Diabetic Neuropathy: Diabetic Ulcers
Understanding diabetic ulcers is the cornerstone to healing them. Such ulcers are generally found on the bottom of the feet of both type 1 and type 2 diabetics. Diabetic ulcers are blisters that have remained undetected by the individual due to a form of diabetic neuropathy (nerve damage within the feet and legs). With nerve damage, one cannot feel these blisters, and oftentimes, they become rather large and infected by the time they are discovered.
A late diagnosis may result in either a toe, foot or leg amputation. Unfortunately, diabetic ulcers account for approximately 80 percent of leg amputations within the United States, indicates Diane Voyatzis, MS, RD, CDE, in her article “Diabetic Foot Ulcer” published on the Beth Israel Deaconess Medical Center’s website.
Diabetic Foot Ulcer: Symptoms
Paying attention to the following symptoms will assist in getting prompt treatment and, thus, a better prognosis:
- Any sores or other abnormalities (such as ulcers or blisters) on the foot or leg
- Pain or swelling of the foot or ankle
- Cold feet and/or discoloration (commonly red, blue or black)
- Difficulty walking
Aids to Promote Diabetic Ulcer Healing
Known aids in the treatment of diabetic ulcers include medication, surgery, skin grafting, hyperbaric oxygen therapy and foot cream-containing human epidermal growth factor (hEGF).
Regranex gel has been shown to speed healing time and is approved by the Food and Drug Administration.
- Debridement, a procedure used to clean the ulcer and remove dead tissue, is known to promote healing.
- Bypass surgery assists with wound healing and improved circulatory flow.
- Amputation may be necessary when the infection has begun to spread to spare the rest of the patient’s body.
Skin grafts – bioengineered or human – have been shown to increase healing time when other methods have failed
Hyperbaric Oxygen Therapy
This type of therapy envelopes the blood with pure oxygen and, in turn, such oxygenated blood forms new blood vessels, which, of course, assists with healing.
Foot Cream with hEGF
In a study published in June 2003 vol. 26 no.6 of Diabetes Care, 61 diabetics participated in a study conducted to determine if hEGF was an effective treatment in healing diabetic ulcers. Researchers came to the conclusion that “an application of hEGF-containing cream, in addition to good foot care from a multidisciplinary team, significantly enhances diabetic foot ulcer wound healing and reduces the healing time.”
Diabetic Foot: Prevention
As the old adage by Benjamin Franklin goes, “An ounce of prevention is worth a pound of cure,” is no less true today. Diabetics may assist in preventing the development of diabetic ulcers by taking the following recommendations and implementing them into their daily routine:
- Cleanse and thoroughly dry feet daily
- Apply unscented lotion or petroleum jelly to dry feet but refrain from applying between the toes
- Conduct a thorough inspection of both feet by means of a mirror or a family member to locate any ulcers
- Wear properly fitted shoes
- Have calluses removed by a podiatrist
- Schedule a monofilament test, at least annually, to test and measure the amount of feeling in the feet
- Keep blood sugar levels under control through an approved diabetic diet, exercise and any prescribed medicinal therapy.
- Avoid smoking
Disclaimer: The preceding article serves for educational purposes only and should not replace the advice and aid recommendation(s) by a licensed health care provider.
Voyatzis, Diane. “Diabetic Foot Ulcer”, Beth Israel Deaconess Medical Center, https://www.bidmc.org/YourHealth/MedicalProcedures.aspx?ChunkID=102704.
Diabetes Care. “Human Epidermal Growth Factor Enhances Healing of Diabetic Foot Ulcers”, https://care.diabetesjournals.org/content/26/6/1856.full.
American Diabetes Association. “Foot Complications”, https://www.diabetes.org/living-with-diabetes/complications/foot-complications.html.