Diabetes leads to many problems, including the development of sores and ulcers on your feet that, in worst case scenarios, can lead to amputations. Dr. Lang is s a Fellow with the American Professional Wound Care Association ( APWCA ). (To learn more about Dr. Lang's education, experience, and certification and the rest of the NOPA team, click here .) Not only can Dr. Edward Lang and his team at New Orleans Podiatry Associates treat diabetic wounds, but they can recommend healthy lifestyle choices that can help you control your diabetes and reduce the risk of wounds forming on your feet. Our web site has other pages, Diabetic Foot Care and Diabetic Handbook , that provide further information about other problems diabetes can cause in your feet and about how to care for your feet if you do have diabetes.
Diabetes can contribute to numerous foot ailments: blisters , bunions , calluses , corns , fungal nail infections , hammertoes , ingrown nails , and plantar warts . Please click on the links to read more about each condition.
The main type of wound that diabetics develop in their feet is the ulcer. The American Podiatric Medical Association reports that nearly 15% of people with diabetes have foot ulcers, most often on the bottoms of their feet. APMA alerts us to the fact that 14-24% of those who develop foot ulcers end up having to undergo amputations. The good news is that we at NOPA can help you get the treatment you need for your ulcers and help you make the lifestyle changes necessary to prevent the development of ulcers in the first place. If you have diabetes and have sores or open wounds on your feet, it's essential for you to call New Orleans Podiatry Associates right away.
Causes of Diabetic Foot Ulcers
Although anyone with diabetes is at risk for developing foot ulcers, the following factors increase the likelihood of their formation:
- Alcohol and/or tobacco use
- Duration of diabetes--the longer you have diabetes, the more likely you are to develop an ulcer
- Foot deformities
- Foot irritation, such as that caused by friction or pressure due to wearing poorly fitting shoes
- Neuropathy --Please note that neuropathy is a condition in which you lose feeling in your feet due to nerve damage, and it makes it difficult for you to notice an open wound or ulcer. If you are experiencing a lack of feeling in your lower legs or feet, it is important for you to inspect your feet at least once a day for any wounds, and you should see a podiatrist as soon as possible.
- Poor circulation in the feet
- Presence of diabetes-related eye, heart, or kidney disease
- Trauma to the foot
- Use of insulin
- Vascular disease
Symptoms of Diabetic Foot Ulcers
As mentioned above, because diabetes sufferers may have neuropathy , which leads to a loss of feeling in your feet, you may not feel pain. It is thus necessary for you to visually examine your feet and your socks.
- Drainage on your socks
- Foul odor, especially if the ulcer has been present for some time
Treatments for Diabetic Foot Ulcers
- Antibiotics if the ulcer has become infected (Note: Please consult your physician before taking any medications.)
- Applying medication and dressing to the wound
- Debridement, or removal of dead skin and tissue
- Hyperbaric oxygen therapy, in which you inhale pure oxygen, thus allowing it to get into the blood where it will create new cells, promote the creation of new blood vessels, and help fight infections
- Managing blood glucose and controlling your diet to minimize the effects of diabetes
- Off-loading, which refers to taking pressure off of the area with the ulcer
- Pulsed lavage therapy, which sends a gentle, pressurized stream of saline solution to the ulcer so that the tissue is softened and easier to debride
- Skin grafts (such as Dermagraft) that will let new skin grow at the wound site
Prevention of Diabetic Foot Ulcers
- Checking your feet daily for the presence of open sores, ulcers, or wounds, especially if you have neuropathy; it is especially important to examine the soles of your feet and the spaces in between your toes.
- Gently smoothing corns and calluses with a clean emery board or pumice stone when your skin is soft after your bath or shower
- Keeping blood flowing to your feet by elevating them when sitting and moving your toes periodically
- Keeping blood glucose levels in the healthy range recommended by your physician
- Trimming and smoothing your toenails on a weekly basis
- Using foot cream to prevent dryness and cracking
- Visiting Dr. Lang regularly so that he might give your feet a proper evaluation
- Washing your feet in warm water with mild soap daily, and drying them effectively, including in between your toes
- Wearing properly fitting shoes, preferably made of canvas or leather
- Wearing shoes or slippers with closed toes at all times, even indoors
- Wearing socks or stockings with soft elastic, and wearing them at night, especially if your feet are cold
It's great that there are so many things you can do to prevent foot ulcers and more serious consequences. The list of recommendations is extensive, so if you have any questions, give us a call, and we'll be happy to answer your questions and provide tailor-made suggestions that are best for you!