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How to Prevent and Treat Diabetic Foot Ulcers



Most people who have diabetes know they need to monitor their bodies and overall health condition.

They know that it is important keep an eye on their blood sugar levels, and monitor what they eat to help them stay safe and healthy.

But not everyone knows how important it is that people who have Type 1 or Type 2 diabetes regularly examine their feet for sores and ulcers.

That’s because:

  • 15 percent of people who had diabetic foot ulcers died within less than a year.
  • The 5-year mortality rate for a diabetic who develops a foot ulcer is greater than that of breast cancer and prostate cancer combined.
  • Of the 435 million people worldwide who are estimated to have diabetes, 19 to 34 percent will experience a foot ulcer during their lifetime.

"Diabetic foot ulcers are the leading cause of diabetic-related amputations. The good news is they are preventable in many cases and treatment is possible with methods like total contact casting and hyperbaric oxygen therapy," says Christopher Barrett, DPM, CWS, program director of the Crozer Health Centers for Wound Healing & Hyperbaric Medicine.

What it Means to Have a Diabetic Foot Ulcer

A diabetic foot ulcer is an open sore or wound that forms when skin tissue breaks down and exposes the layers underneath. These ulcers typically occur under the big toes and balls of the feet.

"Anyone with diabetes can develop foot ulcers, but some may be at higher risk than others," says Barrett. "Those of Native American, African-American or Hispanic descent are at a greater risk for these ulcers. Older men, people who use insulin, and those who have kidney, eye or heart disease related to diabetes are also at a greater risk."

Some common causes of diabetic foot ulcers include:

  • Poor circulation
  • High blood sugar
  • Hyperglycemia
  • Foot deformities
  • Nerve damage.

Reducing Your Risk of Foot Ulcers

It may be easier than you think to prevent diabetic foot ulcers. A good first step is to visit your healthcare provider and discuss your risk of foot ulcers.

"Your healthcare provider should perform a full foot exam at least once a year. More visits may be needed depending on your condition," says Dr. Barrett. "At an appointment, your doctor can evaluate your risk for foot ulcers or wounds and offer specific strategies for prevention."

You can prevent foot ulcers by changing some behaviors, such as reducing your alcohol intake or quitting smoking. If you have high cholesterol or elevated blood sugar, talk to your doctor about dietary changes that can address these issues.

Check your feet every day for redness, cuts, blisters or ulcers. If you notice anything out of the ordinary, no matter how small, see your doctor as soon as possible.

Taking a Breath for Treatment

If you have diabetes, your body struggles to properly heal wounds. Diabetes causes high blood glucose levels which can slow blood circulation. Poor blood circulation makes it harder for your body to take care of wounds because your blood delivers less oxygen to healing tissue.

Fortunately, treatment options like hyperbaric oxygen therapy (HBOT) may help wounds heal faster. HBOT uses pressurized oxygen as a way to stimulate your body's healing processes. "When you have a wound, your body needs even more oxygen than it does normally to help heal and fight off potential infections," says Dr. Barrett. "HBOT works by increasing the amount of oxygen dissolved in the plasma, which gives your tissues what they need to heal the wound."

HBOT is typically done in a series of sessions over a few weeks until there's an improvement in the healing of the wound. In a session, you lie on a gurney and are moved into a clear, tube-shaped chamber for about two hours. Pressurized pure oxygen is then pushed through the chamber to speed the healing process.

When in the chamber, you are able to see everything around you outside, communicate with the technician overseeing your therapy, watch television or relax. The risks of HBOT are minimal. You might notice your ears pop, such as when you travel in a plane or up a mountain, from the air pressure when you first enter the chamber.

"If you or a loved one are dealing with a wound that won't heal like a diabetic foot ulcer, talk your doctor," says Dr. Barrett. "Understanding the risks and treatment options can make all the difference in preventing and treating foot ulcers from becoming a bigger issue."

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