What Are Diabetic Foot Ulcers (DFU)?
Sores or wounds on the foot are called foot ulcers. Foot ulcers are common in people with diabetes due to a decrease in the circulation of small vessels in the foot along with an increase in blood sugar levels. This combination of conditions causes permanent changes in skin quality in the area. Ulcers may occur on any part of the foot but are commonly located on the bottom.
Any person with diabetes could develop a foot ulcer, however, some demographics such as Native Americans, African Americans, Hispanics, and older men have an increased risk.
You may be more likely to develop foot ulcers if you:
- Have diabetes-related diseases such as kidney, eye, and heart disease
- Use insulin
- Are overweight
- Use alcohol and tobacco
Symptoms of foot ulcers include:
- Opening in the skin
- Discharge or drainage in the sock or shoe
- Mal odor
- Black tissue around the ulcer
The signs of a foot ulcer may not be obvious. That is why it is important for people with diabetes to check their feet daily for changes. If there is drainage in the sock or shoe, discoloration, or pain in the area you should contact a doctor.
Some of the signs and symptoms of peripheral neuropathy include:
- Gradual onset of numbness, prickling, or tingling in your feet or hands, which can eventually spread upward into your legs.
- Sharp, jabbing, throbbing, or burning pain
- Sensitivity to light touch
- Pain during activities that did not previously cause pain
- Lack of balance which may result in falling
- Muscle weakness
- Feeling that you are wearing gloves or socks when you are not
- Heat intolerance
- Excessive sweating or inability to sweat
- Bowel, bladder, or digestive problems
- Decrease in blood pressure, causing dizziness or lightheadedness.
Doctors typically diagnose foot ulcers during a diabetic foot exam. A specific classification system is used to determine the severity of an ulcer.
Wagner Classification System:
- 0: No open lesions; there might be a healed lesion or callus.
- 1: A superficial ulcer without penetration to deeper layers
- 2: A deeper ulcer that reaches the tendon, bone, or joint capsule
- 3: Deeper tissues are involved with abscess, osteomyelitis, or tendonitis
- 4: Gangrene in a part of the forefoot or heel
- 5: Extensive gangrene of the entire foot
If you notice an ulcer, you should seek medical care immediately. You should not try to treat a foot ulcer at home due to the risk of infection. Infections from foot ulcers are hazardous to patients with diabetes because of their impaired immune systems. Quickly treatment of foot ulcers allows for an increased chance of healing without infection or complications. Medical treatment reduces the risk of infection and amputation, improves function and quality of life, and reduces health care costs.
Untreated foot ulcers may lead to infection which can cause loss of toes, foot, leg or life depending on severity.
Some of the critical parts of treating an ulcer include:
- Preventing infection
- Taking pressure off the area, also known as “off-loading”
- Removing dead skin and tissue, also known as “debridement”
- Applying medication or dressings to the ulcer
- Managing blood glucose and other health problems
- Using systemic antibiotics for deep infection, drainage, and cellulitis
- Creating a covered, moist environment for the wound
Doctors can treat most non-infected diabetic foot ulcers without surgery. However, surgery can remove pressure on the affected area, correct deformities, and treat infections.
The healing process can range anywhere from weeks to several months. Healing time will depend on the wound size and location, the degree of swelling, blood glucose levels, and patient compliance.
Keir Foot & Ankle helps diabetic patients in Beverly, Palos Park, Morgan Park, Merrionette Park, Alsip and more manage their foot health. We are passionate about helping people with diabetes retain their quality of life and reduce their risk of serious complications. If you are in Beverly, Palos Park, or the surrounding areas, make an appointment with us today.