Diabetic Foot Ulcer: Understanding the Risk and How to Prevent it

image of a minor case of diabetic foot ulcer
Published on Jan 24, 2023

What is diabetic ulcer?

Diabetic foot ulcers are among the most common complications of patients who have diabetes mellitus which is not well controlled. It is usually the result of poor glycemic control, underlying neuropathy, peripheral vascular disease, or poor foot care. Studies have shown that 25% of diabetic patients are likely to develop diabetic foot. 

Diabetic foot is a serious complication that can occur in people with diabetes. It is caused by a combination of factors, including poor blood circulation and nerve damage, also known as neuropathy.

What are the causes of diabetic foot?

Diabetic ulcers are a common complication of diabetes, and are caused by a combination of factors, including:

  1. Peripheral Arterial Disease (PAD): This condition is the most common cause of diabetic foot. It happens when the blood vessels in the legs and feet become narrowed or blocked reducing the amount of blood flow to the feet. This makes it difficult for the body to heal injuries and fight off infections.
  2. Unregulated Blood Sugar Levels: Elevated blood sugar levels could cause damages to the blood vessels and nerves in the feet, leading to poor circulation and a loss of sensation.
  3. Neuropathy: This is another leading cause of diabetic ulcer. Diabetic neuropathy is a type of nerve damage that causes a loss of sensation in the feet, making it difficult to feel injuries and discomforts. The implications are that infections could get severe before they are noticed.
  4. Trauma: People with diabetes are more prone to foot injuries and may develop ulcers from ill-fitting shoes, cuts, or blisters.
  5. Poor circulation: Diabetes can also damage the blood vessels, leading to poor circulation and difficulty healing wounds.
  6. Deformities: Foot deformities such as hammertoes, bunions or calluses may put pressure on certain areas of the foot and create an ulcer.
  7. Infection: Diabetic ulcers are often infected and in some cases, the wound may not heal until the underlying infection is treated.
  8. Other factors: Risk factors for diabetic ulcers include obesity, smoking, high blood pressure and high cholesterol.

How is diabetic foot detected?

Diabetic ulcers can be diagnosed through a number of ways:

  1. Physical examination: The physician checks the feet for indications of trauma, infection, or poor circulation, such as redness, swelling, or a lack of sensation. They may also check for calluses, corns, or other foot deformities.
  2. Laboratory tests: Blood tests may be done to check for diabetes, high blood sugar, high cholesterol, and high blood pressure.
  3. Imaging studies: X-rays, MRI or CT scans may be used to check for bone and joint problems, such as stress fractures, or to look for any signs of infection.
  4. Vascular study: If a poor circulation is suspected, the healthcare provider may order a non-invasive vascular study, such as Doppler ultrasound or ankle-brachial index (ABI) to assess blood flow to the feet.

What are the symptoms of diabetic foot?

Symptoms of diabetic foot can include but are not restricted to:

  • Redness, swelling, or warmth in the affected area
  • Sores or wounds that don't heal
  • Blisters or calluses on the feet
  • Dry, cracked skin on the feet
  • Numbness or tingling in the feet
  • A change in the shape or color of the toenails

How is diabetic foot treated?

Treatment for diabetic foot depends on the specific condition and its severity. The following are some common treatment options:

  1. Wound care: If a wound is present, it will need to be cleaned and treated to prevent infection. This may include using antibiotics, dressings, and other wound care products.
  2. Off-loading: This refers to taking pressure off the wound to help it heal. This can be done by using special shoes, inserts, or casts.
  3. Debridement: This is the process of removing dead or damaged tissue from the wound to promote healing.
  4. Vascular Surgery: Surgery may be recommended to restore and improve blood circulation to the feet.
  5. Medications: Pain medication, antibiotics, and medications to control blood sugar levels may be prescribed as needed.
  6. Physical therapy: Physical therapy may be prescribed to help improve circulation and to strengthen the muscles in the feet.
  7. Education: Patient education on foot care, wound care, and the importance of monitoring blood sugar levels is crucial for preventing future complications.
  8. Amputation: In severe cases, amputation of the affected limb may be necessary to prevent the spread of infection or other serious complications.

Frequently Asked Questions(FAQs)

What are the types of diabetic foot?

Diabetic ulcers can be neuropathic in which neuropathy is dominant, or neuroischemic, where occlusive vascular disease is the major cause. In Neuroischemic Diabetic ulcer, neuropathy is also present.

How can diabetic foot be prevented?

People with diabetes should take special care to keep their feet healthy. This includes regular foot inspections, keeping the feet clean and dry, and wearing comfortable, properly fitting shoes. It is also important to see a healthcare professional regularly to check for signs of diabetic foot and to treat any injuries or infections as soon as they occur.

Is diabetic foot life threatening?

Generally, complications from diabetes might be directly linked with serious morbidity and a reduced quality of life. Infections from untreated diabetic foot could also result to death.

What happens when diabetic foot is left untreated?

People with diabetes should get regular foot exams to help detect and prevent diabetic foot problems in its early stages. If left untreated, infections and ischemia lead to tissue death and eventually, amputation.  

In summary, diabetic foot is a serious complication of diabetes caused by poor blood circulation and nerve damage. Common symptoms include redness, swelling, wounds that don't heal, numbness and tingling in the feet. To prevent diabetic foot, people with diabetes should take good care of their feet and see a healthcare professional regularly.

Disclaimer: The information provided herein is for patient general knowledge only and should not be used during any medical emergency, diagnosis or treatment of any medical condition. Duplication for personal and commercial use must be authorized in writing by

Google Review trustpilot