iWOC Nursing Foundation Transforming Healthcare, One Person At A Time.

Diabetic Ulcers

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.

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 and peripheral vascular disease, can also contribute to ulcer formation.


  • Uncontrolled Blood Sugars

  • Diabetic Peripheral Neuropathy

  • Peripheral Vascular Disease


  • 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.


Diabetic ulcers usually present on the foot at an area of trauma or a weight-bearing surface.  The wound bed is commonly dry and may have necrotic (dead) tissue or a foul odor.    Diabetic ulcers may be small on the outside but have an underlying abscess.  The skin around the wound commonly has hyperkeratosis (callused or overgrown, dry skin). These ulcers are generally painless due to altered sensation or neuropathy.

Care Basics

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.

  • Look at your feet every day.  Check for any skin changes or open areas.

  • Make sure that your shoes fit properly.  Avoid shoes that are too tight, too loose, or otherwise cause distortion of the feet.

  • Consider custom shoes to offload (minimize) pressure.

  • Keep your blood sugars under control.

  • Seek routine nail care and callous trimming by a Podiatrist.

  • Routine diabetic foot care by a Podiatrist (at least yearly).

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 selling 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 purposes, only.  It is not intended to replace the advice of a doctor. The iWOC Foundation disclaims any liability for any decisions made based on this information.