Diabetic Foot Ulcer

What Are Diabetic Wounds?

People with diabetes have a variety of health risks to manage and mitigate, and among them are diabetic wounds. These usually appear in the form of an ulcer, typically on the feet and lower extremities. However, even minor cuts and scrapes can be of concern to diabetics and, if untreated, can turn into open wounds that could lead to (in extreme cases) limb amputations or even be fatal.

Because diabetes produces enzymes and hormones that cause your immune system to be less effective, diabetics are more prone to infections. Uncontrolled diabetes can also lead to poor circulation, which makes it more difficult for the body to deliver nutrients to wounds to aid in the healing process. These are primary differentiators that make diabetic wounds much slower to heal and more serious than wounds on people without the disease.

What Causes Diabetic Wounds?

While all wounds incurred by someone with diabetes should be handled with care (regardless of its severity), foot wounds or ulcers pose a significant and common ongoing problem. Over time, many people with diabetes lose feeling in their extremities, especially in their feet. Because of this loss of sensation, there is also a loss of pain as a result.

While the lack of pain may seem like a positive thing on the surface, it poses a real threat to the health of a diabetic who is no longer receiving warning signs when something goes wrong on their extremities. A small wound on the foot can go unnoticed, causing them to develop into a foot ulcer that is more significant and more susceptible to infection.

How Can You Prevent Diabetic Wounds?

While it may be difficult to prevent wounds from happening, there are several things that can be done to lessen the impact of these injuries. Here are some things diabetics should consider to improve the healing process should a wound occur:

Manage Blood-Glucose Levels

By managing blood-glucose levels, instances of non-healing wounds should be less frequent.

  • Diet: Attempt to eat well-balanced meals that include a mixture of proteins, fats, fruits and/or vegetables, and starches with reasonable portion sizes. It is also important to reduce carbohydrate intake, as they have a significant effect on blood sugar levels. It is also important to coordinate meals and medications, as too little food in proportion to diabetes medications can result in hypoglycemia.

  • Exercise: If possible, getting physical activity can be a huge benefit to managing blood-glucose levels. Exercise prompts muscles to use glucose for energy and also helps your body use insulin more efficiently. It is important to discuss an exercise plan with your doctor to determine an approach that is appropriate for you and your fitness level.

  • Medication: Stay consistent with your insulin treatments and other prescribed medications to manage your blood sugar.

Foot Care

As feet pose the biggest risk for diabetic wounds, it is important to provide extra attention and effort into foot care. The feet should be inspected on a daily basis for overall skin health and any developing cuts, abrasions, or wounds. When problem areas can be identified early, treatment can begin before the wound worsens. This provides the best chance for an efficient healing process.

Other preventative measures can go a long way when it comes to foot care.

  • Avoid walking barefoot to avoid potential puncture or cut hazards. Instead, wear comfortable shoes that support and protect your feet. You should also inspect the inside of your shoes daily to ensure there are no debris present or breakdowns within the shoe that could cause additional friction.
  • Foot health should be maintained by washing them daily, patting the skin dry before applying moisturizer, and carefully trimming toenails as necessary (best done by someone else).

How to Care for Diabetic Wounds

Given the more serious nature of wounds on diabetic patients, it is important to have professional help to manage the process at the onset of any foot injury. This could come in the form of a wound-care center, your doctor, or an in-home nurse practitioner (as we provide at Keystone Wound Care). 

A wound should receive treatment as soon as possible after the injury occurs. The process is relatively simple:

  1. Clean the wounded area with cool, running water (either filtered, boiled and cooled, or distilled)
  2. Dry the area with a clean towel using gentle pats
  3. Apply antibiotic ointment to the wound
  4. Cover the wound with a sterile dressing or bandage

Upon meeting with a care provider, a more formal cleaning and bandaging will be conducted. More advanced foot ulcers may need a proper debridement to clean the wound and give it a suitable environment for healing. For any type of wound, the dressing should be changed regularly (2-3 times daily) to help it remain fresh and free from germs and bacteria.

How to Heal a Diabetic Foot Wound

Healing from a diabetic wound is a matter of keeping the affected area clean, free from friction, and covered appropriately. You should also work diligently to manage glucose levels, and leverage proper nutrition to amplify the healing process. Your healthcare provider should be able to help you navigate or manage your daily treatment, and provide you with the necessary materials for maintenance.

Beyond the basics, there are evolving technologies such as regenerative bandages, engineered biomaterials, and stem cell treatments that could play an integral role in healing diabetic wounds in the future. In the meantime, there are a number of home remedies that can be considered to help treat diabetic wounds within comprehensive treatment plans, including:

  • Honey (safe and conservative local treatment)
  • Aloe vera (analgesic, anti-inflammatory, and soothing properties)
  • Turmeric (a natural antiseptic and antibiotic agent)
  • Coconut oil (anti-bacterial, anti-inflammatory, moisturizing and healing properties)

Conclusion

Wound care for diabetics can be arduous and inherently comes with higher stakes. Still, a proactive approach to wound care and a focus on nutrition and the health of your lower extremities can offset many of the potential complications that one might face. As a diabetic, all wounds should be taken seriously and treated quickly and diligently until healed. Be sure to consult a medical professional to put together an appropriate plan for managing your wound. At Keystone Wound Care, our nurse practitioners are well-versed with treating wounds of all kinds, including diabetic foot ulcers, and can provide the necessary in-home care to promote healing of the affected area.

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