Diabetic Foot Care
Diabetic Foot Care is essential for those suffering from diabetes. More than 16 million Americans have diabetes and of those, between 10 and 15% will develop a diabetic foot ulcer during their lifetime. These ulcers are commonly found along the bottom of the foot and come with complications like swelling, infection, reduced mobility, and sometimes even a need for hospitalization.
Nationwide, diabetes is the leading cause of non traumatic foot amputations. But 75% to 85% of foot amputations are preceded by foot ulcers. This means if we can intervene early to limit the damage caused by an ulcer, we may be able to delay amputation or prevent it entirely.
What Causes a Diabetic Foot Ulcer?
Diabetic Foot Care can Prevent Foot Ulcers
Diabetic foot ulcers are open sores that occur on the foot, primarily on the sole. They are often accompanied by seeping, swelling, and infections and they tend to become much worse without treatment. Over time, it may become quite difficult to walk due to these wounds.
The causes of diabetic foot ulcers are varied and people with chronic ulcers can have a combination of contributing factors. Common factors, beyond having diabetes, include:
- Being overweight
- Using alcohol and/or tobacco
- Poor hygiene
- Poor circulation
- Congenital or acquired foot deformities
- Irritation from the friction of poor-fitting footwear
- Trauma and accidents
- Having a diabetes-related condition like heart, kidney, or eye disease
- Having diabetes for a very long period of time
Additional contributing factors include being over 45 and being of Native American, African American, or Hispanic origin. These groups have both a higher incidence of diabetes and a higher risk of diabetic foot ulcers.
Symptoms of Diabetic Foot Ulcers
Diabetic Foot Care Begins with Understanding Symptoms
One of the most important things to know about diabetic foot ulcers is that pain is not a primary symptom. The person with the ulcer may not sense much pain due to the advanced stage of their diabetes.
When someone has diabetes for a long period of time, they sometimes develop neuropathy, or numbness due to nerve damage. For this reason, it’s critical to notice these early symptoms of diabetic foot ulcers::
- Drainage from the wound
- Redness or swelling in the foot
- An unusual odor coming from the foot
Take these symptoms seriously and see a podiatrist right away. A podiatrist offers simple, painless tests for nerve damage and other issues related to foot wounds. The faster you seek treatment for a diabetic foot wound, the better your prognosis will be.
How a Podiatrist Can Help
Your Podiatrist is Your Partner in Diabetic Foot Care
You may have heard the common saying, “an ounce of prevention is worth a pound of cure”. Professional diabetic foot care can prevent the loss of a limb for diabetics. The truth is that a simple hangnail or pressure sore can turn into a non-healing wound. Instead of waiting until you have a non-healing wound or diabetic foot ulcer, it is best to have regular checkups and preventative care from a podiatrist. Properly trimmed toenails and proper foot care may keep you from requiring more advanced treatments. Doctors of Podiatric Medicine (DPM) are uniquely qualified for diabetic foot care and can spot problems, often before you even know you have one. When you see a podiatrist about a foot care concern related to diabetes, many factors will be considered. Your podiatrist may ask about your family history, examine your feet, and discuss lifestyle concerns like your choice of footwear. A podiatrist helps intervene as early as possible, ideally before a diabetic foot wound reaches an advanced or chronic state. The podiatrist may recommend treatments like:
- The use of dressings to care for the wound and prevent infection
- Topical medications for the foot
- Antibiotics, if there is an infection
- Techniques for off-loading, or reducing pressure on the foot
- New footwear that prevents friction and pressure
- A procedure called debridement, which removes dead skin
Podiatrists work in harmony with other health providers to help patients manage the symptoms of diabetes, monitor blood glucose, ensure there is no infection, care for wounds, and suggest further treatment when necessary. Rarely, foot surgery might be recommended. Surgery is most commonly recommended to prevent or remove pressure on a wound. For example, it might involve reducing the size of a bony growth or bunion. Healing time can be anywhere from a few days to several months, depending on a wide variety of factors like your overall health and the location of the wound.
Preventing Diabetic Foot Wounds
Prevention is truly the best treatment for a diabetic foot wound because it keeps a wound from developing in the first place. Whether a patient has had a foot wound in the past or is simply being proactive, here are some best practices for prevention of diabetic foot wounds:
- Monitor blood glucose levels closely and follow your doctor’s orders
- Learn proper techniques for keeping your feet clean
- Address any redness or swelling immediately to prevent wounds
- Never walk around barefoot indoors or outdoors
- Get moderate exercise that promotes good circulation
- Work with your podiatrist to investigate proper footwear and related equipment
It is a myth that diabetic foot wounds should be kept dry and aired out. Healing actually occurs faster when patients keep wounds covered with an appropriate bandage and retain the moisture needed for proper healing. Topical treatments may further assist with healing.
However, don’t go too far in caring for the wound and assume more moisture is better. Do not soak a diabetic foot wound unless specifically instructed to do so by your doctor and avoid whirlpools and public pools where there is a risk of spreading infection.
It is essential to learn how to do a daily foot check as part of diabetic foot care. Check your feet thoroughly every day in a methodical way.
Take particular care in looking at the sole of your foot and between your toes. Report any of the following to your podiatrist: redness, swelling, bruises, cuts, cracks, blisters, and changes to the shape of your foot
For More Information
Remember, early intervention is the key to preventative diabetic foot care. If you are concerned about changes to your feet, reach out to Family Podiatry of Maryland as soon as possible. We can help you manage your diabetes and provide the best possible care for your feet.
About Dr. Vu
Dr. Dang Vu, DPM has been practicing Podiatry and Podiatric Surgery in Baltimore for for more than 15 years. He offers his services from 3 locations in Baltimore/Hampden, Reisterstown and Towson, MD. He is a Fellow of the American Board of Foot and Ankle Surgeons. He is a member of the Maryland Podiatric Medical Association and the American Podiatric Medical Association. As a leading Podiatrist and Foot and Ankle Surgeon in Baltimore, Dr. Vu is honored to be on staff at Northwest Hospital. His expertise in Diabetic Foot Care is an important focus of his practice. Dr. Vu is on Staff at Hyperheal Wound Care and Hyperbarics at the Pikesville, MD Location. The accredited team at this location can provide limb-saving Hyperbaric Oxygen Treatment (HBOT) for severe cases of non-healing diabetic ulcers or wounds.