Diabetic foot ulcers are painless ulcerations that occur in people with poorly controlled diabetes who experience decreased foot sensation and impaired wound healing. The lifetime incidence of these ulcers in people with diabetes ranges from 19% to 34%.
What are diabetic foot ulcers?
Diabetic foot ulcers are painless ulcerations that occur in people with poorly controlled diabetes who experience decreased foot sensation and impaired wound healing. The lifetime incidence of these ulcers in people with diabetes ranges from 19% to 34%.
What are the main signs and symptoms of diabetic foot ulcers?
Diabetic foot ulcers primarily develop on weight-bearing areas of the foot, like the heel or ball of the foot, and appear round and crater-like. In severe instances, these ulcers may also ooze and bleed.
How are diabetic foot ulcers diagnosed?
Diabetic foot ulcers are diagnosed by a clinician who evaluates the ulcer's dimensions, drainage, and checks for signs of infection or ischemia. Various assessment systems, such as the University of Texas, Wagner-Meggitt, PEDIS, and SAD classifications, are used to categorize these ulcers.
What are some of the main medical treatments for diabetic foot ulcers?
The main medical treatments for diabetic foot ulcers include wound debridement, moist wound dressings, weight reduction on the ulcer, antibiotics for infections, and control of blood sugar levels to enhance healing.
Have any supplements been studied for diabetic foot ulcers?
Several supplements — including magnesium, vitamin E, zinc, arginine, omega-3 fatty acids, vitamin D, protein, and probiotics — have been studied for diabetic foot ulcers; however, there is no strong evidence to support their effectiveness.
How could diet affect diabetic foot ulcers?
The American Limb Preservation Society recommends a diet that is rich in fluids, energy, protein, carbohydrates, fat, and micronutrients like zinc and vitamins C, D, and E to support wound healing in people with diabetic foot ulcers. They suggest specific intake levels based on body weight to meet the higher energy and macronutrient needs of these individuals.
What causes diabetic foot ulcers?
Diabetic foot ulcers are caused by a combination of factors, including nerve damage from poorly controlled diabetes, which leads to foot deformities, dry skin, and decreased sensation. This condition impairs healing and results in the formation of calluses that, under constant pressure, can develop into ulcers.
Examine Database: Diabetic Foot Ulcers
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Frequently asked questions
What are diabetic foot ulcers?
People with poorly controlled diabetes usually experience decreased foot sensation and impaired wound healing. As a result, they may develop foot ulcerations that are painless and heal poorly. The lifetime incidence of diabetic foot ulcers in people with diabetes is 19%–34%.[1]
What are the main signs and symptoms of diabetic foot ulcers?
Diabetic foot ulcers primarily develop on weight-bearing areas of the foot, like the heel or ball of the foot, and appear round and crater-like. In severe instances, these ulcers may also ooze and bleed.
Ulcerations typically develop on the weight-bearing areas of the foot, such as the heel or metatarsal head (also known as the ball of the foot).[2] These ulcerations look round and crater-like. In severe cases, they may ooze and bleed.
What are the complications of diabetic foot ulcers?
Quick answer:
Untreated diabetic foot ulcers can result in serious complications, including osteomyelitis, gangrene, and foot abnormalities. In severe cases, significant tissue loss or life-threatening infections may necessitate amputation.
If not treated early enough, diabetic foot ulcers can lead to complications such as osteomyelitis (infection of the bone), gangrene (tissue death), and foot abnormalities. An amputation may be the only option if there is significant tissue loss or a life-threatening infection.[2]
How are diabetic foot ulcers diagnosed?
Diabetic foot ulcers are diagnosed by a clinician who evaluates the ulcer's dimensions, drainage, and checks for signs of infection or ischemia. Various assessment systems, such as the University of Texas, Wagner-Meggitt, PEDIS, and SAD classifications, are used to categorize these ulcers.
A clinician will assess the ulcer by looking at its length, width, depth, and accompanying drainage as well as looking for signs of infection or ischemia (i.e., cell death due to decreased blood supply).
There are several classification systems for diabetic foot ulcers. Some commonly used ones are the University of Texas (San Antonio), Wagner-Meggitt, PEDIS, and SAD classifications.[3]
What are some of the main medical treatments for diabetic foot ulcers?
The main medical treatments for diabetic foot ulcers include wound debridement, moist wound dressings, weight reduction on the ulcer, antibiotics for infections, and control of blood sugar levels to enhance healing.
The main treatments include wound debridement (removing dead skin and tissue), moist wound dressings, reducing weight on the ulcer (via orthotics or shoe changes), antibiotics to combat infections, and controlling blood sugar levels (poorly controlled blood sugar can impair wound healing).[4]
How can diabetic foot ulcers be prevented?
