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Diabetic Foot Ulcer: Causes, Prevention, and Treatment

Diabetes is a chronic disease that can cause serious health complications, including diabetic foot ulcers. Foot ulcers are open wounds on the feet of people with diabetes caused by poor circulation and nerve damage, which can make it difficult for the body to heal itself. If left untreated, these ulcers can become infected and even lead to amputation. Fortunately, with proper patient education, care and treatment, diabetic ulcers are preventable and treatable.

In this article, we'll discuss common causes of diabetic foot ulcerations and prevention tips, and advanced care treatments available for those who have already developed an ulcer.

Who Is At Risk For Developing Diabetic Foot Ulcers?

Diabetes is a serious health condition affecting millions of people in the United States; unfortunately, obesity plays a major role in its development. A high-carbohydrate and high-fat diet often leads to an increase in body weight, which can contribute to an increased risk of diabetes. This is because overeating sugar, carbohydrates, and saturated fats can lead to an increase in blood sugar levels, which can put a strain on insulin production.

Peripheral artery disease is where plaque builds up in your arteries, narrowing them and preventing blood to the legs and feet.. Diabetic peripheral Neuropathy is when your peripheral nerve cells are damaged, leading to decreased or lack of - feeling in the feet.

Alcohol and cigarette use and being overweight increase the risk of developing diabetic foot ulcers. This is because these behaviors can lead to poor circulation, nerve damage, and other conditions associated with diabetes. Alcohol increases inflammation in the body, inhibiting the healing process of wounds such as a diabetic ulcers.

Diabetic foot complications can occur in patients with diabetes, but they are more common in people who:

  • Are over the age of 50.

  • Have uncontrolled blood sugar levels.

  • Have poor circulation or nerve damage caused by diabetes.

  • Wear ill-fitting shoes and socks that rub against the feet.

  • Have open wounds on the feet that don't heal easily.

  • Have had previous foot ulcers.

What's Causing Your Diabetic Foot Ulcer?

Diabetic foot ulcers are due to various health factors. These include:

Atherosclerosis/Poor Circulation

Diabetes can cause significant health consequences, including damage to the blood vessels. When these are damaged, it reduces blood flow to the feet and can impede the healing of any wounds or ulcers on the feet. This increases the risk of developing diabetic foot ulcers and makes them more difficult to heal.

Neuropathy (Nerve Damage)

Neuropathy is when your peripheral nerve cells are damaged, leading to decreased or no feeling in the feet. This can make it difficult for diabetic patients to detect wounds on their feet, which can go unnoticed and eventually turn into ulcers. Diabetic Neuropathy also makes the skin more prone to injury because of its weakened state.

Trauma Or Injury

Diabetic ulcers can also be caused by trauma or injury to the feet, such as cuts, scrapes, or bruises that go untreated. Trauma or injuries can occur anywhere on foot but are typically found on the toes and around the heel. These wounds pose a higher risk because of the above mentioned poor circulation and nerve damage caused by diabetes.

Poor Foot Care

Neglecting proper foot care is a major risk factor for developing diabetic foot ulcers. For example, not wearing shoes that fit properly can allow the feet to rub against the material, increases the odds of injuries and puts one at risk for ulcers. Not washing and drying the feet properly can also increase the risk, as bacteria can grow and cause infection.

Don't Ignore These Warning Signs of a Diabetic Foot Ulcer

Diabetic foot ulcers can be severe and should not be ignored. If you have the following symptoms, talk to your doctor right away:


Diabetic foot ulcers can be incredibly painful, especially in weight-bearing areas of the foot. This is because these areas bear more pressure from walking and standing, making it difficult for the ulcer to heal. As a result, the pain caused by diabetic foot ulcers can become chronic and severely disrupt one's daily activities. Most people with diabetes have neuropathy, a decreased ability to feel pain. Therefore, when pain is present on their feet, they should seek medical attention immediately.


If you notice swelling in your feet or ankles, it could lead to diabetic foot ulcers. Swelling is caused by fluid buildup due to poor circulation and can make the area more susceptible to developing an ulcer which can lead to an infection. and around the ulcer more susceptible to infection. When circulation is impaired, it affects the body's ability to transport oxygen and nutrients from the bloodstream to surrounding tissues. This lack of oxygen-rich blood causes fluid buildup in the tissue, leading to swelling. Swelling can also occur if the ulcer has become infected.


The skin around the ulcer may also become red or discolored, a sign that the tissue has become infected. The redness occurs when capillaries near the wound are damaged, allowing blood to escape and pool in the surrounding tissue. This can lead to an infection and a spread of the infection known as cellulitis if left untreated.


