The numbers show just how common foot ulcers are for Americans – about 37 million people in the United States currently live with diabetes, and 15 to 20% of them will develop a related sore or wound on their foot that requires advanced care to heal.
Geny George, MD, an endocrinologist with Hartford HealthCare Medical Group in Bridgeport, said tracking blood sugar levels is the first step to avoiding foot ulcers and preventing amputation in the future.
“Poorly controlled diabetes results in foot ulcers from a combination of factors such as decreased sensation in the foot, poor circulation and foot deformities,” she said. “These factors all lead to ongoing trauma, callus formation and ulceration. Wounds then do not heal well on their own due to decreased blood flow to the foot. Healing is also impacted if blood glucose levels remain high.”
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By the numbers
National statistics show that:
- Diabetes-related wounds are the leading cause of limb loss
- Ten Americans undergo amputation every hour
- Up to 55% of diabetic patients who have a leg amputated will require amputation of the second leg
- Half of those living with an amputation will die within two or three years
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Foot checks
Anyone with diabetes should do daily checks of their feet – or ask a family member or friend for help – to spot sores. To avoid them altogether, Dr. George suggested:
- Stopping smoking
- Having comprehensive foot exams at least four times a year by your healthcare provider
- Keeping feet clean, and toenails trimmed
- Wearing supportive socks and shoes
- Improving circulation through healthier eating and regular exercise
Advanced care
If you notice a sore or ulcer, typically on the bottom of the foot, Dr. George suggests asking for a referral to a podiatrist for advanced care.
The management plan for a foot ulcer includes:
- Infection prevention
- Eliminating pressure on the sore, a process called “off-loading”
- Removing dead skin and tissue, called “debridement”
- Using special medication and dressings on the ulcer
- Managing blood glucose levels and other health problems
“The prognosis is good if the ulcers are identified early and optimal treatment is initiated,” Dr. George said. “Unfortunately, if someone does not take care of their glucose levels or the foot ulcers, they can have detrimental effects like gangrene, osteomyelitis, permanent deformity and infection spreading that leads to amputation of the foot.”
