Patients with diabetes are prone to the development of foot ulcers. After years of elevated blood sugar, both nerves and small blood vessels in the feet are damaged. Patients therefore do not feel small injuries occur, and damage to the circulation predisposes people to the development of wounds that may not heal. Diabetes also affects the immune system, leading to an increase chance of infection of foot ulcers.
Ulcers can form on the feet of people with diabetes, usually after an injury or in places that receive constant pressure, such as the ball of the foot. Further testing can be done to assess the circulation of the foot, and to determine the extent of the loss of sensation.
Because pain from infection or enlarging of an ulcer might not be felt, diabetic foot ulcers need to be closely monitored for progression or infection. Calluses on the foot or around the wound should also be monitored regularly and treated when necessary. In some cases, alterations can be made to footwear to promote healing. Topical medications can be applied to encourage wound healing.
Diabetic ulcers may become deep or infected. In cases of bone infection, long courses of intravenous antibiotics may be required. In some cases amputation of the affected toe or even the foot may be necessary.