The number of Americans with diabetes, most commonly type 2 diabetes, is growing more than ever before, according to the Centers for Disease Control and Prevention. The percentage of those diagnosed increases with age, but other risk factors for developing diabetes include diet, activity level, smoking and obesity.
One complication of diabetes is a foot ulcer. Nearly 25% of diabetics will develop a foot ulcer during their lifetime. As many as 40% of people with a healed ulcer will develop a new one within a year.
The development of a foot ulcer typically occurs in three stages:
- A callus forms as a result of neuropathy - damage to the nerves, causing pain and numbness.
- The skin dries out and becomes flakey as skin cells die.
- The callus progresses to a state of hemorrhage, then erodes to become an ulcer.
Patients with foot ulcers can also develop severe buildup of plaque, called atherosclerosis, of the small blood vessels in the legs and feet, leading to vascular complications. Because blood cannot reach the wound, healing is delayed which can lead to necrosis and gangrene.
Nancy Chatham, ANP-BC, CCNS, CWOCN-AP, CLT, HSHS St. John’s Hospital Regional Wound Care and Hyperbaric Center’s Director of Inpatient, Outpatient, Wound and Ostomy Care, says ulcers most often develop on the ball of the foot or the bottom of the big toe.
“Treating these types of ulcers can be a real challenge,” says Chatham. “Often, because they can’t feel the wound due to the numbness, patients continue to walk on their wound. This can cause extensive damage which leads to infection and needing immediate medical care.”
If you are diagnosed with diabetes, taking care of your feet is very important, even if they feel fine.
- Wash your feet thorough every day
- Keep your toenails trimmed and filed with an emery board
- Check your feet daily for sores, cuts, blisters and/or redness; look between your toes
- Do not remove calluses or corns yourself
- Moisturize your feet, but avoid moisturizing between the toes
- Wear shoes that fit well; don’t walk around barefoot
Signs you may be developing a diabetic foot ulcer, include:
- A callus with bleeding beneath it
- A dark or bruised area of your foot
- Redness that does not go away
“If you have a foot ulcer, it is important to see a wound care specialist,” says Chatham. “We can provide several treatment options based on the severity of the ulcer – total contact casting, negative pressure wound therapy and hyperbaric oxygen treatment for example – which can be effective in providing healing.”
HSHS St. John’s Regional Wound Care Center, located in St. John's Pavilion, provides specialized treatment for chronic or non-healing wounds, which are defined as sores or wounds that have not significantly improved from conventional treatments. With state-of-the-art treatments available, including debridement, dressing selection, special shoes and patient education, people with non-healing and chronic wounds now have a place to turn.
A physician’s referral is not required to obtain care at HSHS St. John’s Regional Wound Care Center. For more information, call 217-757-6644.
For more information about diabetes foot complications, visit the American Diabetes Association website.