Diabetic Foot. On this page Basics Summary Start Here Learn More. Learn More Living With Related Issues. See, Play and Learn Images. Research Clinical Trials Journal Articles. Resources Find an Expert. For You Patient Handouts. What is diabetes? How does diabetes cause foot problems?

But there's a lot you can do to prevent a foot wound from becoming a major health problem. How can I protect my feet if I have diabetes?

Good foot care for people with diabetes includes: Checking your feet every day. Look for cuts, redness, and other changes in the skin and toenails, including warts or other spots that your shoes could rub.

Make sure to check the bottoms of your feet too. Washing your feet every day. Use warm water and soap. Don't soak your feet because that can dry out your skin. After you dry your feet, you can use talcum powder or cornstarch between your toes. They soak up moisture that can cause infection.

If you use lotion, don't apply it between your toes. Asking your doctor how to remove corns and calluses safely. Thick skin on your feet can rub and lead to sores. But removing it the wrong way could damage your skin. So you don't want to cut the skin or use medicated pads or liquid removers.

Trimming your toenails straight across with a clipper. If it's hard for you to trim your own toenails, or if they're thick or curve into the skin, have a podiatrist foot doctor do it for you. Always wearing well-fitting shoes and socks or slippers to protect your feet when walking. You don't want to walk barefoot, even indoors.

And be sure your shoes are smooth inside. A seam or pebble could rub your skin raw. Protecting your feet from heat and cold. Working closely with a medical doctor or endocrinologist to accomplish this will enhance healing and reduce the risk of complications.

A majority of noninfected foot ulcers are treated without surgery; however, when this fails, surgical management may be appropriate. Healing time depends on a variety of factors, such as wound size and location, pressure on the wound from walking or standing, swelling, circulation, blood glucose levels, wound care, and what is being applied to the wound.

Healing may occur within weeks or require several months. The best way to treat a diabetic foot ulcer is to prevent its development in the first place.

Recommended guidelines include seeing a podiatrist on a regular basis. He or she can determine if you are at high risk for developing a foot ulcer and implement strategies for prevention.

Reducing additional risk factors, such as smoking, drinking alcohol, high cholesterol, and elevated blood glucose are important in the prevention and treatment of a diabetic foot ulcer.

Wearing the appropriate shoes and socks will go a long way in reducing risks. Your podiatric physician can provide guidance in selecting the proper shoes.

Learning how to check your feet is crucial in noticing a potential problem as early as possible. Inspect your feet every day—especially between the toes and the sole—for cuts, bruises, cracks, blisters, redness, ulcers, and any sign of abnormality. Each time you visit a health care provider, remove your shoes and socks so your feet can be examined.

Adapted from APMA. Updated visitor policies. Other Michigan Medicine Sites About Michigan Medicine UofMHealth. org Medical School Nursing Find a Clinical Trial. Frequently Asked Questions: Diabetic Foot Ulcers. Ulcers are formed as a result of skin tissue breaking down and exposing the layers underneath.

All people with diabetes can develop foot ulcers, but good foot care can help prevent them. Treatment for diabetic foot ulcers varies depending on their causes. One of the first signs of a foot ulcer is drainage from your foot that might stain your socks or leak out in your shoe.

Unusual swelling, irritation, redness, and odors from one or both feet are also common early symptoms. The most visible sign of a serious foot ulcer is black tissue called eschar surrounding the ulcer.

This forms because of an absence of healthy blood flow to the area around the ulcer. Partial or complete gangrene , which refers to tissue death due to infections, can appear around the ulcer.

In this case, odorous discharge, pain, and numbness can occur. Signs of foot ulcers are not always obvious. Talk with your doctor if you begin to see any skin discoloration, especially tissue that has turned black, or feel any pain around an area that appears callused or irritated. Your doctor will likely identify the seriousness of your ulcer on a scale of 0 to 5 using the Wagner Ulcer Classification System :.

Poor circulation can also make it more difficult for ulcers to heal. High glucose levels can slow the healing process of an infected foot ulcer, so blood sugar management is critical. People with type 2 diabetes and other ailments often have a harder time fighting off infections from ulcers.

Nerve damage is a long-term effect and can lead to a loss of feeling in your feet. Damaged nerves can feel tingly and painful. Nerve damage reduces sensitivity to foot pain and results in painless wounds that can cause ulcers. All people with diabetes are at risk for foot ulcers, which can have multiple causes.

Some factors can increase the risk of foot ulcers, including:. Stay off your feet to prevent pain from ulcers. Pressure from walking can make an infection worse and an ulcer expand.

Doctors can remove foot ulcers with a debridement, the removal of dead skin or foreign objects that may have caused the ulcer. An infection is a serious complication of a foot ulcer and requires immediate treatment. Not all infections are treated the same way.

Tissue surrounding the ulcer may be sent to a lab to determine which antibiotic will help. If your doctor suspects a serious infection, they may order an X-ray to look for signs of bone infection.

Your doctor may prescribe antibiotics, antiplatelets, or anticlotting medications to treat your ulcer if the infection progresses even after preventive or antipressure treatments. Many of these antibiotics attack Staphylococcus aureus , bacteria known to cause staph infections, or ß-haemolytic Streptococcus , which is normally found in your intestines.

