, and heal pain/spurs.

Although diabetic neuropathy greatly increases your likelihood for foot injury and possible amputation, following these steps can give you the greatest chance for avoiding this surgery.

Contact the Amputation Prevention Centers of America for more information on diabetic amputation and neuropathy.

Inherited Neuropathy — Can Numbness Be Hereditary?

Inherited Neuropathy

Eye color, shoe size, and height all have one thing in common — they’re hereditary. It turns out inherited neuropathy can be, too.

While it’s rare, children who have a parent with heritable neuropathy have a 50 percent chance of developing the condition, as well. It can show up as early as birth, but it’s more frequently diagnosed in middle- and older-age. Type 2 diabetes and obesity are also risk factors.

According to an Annals of Indian Academy of Neurology study, there are more than 30 genes that are linked to inherited neuropathy. A neurologist can diagnose whether you have the condition via nerve conduction studies, nerve biopsies, or genetic testing.

There are two common forms of inherited neuropathies — Charcot-Marie-Tooth (CMT) and Hereditary Neuropathy with Liability to Pressure Palsies (HNPP). Overall, they share many similar symptoms. Individuals experience pain and tingling in their hands and feet, muscle weakness and loss of mass in their feet and lower legs.  They also experience impaired sweating, low blood pressure upon standing up, and physical deformities, such as high foot arches, hammertoes, and curved spine.

What Happens With CMT?

CMT affects approximately 1 in 3,300 people. There are many CMT subtypes, but CMT1A is the most common. It affects 20 percent of people who seek medical attention for undiagnosed peripheral neuropathy.

Patients with CMT have difficulty lifting their feet, weak ankles, drop foot, and have unsteady balance. They also exhibit poor hand coordination, making it harder to hold pencils, button or zip clothes, and turn door knobs. Additionally, they can be hyper-sensitive to cold temperatures. Muscle weakness and poor circulation can turn hands and feet cold, as well as lead to ankle and foot swelling.

Sometimes, individuals with CMT can also lose their knee-jerk reactions and experience hand tremors. This is called Roussy-Levy Syndrome. Additionally, weak breathing and shortness of breath are rare, but they can be life-threatening. If those symptoms appear, a respiratory specialist might recommend a ventilator.

What Occurs With HNPP?

HNPP is even more rare than CMT, appearing in 2-5 individuals per 100,000.

Affected individuals are extremely sensitive to pressure, and they can have difficulty carrying heavy bags, leaning on their elbows, or sitting in chairs. Frequently, they experience tingling, numbness, and loss of sensation in areas impacted by the neuropathy. These symptoms typically strike the hands, arms, feet, and legs.

Often, HNPP episodes last for several months. Long durations can lead to permanent muscle weakness and sensation loss.

Prevention & Treatment

There’s no way to prevent inherited neuropathy, but genetic counseling is available to parents who worry about passing the condition on to their children.

Additionally, there’s no cure, but ongoing management techniques can greatly improve quality of life. For example, pain medications, physical therapy, corrective surgery, therapeutic shoes, braces, and support devices can greatly reduce the impact inherited neuropathy has. A balanced diet and exercise are also beneficial.

Be sure to seek medical attention as soon as symptoms for inherited neuropathy appear. The earlier the diagnosis, the better prognosis and outlook you’ll have.

For more information, contact the Amputation Prevention Centers of America.

Can’t Feel Your Hands or Feet? It Could Be Diabetic Neuropathy

Diabetic Neuropathy

If you have diabetes, you know controlling your blood sugar is important. But it’s not just about monitoring your insulin. Healthy glucose levels help stave off diabetic neuropathy, a painful nerve condition that affects your mobility and quality of life.

What is diabetic neuropathy?

Diabetic neuropathy is feeling loss in your extremities from nerve damage. It typically strikes the legs and feet, but numbness can appear in other parts of your body.

What causes diabetic neuropathy?

Long-term high blood sugar levels (higher than 130 mg/dL before eating; higher than 180 mg/dL after eating) can injure your nerves. Once damaged, it’s harder for them to fire signals throughout your body. Nerve inflammation, genetic factors, smoking and excessive alcohol consumption can also be factors.

Types of diabetic neuropathy

There are four main types. Talk with your doctor about which form you have.

