One of the most common conditions people with elevated blood glucose levels or diabetes are at risk of developing is diabetic ulcers. Ulcers can develop anywhere on the body, but for those with high or poorly managed blood glucose levels, the most common place for them to occur is the lower extremities. The legs, ankles, and bottom of the feet are most susceptible to diabetic ulcers due to gravity, their location on the body, circulation impairments, etc.
Ulcers are a significant complication risk of diabetes and a leading cause of nontraumatic lower limb amputations in diabetics across the country, according to the American Podiatric Medical Association. Despite receiving many warnings and advice on the benefits of condition management and foot hygiene, many people with diabetes are not fully aware of what causes diabetic ulcers, their symptoms, and how they can impact their overall health.
What Are Diabetic Ulcers?
Ulcers are wounds that heal slowly. Slow healing injuries are prevalent in those with diabetes. The condition decreases the body’s resistance to infection and trauma and compromises its ability to heal or recover. Without proper care, diabetic ulcers can turn into festers and weep or ooze liquid, blood, or pus.
Symptoms of diabetic ulcers include:
- Pain in the legs or feet that occurs with or without cause or movement
- Slow healing or non-healing injuries or sores
- Cracked, peeling, or inflamed skin
- Discolored skin that may seem tender to the touch
- Bleeding, burning, or irritation to the skin, especially on the feet, ankles, or bottom of the feet
- A bluish tint to the toenails or the skin on the legs or feet
- Leg hair that no longer grows
Advanced stage diabetic ulcers can lead to gangrene, a condition that destroys skin and tissue, omits an unpleasant smell, causes prominent skin discoloration, and requires antibiotics and surgery to remove the affected limb to prevent the infection from spreading.
As foot and leg injuries and deformities become more likely with age, many ulcers develop from a combination of issues, not just elevated blood sugar. Also, when blood sugar levels remain unchecked, the risk of diabetic ulcers increases significantly.
Diabetic ulcers are often a result of peripheral nerve damage. Damaged nerves, also known as peripheral neuropathy, often cause abnormal sensations that include severe pain, hot or cold, pricks, etc. Over time, as the damage progresses, the peripheral nerves lose their ability to sense stimuli, making it difficult for those affected to feel injuries and wounds.
Not everyone with neuropathy or ulcers has diabetes. There are idiopathic cases where the exact cause is unknown. However, damaged nerves and neuropathy are common in people who are unaware they have diabetic ulcers. The condition is preventable with proper blood sugar management and foot care.
Risk Factors for Diabetic Ulcers
Anyone with diabetes or elevated blood glucose levels is susceptible to diabetic ulcers though those with additional diabetes-related conditions affecting the eyes, kidneys, and cardiovascular system are more vulnerable. There are other risk factors and causes that contribute to their development.
Friction and pressure sores: These injuries develop from ill-fitting footwear, improper foot care, sedentary habits, excess body weight, etc. It’s not uncommon for pressure and friction ulcers to develop and become severe before many sufferers realize they have them.
Diabetes type: Individuals with insulin-resistant diabetes are more likely to develop ulcers. Their bodies cannot metabolize insulin properly and many standard glucose medicines.
Vascular conditions: An essential component of the body’s healing capacity involves the vascular system. When comorbidities are present, such as diabetes or peripheral artery disease (PAD), they interfere with blood flow and cause abnormal changes to the veins and vessels in the vascular system. These effects reduce healing efficiency and increase the risk of diabetic ulcers.
Prevention and Treatment Strategies for Diabetic Ulcers
Diabetic ulcers are treatable, especially in the early stages of development. Without timely diagnosis and wound care, they can lead to severe infections or eventual limb loss.
Patient behaviors to manage diabetes and ulcers have the most significant impact on their outcomes. Extreme diligence is necessary to prevent infections and ulcers from developing. Wound management is also essential to prevent limb amputation.
People with diabetes should routinely inspect their legs and feet for sores. Redness and bruising often indicate trauma and the need for medical care. Because the most common place for diabetic ulcers to develop is on the bottom of the feet, individuals should see their doctor for regular diabetic foot health inspections.
Diabetics should keep their feet covered and avoid walking around barefoot. Socks and shoes are protective barriers that help prevent foot injuries, such as cuts, scrapes, bruises, etc., that can develop into ulcers.
Make lifestyle and health changes to regulate blood glucose levels. Depending on the patient and diabetes treatment, some glucose spikes and fluctuations may be regular but should be avoided. Strict blood glucose management is critical.
Treat all leg, ankle, or foot injuries right away. Clean and follow all treatment protocols for wounds and ulcers, no matter how small or minor they seem. Assumptions can be dangerous when dealing with diabetic ulcers and injuries. The risk of severe and life-threatening complications is high. Properly cleaning and dressing wounds is an essential prevention tactic.
Delays in care are common in individuals with diabetic ulcers. It’s also the most significant factor in advanced cases where amputations are necessary. Patients should get medical care at the first sign of suspected foot ulcers. Treatment can reduce infection and amputation risks, ensure proper wound care, and improve limb health, function, and overall quality of life.
To learn about diabetic ulcers or to schedule an appointment for an assessment to learn diabetic ulcer treatment options, contact Alliance Vascular Institute at (661) 480-5956.