How to Recognize, Prevent and Treat Diabetic Ulcers with Dr. Brad Backoff

If you have diabetes, you’re at risk for developing a diabetic wound. Podiatric physicians at Ankle & Foot Care Centers urge people with diabetes to stay on top of their foot health to avoid complications such as ulcers, which could develop into worse conditions if left untreated.

Dr. Bradley Backoff, a podiatric physician at Ankle & Foot Care Centers, says between 10 and 20 percent of diabetics experience a diabetic ulcer.

Dr. Backoff discusses what diabetic ulcers are, how they’re formed, how to recognize them early on and how to prevent and treat them.

What are diabetic ulcers?

A diabetic foot ulcer is an acute or chronic wound, which is a result of abnormal pressure and shear forces, generally found on the boney prominences of the foot.

“In addition to these forces, poor blood flow and neuropathy, a loss of feeling or sensation in the limbs, are thought to play a major role in decreasing the body’s ability to repair itself, contributing to the formation of an ulcer,” explains Dr. Backoff.

What are the risk factors, signs and symptoms?

In addition to diabetes, some common risk factors include decreased blood flow to the feet, neuropathy, abnormal foot structure, poor shoe selection, kidney problems, edema, which is the swelling of the legs and feet, and smoking.

A diabetic ulcer typically starts out as a callous, which forms as a result of a pressure point.

“Any diabetic with a callous, blister, or wound on the foot or leg should have it examined as soon as possible,” says Dr. Backoff. “Some other common symptoms individuals may notice are an increase in pain when they previously lacked sensation, a foul odor, or drainage in the socks or shoes.”

When left untreated, ulcers can lead to other complications, such as infection or the formation of an abscess, which is the collection of bacteria that requires surgical drainage. Another serious condition that can result is osteomyelitis, an infection of the bone. In the most serious cases, ulcers can lead to gangrene and the need for amputation of the lower extremities.

“Around 80 percent of amputations in the diabetic foot result from the presence of, or complications from an ulcer,” explains Dr. Backoff.

How do you prevent and treat ulcers?

Ulcers may be prevented by maintaining good control of blood sugars, wearing proper footwear, performing daily foot inspections and visiting a primary care physician and podiatrist on a regular basis.

“Diabetics should have a comprehensive diabetic foot exam to assess their foot health and determine their risk level,” says Dr. Backoff.

“Generally speaking, diabetic patients should see a podiatrist at least once a year, but patients who have a foot deformity, neuropathy, or peripheral vascular disease are at risk for ulcers, and should be seen more often.”

Ulcers are treated with a combination of local wound care and offloading, which refers to taking weight off the pressure points by placing an individual in a special shoe, boot, cast or bandage.

Vascular surgery may be necessary if the blood flow is poor and prevents the ulcers from healing. If there is an active infection, antibiotics, or in severe cases, amputation, may be necessary.

“Staying informed and aware of one’s health and seeking out treatment is the best thing anyone can do, but especially diabetics who are at risk for ulcers and other serious complications. Awareness is crucial for prevention of conditions associated with diabetes.”