Talk with your doctor about other health conditions you have that might increase your risk of infections by these harmful bacteria, including HIV and liver problems.

Your doctor may recommend that you seek surgical help for your ulcers. A surgeon can help alleviate pressure around your ulcer by shaving down the bone or removing foot abnormalities such as bunions or hammertoes. You will likely not need surgery on your ulcer.

The ulcer should be red or pink. Other methods the provider may use to remove dead or infected tissue are: Put your foot in a whirlpool bath. Use a syringe and catheter tube to wash away dead tissue. Apply wet to dry dressings to the area to pull off dead tissue.

Put special chemicals, called enzymes, on your ulcer. These dissolve dead tissue from the wound. Order hyperbaric oxygen therapy helps deliver more oxygen to the wound. Taking Pressure Off Your Foot Ulcer. Foot ulcers are partly caused by too much pressure on one part of your foot.

Be sure to wear shoes that do not put a lot of pressure on only one part of your foot. Wear shoes made of canvas, leather, or suede. Don't wear shoes made of plastic or other materials that don't allow air to pass in and out of the shoe.

Wear shoes you can adjust easily. They should have laces, Velcro, or buckles. Wear shoes that fit properly and are not too tight. You may need a special shoe made to fit your foot. Don't wear shoes with pointed or open toes, such as high heels, flip-flops, or sandals.

Wound Care and Dressings. Care for your wound as instructed by your provider. Other instructions may include: Keep your blood sugar level under good control. This helps you heal faster and helps your body fight infections.

Keep the ulcer clean and bandaged. Cleanse the wound daily, using a wound dressing or bandage. Try to reduce pressure on the healing ulcer. Do not walk barefoot unless your provider tells you it is OK.

Good blood pressure control , controlling high cholesterol , and stopping smoking are also important. Your provider may use different kinds of dressings to treat your ulcer. Your provider will tell you how often you need to change the dressing. You may be able to change your own dressing, or family members may be able to help.

A visiting nurse may also help you. Other types of dressings are: Dressing that contains medicine Skin substitutes Keep your dressing and the skin around it dry. When to Call the Doctor. Call your provider if you have any of these signs and symptoms of infection: Redness, increased warmth, or swelling around the wound Extra drainage Pus Odor Fever or chills Increased pain Increased firmness around the wound Also call if your foot ulcer is very white, blue, or black.

Alternative Names. Minus Related Pages. Feeling No Pain Some people with nerve damage have numbness, tingling, or pain, but others have no symptoms. Amputation: What to Know. Read about how you can: Prevent diabetes-related amputations Recover from a diabetes-related amputation Care for your mental health after an amputation.

Could You Have Nerve Damage? Anyone with diabetes can develop nerve damage, but these factors increase your risk: Blood sugar levels that are hard to manage Having diabetes for a long time, especially if your blood sugar is often higher than your target levels Being overweight Being older than 40 years Having high blood pressure Having high cholesterol Nerve damage, along with poor blood flow—another diabetes complication—puts you at risk for developing a foot ulcer a sore or wound that could get infected and not heal well.

Smoking reduces blood flow to the feet. Follow a healthy eating plan , including eating more fruits and vegetables and less sugar and salt. Get physically active —10 to 20 minutes a day is better than an hour once a week.

Take medicines as prescribed by your doctor. Tips for Healthy Feet Get to the bottom of any foot problems by using a mirror or asking for help. See your regular doctor or foot doctor right away: Pain in your legs or cramping in your buttocks, thighs, or calves during physical activity. Tingling, burning, or pain in your feet.

Loss of sense of touch or ability to feel heat or cold very well. A change in the shape of your feet over time. Loss of hair on your toes, feet, and lower legs. Dry, cracked skin on your feet. A change in the color and temperature of your feet. Thickened, yellow toenails.

A blister, sore, ulcer, infected corn, or ingrown toenail. Tips for Healthy Feet infographic Diabetes Foot Problems: When to See Your Doctor infographic How Diabetes Can Affect Your Body Infographic Your Diabetes Care Schedule Diabetes Features CDC Diabetes on Facebook CDCDiabetes on Twitter.

Last Reviewed: April 11, Source: Centers for Disease Control and Prevention. Facebook Twitter LinkedIn Syndicate. Not all physicians need to be capable of treating diabetic foot ulcers themselves, but it is extremely important to be knowledgeable enough to perform an initial evaluation, refer patients promptly, and help with follow-up of patients with healing wounds.

Ingrid Kruse, DPM, is a staff podiatrist at the VA San Diego Healthcare System and a clinical instructor in the Department of Family Medicine at the University of California, San Diego UCSD Medical School.

Steven Edelman, MD,is a professor of medicine at the UCSD School of Medicine and founder and director of Taking Control of Your Diabetes, a nonprofit organization to educate and motivate people with diabetes.

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Volume 24, Issue 2. Previous Article Next Article. Article Navigation. Departments April 01 Evaluation and Treatment of Diabetic Foot Ulcers Ingrid Kruse, DPM ; Ingrid Kruse, DPM. This Site. Google Scholar. Steven Edelman, MD Steven Edelman, MD.

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