Diabetic ulcers usually occur on the foot or lower part of the leg in a person with diabetes. The outer layers of skin break down and are slow to heal, leaving deeper tissue exposed. People with diabetes are more likely to get this condition because the illness can cause poor blood supply to the feet and lower limbs, which is often coupled with reduced sensation in the skin. Diabetic ulcers can be prevented with good foot care, but once present they should be treated by a doctor straight away to avoid infection.
People with Type I or Type II diabetes mellitus may acquire diabetic ulcers. Over time, if blood sugar levels are not strictly controlled, higher amounts of sugar in the blood damage the nerves that supply sensation to the skin of the feet and lower parts of the legs. This damage means that sensation is reduced, a condition known as peripheral neuropathy. The risk of this happening increases with age and the overall length of time someone has had diabetes.
Having peripheral neuropathy means that the foot and lower leg feel relatively numb, with the result that one might not notice a small injury. This could be a minor cut, perhaps caused by stepping on something sharp. Once the injury has taken place, loss of feeling tends to make things worse, because there is no foot pain to alert one to further damage. This means that the injured foot is likely to be walked upon as normal, causing it to worsen and leading to ulceration.
In addition to nerve damage, diabetes may compromise the function of blood vessels supplying the feet and lower leg. Fatty deposits may build up inside the walls of arteries, narrowing the space inside and decreasing blood flow. As for nerve damage, the risk of this happening increases with age and length of illness. It is also greater in smokers, the inactive and obese, and those who have raised cholesterol and high blood pressure. The resulting poor blood supply means that diabetic ulcers are slow to heal and infection might set in which, if allowed to spread, could lead to amputation.
Prevention is the best plan for diabetic leg ulcers and foot ulcers. Carefully controlling blood sugar, and altering any factors which can lead to furring of the arteries, such as smoking, are part of prevention. Foot care is extremely important, with regular inspection both by the patient and by professionals needed to check for any minor injuries before they develop into ulcers. If prevention has failed, diabetic ulcer treatment needs to begin immediately. Existing diabetic ulcers should be cleaned and dressed by medical staff, and any infection attended to with antibiotics.