Diabetic foot ulcers may produce pus or other types of drainage that can be a sign of infection. This drainage is typically yellow, brown, or green and can have a foul odor. In some cases, the drainage may also be bloody due to the damage to the blood vessels around the ulcer. It is essential to monitor any drainage and contact your doctor immediately if it persists.

Changes In Skin Color

The skin around diabetic foot ulcers can appear pale, blue, or black. This is caused by peripheral vascular disease, where narrowed blood vessels prevent oxygen-rich blood from reaching the surrounding area. This lack of oxygen and nutrients in the tissues causes discoloration, making it difficult for the ulcer to heal. Sometimes, an ulcer that does not heal can form a hard, blackened layer of skin called an eschar.

Stay One Step Ahead: How to Prevent Diabetic Foot Ulcers

The best step to prevent diabetic foot ulcers is to keep your diabetes in check. Regularly monitor blood sugar levels and work with your healthcare team to ensure they stay within the target range. You should also:

Practice Good Foot Care

Good foot care is essential to prevent diabetic foot ulcers. This includes washing and drying the feet thoroughly each day, especially between the toes, as this can help keep bacteria and fungi at bay. It is also important to trim toenails regularly to prevent them from growing too long and curling into the skin of the foot, which can cause irritation, inflammation, and even ulceration. Wear comfortable shoes that fit properly to avoid pressure points, and inspect the feet regularly for any signs of cuts, blisters, or sores.

Inspect Your Feet Daily

Inspecting your feet daily is an important part of preventing diabetic foot ulcers. A good routine should include thoroughly inspecting your feet and paying particular attention to the soles and areas between the toes. If you have difficulty seeing the bottom of your feet, you can use a mirror or ask someone else to check for you.

Protect Your Feet

It is essential to wear shoes when walking or standing to protect the feet from injury. Shoes with a low heel and well-cushioned sole can help provide extra protection for the feet. Sandals or flip-flops should be avoided as these can cause cuts and scrapes due to the lack of coverage they provide. Additionally, always wear socks or stockings to keep your feet dry and warm. Checking your shoes daily by running your hands inside the shoe before putting them on to make sure nothing fell into your shoe is also a good habit to form.

Manage Your Diabetes

To manage your diabetes and prevent diabetic foot ulcers, it is essential to follow your doctor's instructions for managing diabetes. This includes taking medications as prescribed and monitoring blood sugar levels regularly. Medications may include insulin therapy, oral hypoglycemic agents, and other medications that can help control blood sugar levels while helping to reduce the risk of ulcer formation. Additionally, healthy lifestyle habits such as eating a balanced diet and getting regular physical activity can help improve diabetes management and help prevent foot ulcers.

Heal Your Diabetic Foot Ulcers With the Right Care and Treatment

If you notice any signs of a diabetic foot ulcer, contact your doctor immediately. The sooner diabetic foot care treatment begins, the better the chances are for successful healing. At Northern Ankle Foot Associates, we are Diabetes foot specialists and Certified Wound care Physicians who can help diagnose the cause of your ulcer and provide you with specialized treatment to help promote healing. Treatment may include:

Pressure Off the Area

In addition to specialized medical treatment, we take steps to reduce the pressure on the ulcer. This can be done by wearing shoes with extra cushioning or custom orthotics, using a special boot or cast for offloading and wearing compression stockings. Offloading helps distribute weight away from the area of injury and keeps the wound from further irritation. It is also essential to keep the wound clean and dry and monitor for signs of infection or other complications.


If the ulcer is already present, debridement (removal of dead skin and tissue) can help reduce the chances of infection and promote healing. This may include removal of necrotic (dead) tissue. The diabetic foot wounds should then be cleaned and dressed regularly to ensure it remains bacteria-free.

Wound Management

Once the wound is clean, your podiatrist may recommend a topical ointment or dressing to keep the area moist and promote healing. Moisture helps encourage cell growth and prevent the wound from drying out. Additionally, regular monitoring will help ensure that the ulcer is healing properly and that any new signs of infection are addressed quickly.


In some cases, foot surgery may be essential to address the ulcer. This can include removal of infected tissue, skin grafts or other reconstructive surgeries to reduce tension in the affected area and promote healing. After surgery, it is essential to keep the wound clean and dry, follow your doctor's instructions for care, and take any prescribed medications as directed.

Let Northern Ankle Foot Associates Help You Eliminate Diabetic Foot Ulcers.

Diabetic foot ulcers can be painful and challenging to manage, but with the proper care and treatment, they can become a thing of the past. At Northern Ankle Foot Associates, we specialize in treating foot ulcers associated with diabetes and helping patients find relief from their symptoms. Most importantly, we help prevent future ulcerations and allow you to live your best life. Contact us today to learn how we can help you say goodbye to your diabetic foot ulcers and enjoy improved mobility!

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