  1. Peripheral: This is most common, impacting up to 50 percent of diabetics, according to the National Institutes of Health (NIH). It starts in the legs and feet, can spread to the arms and hands and worsens at night. Typical symptoms include numbness, reduced temperature sensitivity, tingling, burning and sharp pains, as well as sensitivity to touch, muscle weakness, poor balance and decreased coordination. Because you can’t feel pressure, ulcers and sores are likely to develop on your feet.
  2. Autonomic: This neuropathy, found in up to 30 percent of diabetics, affects your heart, bladder, stomach, intestines, sex organs and eyes. It prevents you from recognizing blood sugar drops, and a sluggish stomach causes nausea, vomiting, bloating and appetite loss. Incontinence and constipation occur frequently, too. Sharp blood pressure drops and racing heart rates are possible, as well as sexual effects — vaginal dryness in women and erectile dysfunction in men.
  3. Radiculoplexus neuropathy: Most common in individuals with Type 2 diabetes and older adults, this type attacks thighs, hips, buttocks and legs. Eventually, your muscles shrink, making it harder to stand from a seated position. You could also experience abdominal swelling and weight loss.
  4. Mononeuropathy: Also called focal neuropathy, it’s most common in older adults. It affects the face, torso and legs, causing severe pain that suddenly strikes the shin, foot, lower back, thigh, chest or abdomen. However, it tends to disappear on its own within a few weeks or months.

 

What increases your risk?

Your risk increases the longer you’ve had diabetes, and improper blood-sugar control raises your likelihood even more. Existing kidney disease also releases toxins into your blood that cause nerve damage. Additionally, a BMI >24 and smoking put you at risk.

Can you prevent or manage it?

According to the NIH, exercise, following your diabetic meal plans, smoking cessation and taking prescribed medications can prevent neuropathy. Also, limit alcohol consumption to one daily drink for women, two for men.

If you have neuropathy, you can limit its impact. Maintain healthy blood sugar, blood pressure, cholesterol and weight ranges. Keep your feet clean and dry, checking them daily for sores, cuts or ulcers.

When should you see your doctor?

Any time you have a lingering cut or sore on your foot, seek medical attention. Discuss dizziness, new burning or tingling sensations or progressive weakness, as well as digestive or sexual function changes with your doctor. These symptoms don’t automatically mean you have diabetic neuropathy, but get them checked to ensure you don’t overlook effective treatment.

If you have any questions, contact the Amputation Prevention Centers of America.

Living with – and Limiting – Diabetic Neuropathy

Diabetic Neuropathy
Diabetic neuropathy is nerve damage that causes numbness in your extremities and it has no cure. The good news is you can limit how much it impacts your body and life. Work with your doctor to secure a proper diagnosis and outline an effective treatment plan.

What will your doctor do if you have diabetic neuropathy?

Your doctor will ask about your symptoms and medical history, as well as check your heart rate, blood pressure and muscle tone. He or she will also check your reflexes, mainly in your ankles. A tuning fork test will determine sensitivity in your feet to vibration and a nylon fiber pinprick tests sensitivity to touch.

What are your treatment options?

Proper treatment can slow progression. There are several things you can do.

  • Medication: Discuss available medications with your doctor, including alternative therapies. Some medications can ease neuropathic pain by 30 percent to 50 percent. In some cases, alternative therapies, such as acupuncture, can alleviate symptoms when combined with medication.
  • Diet: Eating smaller meals improves digestion. Limit fiber and fat, concentrating mainly on fruits, vegetables, low-fat dairy, whole grains and moderate amounts of fish, poultry and nuts. Eat only small amounts of red meat.
  • Blood Sugar: Keeping your blood sugar in a healthy range (lower than 130 mg/dL before eating, lower than 180 mg/dL after eating) and maintaining a hemoglobin A1C of less than 7 percent can reduce nerve damage by up to 60 percent, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
  • Exercise: Strive for 30 minutes of exercise five days a week. Biking, walking, swimming, running and aerobics are good options to improve circulation to your arms, legs, hands and feet.
  • Get warm: Take a warm bath. It can boost your circulation.
  • Vitamins: Vitamin D can protect you against nerve pain. Getting enough on your own is difficult, so add a supplement to reach the 600-800 IU you need daily. Recent research revealed enough Vitamin D reduces neuropathy symptoms within two months. Low B12 also causes nerve damage and low B6 can decrease the chemicals in your body responsible for sending messages. Have your doctor check your levels.
  • Capsaicin cream: Hot peppers might make you think about having a spicy mouth, but the chemical ingredient that causes that sensation — capsaicin — can also alleviate the burning and pain associated with nerve damage. In fact, a study published in the journal Pain showed wearing an 8-percent capsaicin patch reduced pain by 30 percent after two weeks. Only your doctor can prescribe a higher-level cream, but even a 0.1-percent cream can provide up to 11-percent relief.

Contact us

Overall, since there’s no cure, you can’t completely alleviate the symptoms associated with your diabetic neuropathy. But, with proper treatment — and consultation with your doctor — you can significantly reduce how much it impacts your quality of life.

If you have any additional questions about diabetic neuropathy, contact the Amputation Prevention Centers of America.

What’s that Sore? Diabetic Foot Ulcer 101

Diabetic Foot Ulcer

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 foot 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 foot 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 43 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 diabetic foot ulcer can also lead to ischemia where tissue dies, becomes gangrene, potentially leading to death.

What can you do?

Seek treatment for a diabetic foot ulcer within six weeks. 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. If you have any questions about a diabetic foot ulcer, please contact the Amputation Prevention Centers of America.