What’s that Sore? Diabetic Foot Ulcer 101

Diabetic Foot Ulcer

Do you have a sore on your foot that’s been there for a while without improving? If you have diabetes, chances are you’ve developed a diabetic foot ulcer.

In that case, it’s important to understand what the ulcer is, what caused it, what risks it presents, and how you can treat it.

What’s a diabetic foot ulcer?

According to the American Podiatric Medical Association, diabetic foot ulcers affect approximately 15 percent of people with diabetes. They’re open sores on the feet from the ankle down. Most develop on the bottom of your feet, particularly under your big toe or the ball of your foot. Typically, ulcers begin with foot injuries, such as cuts or blisters.

These wounds can linger for weeks without improvement. Between 14-24 percent of ulcers end with amputation.

Who’s at risk?

Some individuals face a higher ulcer risk. Native-American, African-American, and Hispanic patients are more likely to develop ulcers, as are men and patients over 60. Additionally, individuals with vision problems, chronic kidney disease, and obesity experience greater risk. Heart disease and high blood sugar also impede your body’s ability to heal and fight infection.

Some behaviors also make foot ulcers more likely to develop. Alcohol consumption, poorly-trimmed toenails, tobacco use, poor hygiene, and wearing poorly-fitted shoes (ones without enough cushioning or room for your toes) can promote ulcer formation.

What causes ulcers?

In addition to high blood pressure and injury, there are other causes of ulcer development and poor healing. In fact, nearly 43 percent of ulcers occur in people with both of these conditions:

Diabetic neuropathy: This common complication involves nerve damage in your feet, frequently leading to total sensation loss.  This makes it harder for you to notice any scrapes, cracks, or blisters.

Peripheral artery disease (PAD): This condition blocks arteries in your legs, strictly limiting blood flow. Without proper circulation, your body can’t get enough oxygen to the wound for healing.

Are ulcers life-threatening?

They can be. Without treatment, infectious bacteria can damage and kill your skin and tissues. It can also infect your blood stream or cause a bone infection (osteomyelitis), both of which can lead to sepsis.

If you have PAD, an untreated diabetic foot ulcer can also lead to ischemia where tissue dies, becomes gangrene, potentially leading to death.

What can you do?

Seek treatment for a diabetic foot ulcer within six weeks. Waiting longer drastically reduces your chances to heal.

Your doctor will prescribe medication to prevent or treat infection and will remove dead skin or tissue (debridement). He or she will tell you to alleviate pressure from your foot by wearing a brace, specialized cast, or using a wheelchair or crutches. Control your blood sugar levels (between 80-130 mg/dL before eating and under 180 mg/dL after eating) and monitor your feet daily for any injuries or changes.

With this knowledge, you can keep track of any lingering wounds on your feet and pursue your best treatment options. If you have any questions about a diabetic foot ulcer, please contact the Amputation Prevention Centers of America.

How Oxygen Therapy Works | HBO Therapy

HBO Therapy
If you have a foot ulcer or leg wound that is linked to diabetes, you likely know how long these sores can linger. And, the longer they take to heal, the more vulnerable you are to infection and other risks. Speeding up the healing process is better for your health all around.

That’s where hyperbaric oxygen (HBO) therapy comes in. Research and clinical experiences show this therapy can reduce the presence of certain non-healing wounds. It can also speed up how quickly they improve. The key is increasing the amount of oxygen that reaches injured tissue.

How is HBO Therapy performed?

HBO therapy exposes patients to 100 percent oxygen inside a pressurized chamber that has up to three times the air pressure of our everyday environment. During the session, the lungs are able to take in more oxygen than they usually can, funneling it into the blood stream. That’s critical because more oxygen equals more healing.

What does oxygen do?

Your body’s tissues need oxygen to function properly, and they also need it to fix any problems, such as wounds or sores. During HBO therapy, oxygen dissolves into the body’s fluids, including blood, plasma, and central nervous system fluids. The oxygen can easily be transported through the circulatory system. Once it reaches a foot ulcer or leg wound, oxygen increases the ability of white blood cells to kill bacteria.  It also helps to fight infection, and reduce swelling. Additionally, it helps the body grow new blood vessels that will continue to help oxygen reach injured tissue.

How good are the results?

Recent clinical trials show HBOT can be an effective tool in improving the condition of long-lasting foot ulcers or leg wounds. The Journal of Anesthesiology Clinical Pharmacology conducted a study that followed 30 individuals with chronic non-healing wounds for 30 days. The participants treated with HBO therapy saw a 59% reduction in wound area. Patients treated with more conventional therapies only saw a 26% improvement.

Other studies also showed HBO therapy can improve the condition of these wounds. An additional 12 randomized trials involving 577 people, many of whom reported having diabetic foot ulcers, showed positive results. Based on the study outcomes, patients who received HBO therapy saw foot ulcer improvement at six weeks. HBO also reduced the size of leg vein wounds.

Contact the Amputation Prevention Centers of America if you have any questions regarding HBO therapy.