People with diabetes are especially susceptible to foot wounds which can quickly become serious. Wounds occur because diabetes can cause changes in the feet such as dry, fragile skin and reduced blood flow when cholesterol clogs arteries. High blood sugar damages nerves, causing numbness, so the person may not feel a blister or sore.
The person living with diabetes might also develop flat feet, hammertoes, bunions or protruding bones on the soles of the feet. These changes can lead to the “perfect storm,” allowing calluses, ulcers and infection to develop.
The best treatment for diabetic foot ulcers (DFUs) is prevention. This includes controlling blood sugars, keeping skin on the feet moisturized and protected from trauma to prevent any cracks where germs can enter, and wearing well-fitting, supportive shoes with rounded toes.
All surfaces of the feet should be inspected daily for reddened areas, calluses, blisters or bleeding under the skin. If problems are noticed, or if the person is unable to safely trim his or her toenails, then the person should seek the care of a podiatrist.
Aggressive care at the earliest sign of ulceration is important to promote healing and prevent infection. If a thick callus, open area or bleeding under the skin of a foot occurs, an individual with diabetes must receive care at a wound center. Treatment for a DFU may range from simple pressure-relieving techniques to serial debridements, antibiotics or daily hyperbaric therapy.
Every person with diabetes should engage their provider or certified diabetes educator (CDE) in a discussion about his or her need for specialized foot care. The National Certification Board for Diabetes Educators offers a helpful online resource to find a CDE near you.
Jan Levesque, MSN, APRN, FNP-BC, CDE, Diabetes Specialist, Derry Medical Center, [email protected]