DIABETIC ULCERS Q & A
What Are Diabetic Ulcers?
Ulcers are wounds or sores that become chronic, meaning they persist and do not heal normally. Unhealed wounds can quickly become infected, leading to complications that, if left untreated, may result in amputation. Diabetic ulcers typically develop in up to 25% of diabetics, often occurring in the feet or lower legs.
What Causes Diabetic Ulcers?
Diabetic ulcers occur when a small sore or wound does not heal and progresses into a festering ulcer. Something as simple as a blister, dry and cracked skin, or a small cut can spiral into a diabetic ulcer. These ulcers are becoming one of the leading causes of amputation.
Ulcers develop in diabetics at a higher rate due to two traits of the disease:
- First, diabetes can cause poor circulation, making it difficult for blood to flow to the wound site to promote healing and fight infection.
- Second, numbness due to diabetic peripheral neuropathy, prevents patients from feeling pain from the wound, not even realizing it is there. Without knowing that treatment is needed, the wound has time to develop into an infected ulcer that gets even more difficult to maintain and treat.
Patients with diabetes can concurrently have a vascular condition called peripheral arterial disease (PAD). PAD is a blockage of arteries in the legs that causes poor circulation. The decreased blood flow makes it difficult for the wound to heal. Diabetic ulcers can be a symptom of PAD.
Frequently Asked Questions
Diabetic Ulcers Patient Education
What Are Symptoms of Diabetic Ulcers and Peripheral Arterial Disease (PAD)?
Symptoms of diabetic ulcers include:
- Redness, itching, burning and irritation
- Discomfort and pain if peripheral diabetic neuropathy not present
- Blistering, peeling, and cracking skin
- Continuing tenderness and pain, as the ulcer progresses
- As the ulcer penetrates into deeper tissue, broken skin and bleeding appears. Tissue damage may reduce pain.
- Infection that can spread to the bones and blood
Symptoms of PAD include:
- Wounds and sores that will not heal
- Pain when legs are at rest
- Toes, feet and legs appear blue
- Leg hair and toenails do not grow
Do Patients Need Treatment?
Yes. Diabetic ulcers can lead to amputation if left untreated. With both ulcers and PAD, early treatment to improve blood flow, attack infection, and promote healing will help prevent further damage and the need to amputate. Minimally invasive treatments are available for diabetic patients with PAD.
What Are Diabetic Ulcer Risk Factors?
The risk of developing diabetic ulcers is higher in diabetic patients with:
- Diabetic peripheral neuropathy
- Peripheral arterial disease (PAD) or other vascular disease causing poor circulation
- Foot deformities
- Inappropriate footwear such as tight shoes and high heels
- Uncontrolled blood sugar
- Previous occurrence of diabetic ulcers
- Lack of mobility/bed ridden
Can Diabetic Ulcers Be Avoided?
Preventing diabetic ulcers takes diligence and care. Here are measures diabetic patients can take to help avoid diabetic ulcers:
- Seek medical attention at the very first signs of a sore or wound for treatment
- Stop smoking and drinking alcohol
- Control elevated blood glucose levels
- Wear appropriate footwear
- Check feet every day. Look for abnormalities, redness, bruising, blisters, cuts, etc. Examine the entire foot, including between the toes.
How Are Diabetic Ulcers and PAD Treated?
Treatment for diabetic ulcers can involve several professionals, including a primary doctor, a diabetes specialist, a wound care specialist, a foot specialist, an infection specialist, and a vascular specialist trained in interventional radiology to address peripheral arterial disease (PAD). A vascular specialist can recommend the best treatment to restore blood flow and improve circulation. This may include procedures such as angioplasty, atherectomy and stenting.
At Alliance, we use the most up-to-date minimally invasive procedures to diagnose and treat diabetic ulcers and PAD. We are dedicated to providing safe and optimal care to diabetic PAD patients.