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7 FAQs About Diabetic Foot Ulcers

Updated: Jul 3

diabetic foot ulcer picture
A picture of a diabetic foot ulcer

A diabetic foot ulcer is a type of wound or sore on your foot. This wound, because of all the ways that diabetes can attack your feet from lowering your circulation, attacking the nerves in your feet, and even changing the shape of your feet and toes over time, can make healing a diabetic foot ulcer an uphill battle. But all is not lost, there are many treatment options for someone with a foot ulcer. Having a diabetic foot ulcer can be a scary, and life-changing experience. I decided to put together some of the most common questions my patients ask me, as a foot doctor, about their diabetic foot ulcer.

1. What are diabetic foot ulcers caused by?

Diabetics are at increased risk of developing a foot ulcer because of all of the ways that diabetes attacks the feet. Both Type I and Type II diabetes can affect your circulation to your feet. Poor circulation in your feet means that your feet are not getting as much blood flow as they should stay healthy. If you're not getting enough blood flow in your feet, then your feet are getting enough oxygen, nutrients, or infection-fighting cells. All of these factors increase your risk of having a diabetic foot ulcer.

Diabetes also attacks the nerves in your feet. This is known as diabetic neuropathy or peripheral neuropathy. Diabetic neuropathy makes it much harder if not impossible for a diabetic to feel their feet. Because of this, someone with diabetic neuropathy won't be able to tell if their skin is injured, or if they stepped on something unless they have a habit of checking their feet daily. Diabetic neuropathy also makes the skin of the feet dryer and makes this skin more prone to forming a callus, which over time the pressure from this callus can increase your risk of developing a foot ulcer.

2. Are diabetic foot ulcers an emergency?

A diabetic foot ulcer is definitely an urgent problem that should be seen by a foot doctor or podiatrist immediately. A diabetic foot ulcer becomes an emergency when there is infection or gangrene. To lower your risk of developing an infection due to your diabetic foot ulcer, or gangrene, you should see your doctor as soon as your notice the foot ulcer.

3. What does a diabetic foot ulcer look like?

Diabetic foot ulcers can look different from person to person, but usually, they will have a round or oval shape. Sometimes they will have drainage, but sometimes not. The color of the base of the ulcer is different too and ranges from red, pink, yellow, white, or purple/black color. Here are some examples:

diabetic foot ulcer pictures

4. Who treats a diabetic foot ulcer?

A podiatrist or foot doctor is one kind of doctor who can treat a diabetic foot ulcer. Foot doctors have specialized training, focused on the foot and leg, and how diseases will show up here as well. Surgical training for podiatrists is at least 3 years long during residency and covers many aspects of surgery including treating diabetic foot ulcers, and limb salvage or saving as much of a foot or leg as possible during infection.

In addition to a podiatrist, someone with a diabetic foot ulcer should regularly be seeing their primary care doctor and any other specialists who are a part of their care team including an endocrinologist, vascular doctor/interventional cardiologist. This is because diabetes affects your body in so many different ways, we need to be sure that you are as healthy as possible in order to heal a diabetic foot ulcer quickly, Healing a diabetic foot wound is a group project and truly takes a village.

5. How long does it take for a diabetic foot ulcer to heal?

This is a difficult question to answer. How fast a diabetic foot ulcer will take to heal depends on so many factors, but these can include:

  • Total volume of the ulcer - This doesn't include just the length and width, but also the depth of the ulcer as well. The higher this number is, the longer it will take the heal.

  • How well your diabetes is being controlled - Your A1C gives us the best idea of how well your blood sugar is being controlled, but daily blood sugar checks are also important. The higher your A1C is, the higher your average daily blood sugar is, and the harder it will be to heal a diabetic foot wound.

  • Circulation - Circulation is critical for healing. If your feet aren't getting enough blood flow, it will be very difficult, if not impossible for a foot ulcer to heal.

  • Location of ulcers - Ulcers over tendons, or with bone exposed take much longer to heal than on other parts of your foot.

  • Amount of pressure the ulcer is under - Pressure on an ulcer forces the ulcer to stay open. Even your foot resting on a mattress, taking a step in or shoe, or standing, can sometimes be too much pressure for a wound and block the healing process.

  • Underlying infection - Infection of the ulcer itself, infection deep in the foot, including bone will cause a diabetic foot ulcer to stay open. It's important that any possible infection is treated in order to give the diabetic foot wound the best chance at healing.

  • Other health problems - Additional health problems like kidney disease or high cholesterol on top of diabetes will make it harder for a diabetic foot ulcer to heal.

  • Smoking - Smoking damages blood vessels, which can lead to poor circulation, and make it very difficult for a diabetic foot ulcer to heal.

In the short term, a diabetic foot ulcer can take several weeks to heel. On average, a typical patient with a diabetic foot wound is looking at several months before the ulcer is closed. Unfortunately, it's not uncommon for diabetic foot ulcers to take over a year to heal.

6. What happens if you don't treat diabetic foot ulcers?

Not treating a diabetic foot ulcer increases your risk of infection. These types of infection include cellulitis (soft tissue infection), osteomyelitis (bone infection), and in severe cases sepsis (infection in your bloodstream, which is life-threatening). Gangrene or necrotizing fasciitis (also commonly known as flesh-eating bacteria) is seen in diabetic foot ulcers as well. The majority of these complications also lead to amputation as well. It is so important, that if you are a diabetic, and see that you have a foot ulcer, to see a doctor immediately. Seeing a foot doctor as soon as possible lowers your risk for infection and amputation.

diabetic foot ulcer prevention

7. How to prevent a diabetic foot ulcer

Some key tips for lowering your risk of getting a diabetic foot ulcer are

Hopefully, this post has helped give you some clarity on diabetic foot ulcers. Have any more questions that I didn't talk about today, leave them in the comments, and I can answer them in another blog post.

Do you have a diabetic foot ulcer and live in Phoenix, AZ? My name is Dr. Tarr, I am a board-certified foot doctor, and I am the owner of Direct Podiatry Arizona in Tempe. To view available appointment times, click the link here.

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About the author

Dr. Sondema N. Tarr, DPM - Board Certified Podiatrist

Hello everyone! My name is Dr. Tarr. I am a foot doctor and also the owner of Direct Podiatry Arizona. To learn more about me, and the practice click below. 

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