Endocrinology and Diabetes
Diabetic Foot Ulcers
Foot ulcers are a serious concern for people with diabetes. We’re here to help you heal and stay as healthy as possible.
Medically reviewed by Misty Humphries, M.D. on Oct. 16, 2024.
Diabetic Foot Ulcers
Diabetic foot ulcers are sores that don’t heal. They often happen on the feet and toes of people with diabetes.
Diabetic foot ulcers can easily become infected, especially if you have nerve or circulation problems. An infected ulcer can lead to serious problems, such as dead tissue (gangrene). Dead tissue requires surgery.
At our diabetes clinics, we use the latest techniques to treat diabetic ulcers and help you avoid future foot sores. We’re passionate about preventing complications and the need for surgery.
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Symptoms of Diabetic Foot Ulcers
You may not notice a foot ulcer at first, especially if you have nerve or circulation problems in your feet. Without treatment, your symptoms will worsen as the infection sets in and spreads.
Common Symptoms
Early symptoms of a foot ulcer include:
- A discolored spot on your foot or toe
- A stain on your sock from drainage or pus
- Hard spots, lumps, or ridges on your foot
- Odor from your foot
- Pain
- Swelling or redness
- Blistering
Emergency Symptoms
Get medical care right away if you experience:
- Bad odor from a foot ulcer
- Black or dark skin around the ulcer
- Severe pain, redness, and warmth of the entire foot or extending up the leg
- Fever, along with pain and redness of the foot
Causes of Diabetic Foot Ulcers
Complications related to diabetes often cause diabetic foot ulcers. These complications may include:
Circulation Problems
Diabetes can lead to blood vessel damage and blood flow problems in your feet. With poor blood flow, it’s difficult for your body to heal. A small injury can turn into an infected ulcer.
Nerve Damage
Over time, high blood sugar damages your nerves (diabetic peripheral neuropathy). You may not be able to feel an injury on your foot, and a sore can become an ulcer.
Risk Factors for Diabetic Foot Ulcers
Certain factors and conditions raise your risk of developing a diabetic foot ulcer.
Changes in How You Walk
If you have nerve problems, nerve pain, or loss of strength or reflexes, it can affect how you walk. This change can lead to foot problems, such as bunions or hammertoes. Bunions and hammertoes cause your shoes to rub against your feet, leading to sores. Poor-fitting shoes can also cause foot sores.
Peripheral Artery Disease
When you have blood vessel damage in your feet that restricts blood flow, it can lead to peripheral artery disease (PAD). People with diabetes who develop PAD have a higher risk of having foot ulcers.
Uncontrolled High Blood Sugar
Long-term high blood sugar causes inflammation in your body and damage to your nerves. You may not notice a foot sore until it has become an ulcer. High blood sugar also makes it harder for your body to heal and fight infection.
Diagnosing Diabetic Foot Ulcers
To determine if you have a diabetic ulcer, your provider will first do an exam. If you have one, your provider will then classify how severe it is based on:
- How deep it is
- Signs of infection
- Signs of gangrene
You may also need imaging tests such as an MRI or an X-ray. These tests can show how deep the wound is and whether it affects your bones.
Diabetic Foot Ulcer Treatments at UC Davis Health
Treatment for diabetic foot ulcers depends on how deep and infected the wound is and whether there is tissue damage. At our diabetes clinics and wound care clinic, we use the most advanced treatments to stop the progression of foot ulcers and help you heal. If you need surgery, we offer the latest reconstructive techniques.
Topical Care
If the ulcer affects just the top layers of your skin, you may only need to have it drained and bandaged.
Antibiotics
If the wound is infected, antibiotics can help your body fight the infection.
Debridement
If infection has caused damage to your tissues, you may need surgery to remove (debride) the infected tissue.
Skin Graft
A skin graft involves surgically replacing damaged skin on your foot with healthy skin from a different part of your body.
Bone Surgery
If the infection has reached the bone, we may need to scrape or remove your damaged bone.
Amputation
If an infected ulcer leads to tissue death, you may need to have the area amputated. Learn more about the care we provide in our Amputee Clinic.
Improvement of Blood Flow
Improving blood flow can save limbs and is typically accomplished during vascular surgery.
Preventing Diabetic Foot Ulcers
Catching foot sores early can prevent complications. Take these steps to lower your risk for severe foot ulcers.
Check Your Feet
Check your feet daily for sores and callouses. If you can’t see your feet easily, ask for help. You can also use a mirror to examine all sides of your feet and in between your toes.
Manage Blood Sugar
Keeping your blood sugar in a healthy range helps to prevent complications that put you at risk for foot ulcers.
Take Care of Your Feet
Keep your feet clean and moisturized. Trim your nails regularly. Wear socks and shoes to protect your feet.
Wear the Right Shoes
Wear shoes that are comfortable and don’t rub or press anywhere on your feet or toes. A podiatrist (foot doctor) at our Orthopaedic Foot and Ankle Clinic can help you find shoes that fit properly.
Who does it affect?
15-25%Of people with diabetes develop a foot ulcer in their lifetime
Source: National Library of Medicine: Diabetic Foot Ulcer
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