Newsletters About Diabetes 

PREVENTING FOOT ULCERS FOR DIABETES PATIENTS

3/11/2008
As many as one in four diabetic people with diabetes will develop a foot ulcer

Preventing Foot Ulcers For Diabetes Patients

As many as one in four diabetic people with diabetes will develop a foot ulcer in their lifetime. Diabetic foot ulcers can become infected, cause disability, and ultimately lead to limb amputation.
Researchers searched online for recent diabetes medical articles on diabetic foot ulcers. They found 165 diabetes articles published between 1980 and 2000.
The leading cause of diabetes foot ulcers is peripheral neuropathy (nerve damage). Pressure on the sole of the diabetic’s foot is another cause. Repeated rubbing against the diabetic’s foot can lead to ulcers, as can injuries (caused by things like cutting toenails), especially from falls. People with diabetes may have problems with wound healing, so the diabetic’s ulcers don’t get better.
Doctors taking care of diabetic patients with diabetes should be aware of their risk factors. These include previous diabetes foot ulcers, previous amputation, having diabetes for a long time, trouble controlling blood glucose, and vision problems. Diabetic’s feet should be examined for problems such as calluses, hammertoes, and bunions. Doctors should check joints for flexibility. They should look for dry skin, fissures (cracks), and other skin problems. They also should check that the diabetic patient’s shoes fit well.
Loss of feeling in the diabetic’s feet can keep people from realizing they're getting an ulcer. Several tests are used to check for loss of feeling. The most common is the monofilament test. The tester gently touches parts of the diabetic’s foot with a thin plastic thread to find areas of reduced feeling. Other devices, such as tuning forks, use vibration to test for feeling.
Helping diabetic patients understand the causes and treatments lowered the risk of foot ulcers and limb amputations.
A one day workshop on foot care for doctors and nurses helped diabetic patients take better diabetic care for themselves. Published guidelines for doctors recommend that every patient with diabetes have a yearly foot examination.
Tighter blood glucose control leads to a lower risk of peripheral neuropathy. Stopping smoking may also help the diabetic patient. Some studies found that people with diabetes who smoke are at higher risk for foot ulcers and amputation. Referrals to podiatrists can get the diabetic patients needed treatment. Specially made diabetes shoes may possibly help. Diabetic patients under the care of podiatrists had fewer deep ulcers. Patients with diabetes under the care of multidisciplinary teams were at lower risk for amputation.
In summary, diabetic patients must take seriously the need for proper foot care. With proper foot maintenance and care a diabetes patient may live a long and productive life.