Quick answer:
Prevention of diabetic foot ulcers requires consistent foot care, which includes daily foot inspections, proper washing, regular doctor visits for callus removal, trimming the toenails straight across, wearing well-fitting shoes, avoiding barefoot walking, protecting the feet from extreme temperatures, and having the feet checked during healthcare appointments.
Consistent foot care is essential in preventing diabetic foot ulcers. Proper foot care includes the following:
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Check both feet every day (look for any cuts or calluses).
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Wash both feet with soap and water.
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See a doctor about removing calluses or corns.
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Trim toenails straight across (reduces ingrown toenails).
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Wear shoes that fit correctly.
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Avoid walking barefoot to prevent cuts and abrasions.
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Protect feet from extreme hot or cold environments.
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Have feet checked regularly at healthcare appointments.
Have any supplements been studied for diabetic foot ulcers?
Several supplements — including magnesium, vitamin E, zinc, arginine, omega-3 fatty acids, vitamin D, protein, and probiotics — have been studied for diabetic foot ulcers; however, there is no strong evidence to support their effectiveness.
Magnesium, Vitamin E, Zinc, Arginine, omega-3 fatty acids, Vitamin D, protein, and probiotics have been studied for diabetic foot ulcers, but there is no strong evidence that any of these supplements are beneficial.[5]
How could diet affect diabetic foot ulcers?
The American Limb Preservation Society recommends a diet that is rich in fluids, energy, protein, carbohydrates, fat, and micronutrients like zinc and vitamins C, D, and E to support wound healing in people with diabetic foot ulcers. They suggest specific intake levels based on body weight to meet the higher energy and macronutrient needs of these individuals.
Because there is limited evidence on diet and diabetic foot ulcers, the American Limb Preservation Society (ALPS) recommends a diet with adequate fluids, energy, protein, carbohydrates, fat, and micronutrients (i.e., Zinc, Vitamin C, Vitamin D, and Vitamin E) to facilitate proper wound healing. People with diabetic foot ulcers, like other wound patients, have higher energy and macronutrient needs. The ALPS guidelines therefore recommend foods rich in the aforementioned micronutrients with an intake of 30–35 kcal per kilogram of body weight, 1.25–1.5 grams of protein per kilogram of body weight, and 25-35 mL of fluid per kilogram of body weight daily. Carbohydrate and fat intake should be individualized to the person’s current level of diabetes control while supporting their overall energy needs.
What causes diabetic foot ulcers?
Diabetic foot ulcers are caused by a combination of factors, including nerve damage from poorly controlled diabetes, which leads to foot deformities, dry skin, and decreased sensation. This condition impairs healing and results in the formation of calluses that, under constant pressure, can develop into ulcers.
The development of diabetic foot ulcers is multifactorial. Since poorly controlled diabetes can cause nerve damage, the resulting neuropathy (dysfunction of peripheral nerves) causes foot deformities, dry skin, and decreased sensation. Moreover, diabetes can impair the body’s ability to heal. As a result, a callus (thickened skin) develops. Over time, constant pressure on that callus damages the skin, producing an ulcer.[1]
References
Examine Database References
- Diabetic Foot Ulcers Symptoms - Purandare H, Supe AImmunomodulatory role of Tinospora cordifolia as an adjuvant in surgical treatment of diabetic foot ulcers: a prospective randomized controlled studyIndian J Med Sci.(2007 Jun)
- Diabetic Foot Ulcers Symptoms - Carvalho AF, Feitosa MC, Coelho NP, Rebêlo VC, Castro JG, Sousa PR, Feitosa VC, Arisawa EALow-level laser therapy and Calendula officinalis in repairing diabetic foot ulcers.Rev Esc Enferm USP.(2016)
- Wound Healing - Halschou-Jensen PM, Sauer J, Bouchelouche P, Fabrin J, Brorson S, Ohrt-Nissen SImproved Healing of Diabetic Foot Ulcers After High-dose Vitamin D: A Randomized Double-blinded Clinical Trial.Int J Low Extrem Wounds.(2023-Sep)
- Wound Healing - Yildiz Karadeniz E, Kaplan Serin EUse of honey in diabetic foot ulcer: Systematic review and meta-analysis.J Tissue Viability.(2023 May)
- Wound Healing - Wang C, Guo M, Zhang N, Wang GEffectiveness of honey dressing in the treatment of diabetic foot ulcers: A systematic review and meta-analysis.Complement Ther Clin Pract.(2019 Feb)