Diabetic Foot Ulcer
|Copyright © Nucleus Medical Media, Inc.|
- Repetitive trauma or pressure on the foot
- Puncture wound on the foot
- Objects in the shoe that can damage the skin (such as a small rock)
- Sores, ulcers, or blisters on the foot or lower leg
- Difficulty walking
- Discoloration in feet: black, blue, or red
- Fever, skin redness, swelling, or other signs of infection
- Wound culture to determine if an infection is present
- X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones; to determine if there is evidence of infection in the bones ( osteomyelitis )
- CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body; to evaluate a suspected pocket of pus called an abscess or to look for infections in the bone
- MRI scan —a test that uses magnetic waves to make pictures of structures inside the body; to evaluate a suspected pocket of pus called an abscess or to look for infections in the bone
- Ankle-brachial pressure—a test to determine if blood is flowing well to your feet
- Doppler or arteriographic studies —to assess for adequate blood flow to feet, which is necessary for healing
- Blood glucose and glycohemoglobin test
- Complete blood count to determine if there is an infection—A high white blood cell count may mean that there is an infection.
Blood Sugar Control
- Clean your feet daily. Dry them thoroughly, especially between the toes, before putting shoes and socks on.
- Do not wear garters and tight stockings around the legs.
- You may want to use petroleum jelly or an unscented lotion to moisturize dry, leathery feet. Do not put lotion between the toes. The extra moisture may attract bacteria.
- Inspect your feet daily. Look for sores that you may not be able to feel. Use a mirror or the assistance of another person to see all parts of your feet.
- Your doctor should look at your feet and test the feeling in them at least once a year. If you find a sore at any time, make an appointment to see your doctor right away.
- People with diabetes may have toenails that are brittle and difficult to cut. You may also want to have a foot specialist trim your toenails regularly.
- Buy properly fitted shoes. Some insurance companies will pay for custom-made shoes with inserts. A doctor can give you a prescription for the shoes.
- Avoid smoking.
- Talk to your doctor about exercise. Daily exercise will help to improve blood flow and blood sugar levels.
- Calluses can increase the pressure on the foot and lead to foot ulcers. Have your foot doctor remove any calluses. This could reduce the risk of developing a foot ulcer.
- Ask your doctor if you should use a special infrared thermometer. It can check the temperature of your feet.
American Diabetes Association http://www.diabetes.org/
American Podiatric Medical Association http://www.apma.org/
Canadian Diabetes Association http://www.diabetes.ca/
Podiatrists in Canada http://www.podiatrycanada.org/
Andersen CA, Roukis TS. The diabetic foot. Surg Clin North Am . 2007;87:1149-1177.
Bakker K, Apelqvist J, Schaper NC; International Working Group on Diabetic Foot Editorial Board. Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes Metab Res Rev. 2012;225-231.
Diabetic foot ulcer. DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 22, 2012. Accessed July 31, 2012.
Frykberg RG. Diabetic foot ulcers: pathogenesis and management. Am Fam Physician . 2002;66:1655-1662.
Leung PC. Diabetic foot ulcers-a comprehensive review. Surgeon . 2007;5:219-231.
Ndip A, Bowling F, Stickings D, Rayman G, Boulton AJ. The Diabetic Foot in 2008: an update from the 12th Malvern Diabetic Foot Meeting. Int J Low Extrem Wounds. 2008;7:235-238.
Nelson EA, O’Meara S, Craig D, et al. A series of systematic reviews to inform a decision analysis for sampling and treating infected diabetic foot ulcers. Health Tech Assess . 2006;10.
Nelson EA, O’Meara S, Golder S, et al. Systematic review of antimicrobial treatments for diabetic foot ulcers. Diabet Med . 2006;23:348-359.
Singh N, Armstrong DG, Lipsky BA. Preventing foot ulcers in patients with diabetes. JAMA . 2005;293:217-228.
2/7/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Armstrong DG, Holtz-Neiderer K, Wendel C, Mohler MJ, Kimbriel HR, Lavery LA. Skin temperature monitoring reduces the risk for diabetic foot ulceration in high-risk patients. Am J Med. 2007;120:1042-1046.
2/7/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Lavery LA, Higgins KR, Lanctot DR, et al. Home monitoring of foot skin temperatures to prevent ulceration. Diabetes Care. 2004;27:2642-2647.
4/8/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Löndahl M, Landin-Olsson M, Katzman P. Hyperbaric oxygen therapy improves health-related quality of life in patients with diabetes and chronic foot ulcer. Diabet Med. 2011;28(2):186-190.
- Reviewer: Brian Randall
- Review Date: 09/2012 -
- Update Date: 09/10/2012 -