Updated May 22, 2006

Foot Ulcer

A break in the skin of the foot caused by infection or injury. Because of diabetes-related vascular and nerve disease, such as poor blood circulation and neuropathy, people with diabetes can lose sensation in their feet and thus fail to notice otherwise painful calluses or sores on the bottoms of their feet. Eventually, the skin in the injured area breaks down, causing ulceration. If untreated, the underlying bone can become infected. When the infection is very deep, a part of the foot, or even as much as the foot and part of the leg, may need to be removed to save the person’s life. In fact, more than half of all foot amputations done in the United States are performed in people with diabetes.

Doctors can treat foot ulcers by draining any pus that has accumulated in them, removing dead or diseased tissue, and administering antibiotics. To help ulcers heal, they may use custom-made orthotic devices to take weight or pressure off the ulcer. In extreme cases, surgery may be necessary to restore adequate circulation to the feet.

To prevent foot ulcers, it’s important to practice proper foot care. Here are a few important tips:

• Keep your feet clean and dry, especially between the toes.
• Examine your feet daily under good lighting. If you notice cold spots, which can indicate decreased circulation, sores, or signs of infection (redness, swelling, or areas of increased warmth), call your doctor. If you have trouble seeing your feet, use a mirror or ask someone to help you.
• Never go barefoot except in the shower or in bed.
• Wear only properly fitting shoes.
• Always check the insides of your shoes for objects such as stones or paper clips before putting them on.
• Avoid subjecting your feet to extremely hot or cold temperatures. Never apply any kind of heat to your feet. And never test the temperature of bath water using your feet; use a bath thermometer or your hand instead.

In addition to proper foot care, you can also help keep your feet healthy by quitting smoking (smoking can decrease the circulation in your feet) and keeping your blood sugar levels in target range.

This article was written by Robert S. Dinsmoor, a Contributing Editor of Diabetes Self-Management.

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