What Is It

Diabetic Foot Ulcers are a major complication of diabetes mellitus. Diabetic ulcers are also known as neuropathic ulcers.  They occur in 15% of all patients with diabetes and precede 84% of all lower leg amputations.

Who’s At Risk

Diabetic foot ulcers occur as a result minor trauma in the presence of various factors.  However, the most common cause is uncontrolled blood glucose (sugars) over a prolonged period of time.  Two other disorders, diabetic neuropathy (loss of sensation or feeling in the foot) and peripheral vascular disease (poor circulation), can also contribute to ulcer formation.

What It Looks Like

  • Location: On the foot – at an area of trauma or weight-bearing surface
  • Ulcer base: Usually dry, may have necrotic tissue
  • Ulcer edge: May be small at surface with an underlying subcutaneous abscess
  • Drainage: Varies but usually has a foul odor
  • Pain: Usually no sensation due to neuropathy
  • Peri-skin: Calloused or hyperkeratosis (overgrown, dry skin)
  • Pulses: Present

What You Can Do

The basis of diabetic foot care is prevention of complications.  This requires frequent monitoring and daily care.  A mirror can be used to visualize areas of the feet that are difficult to see, otherwise.

  • Take care of your diabetes. Work with your health care team to keep your blood glucose in your target range.
  • Wear shoes and socks at all times. Never walk barefoot.
  • Check your feet every day. Look for red spots, cuts, swelling, and blisters. If you cannot see the bottoms of your feet, use a mirror or ask someone for help.
  • Keep your skin soft and smooth. Rub a thin coat of skin lotion over the tops and bottoms of your feet, but not between your toes.
  • Wear comfortable shoes that fit well and protect your feet. Check inside your shoes before wearing them. Make sure the lining is smooth and there are no objects inside.
  • Protect your feet from hot and cold. Wear shoes at the beach or on hot pavement. Don’t put your feet into hot water. Test water before putting your feet in it just as you would before bathing a baby. Never use hot water bottles, heating pads, or electric blankets. You can burn your feet without realizing it.
  • Keep the blood flowing to your feet. Put your feet up when sitting. Don’t cross your legs for long periods of time. Don’t smoke.
  • Wash your feet every day. Dry them carefully, especially between the toes.
  • Have your doctor do a complete foot exam at least yearly and more often if you have foot problems.
  • Have all foot care, including callus, corn, or toenail trimming, done by your doctor.
  • See your doctor immediately for any cuts or breaks in the skin, ingrown nails, or your foot changes color, shape, or just feels different (for example, becomes less sensitive or hurts).
  • Be more active.
  • Ask your doctor about insurance coverage for special shoes.

When To Seek Help

Contact your physician immediately if there are any signs of an infection. An infection can spread to the rest of the body and cause serious problems. Signs of an infected ulcer include:

  • Redness, tenderness, warmth, or swelling around the ulcer
  • A foul odor or pus from the ulcer
  • Fever, weakness, and confusion are signs that the infection may have spread to the blood or elsewhere in the body
This information is for educational information, only.  It is not intended to replace the advice of a doctor. The iWOC Nursing Foundation disclaims any liability for any decisions made based on this information.