Diabetic pressure ulcers, also known as diabetic foot ulcers, are open sores or wounds, commonly found on the feet, that arise due to complications from diabetes. These ulcers can lead to severe infections and, in extreme cases, even amputation if not properly managed. Preventing these ulcers involves understanding and mitigating the risk factors associated with their development.
What are the possible risk factors for diabetic pressure ulcers?
Risk factors related to diabetic pressure ulcers are explained in this article by Delhi NCR’s top general and laparoscopic surgeon for foot ulcers Dr Amita Jain.
Poor Blood Circulation
Diabetes is known to cause vascular issues, where blood flow to certain body parts—especially the extremities—is reduced. This poor circulation limits the amount of oxygen and essential nutrients reaching the skin and tissues, which hinders wound healing and increases the risk of ulcer formation. When blood vessels narrow or become blocked, it makes it much easier for pressure ulcers to form, as the cells don’t receive what they need to repair and regenerate.
Neuropathy (Nerve Damage)
Neuropathy, a condition resulting from prolonged high blood sugar levels, can lead to nerve damage, most often affecting the feet and lower limbs. Neuropathy impairs a person’s ability to feel pain, heat, or cold. Because of this, small injuries like cuts, blisters, or pressure spots can go unnoticed and untreated, creating conditions where ulcers are more likely to develop. For diabetics, neuropathy is a significant risk factor for pressure ulcers since minor injuries can worsen without early intervention.
Hyperglycemia (High Blood Sugar Levels)
Consistently high blood sugar levels can slow down the body’s natural healing process. Hyperglycemia impairs white blood cell function, reducing the immune response needed to fight off infection, a common complication with pressure ulcers. High blood sugar also creates an environment where bacteria can flourish more easily, increasing the likelihood of infected ulcers. Diabetics with poor blood sugar management are at a much higher risk for both developing ulcers and experiencing complications in ulcer healing.
Foot Deformities
Foot deformities, such as bunions, calluses, and hammertoes, are more common in people with diabetes due to changes in bone and joint structures caused by prolonged high blood sugar levels. These deformities can lead to areas of increased pressure on certain parts of the foot, causing skin breakdown and making it easier for ulcers to form. Diabetic foot deformities can also limit mobility, which in turn may prevent proper inspection and care of the feet, contributing to further complications.
Poor Footwear Choices
Wearing inappropriate footwear can exacerbate pressure points on the feet and create friction against the skin, which can lead to blisters and cuts. For diabetics, even minor foot injuries can progress into ulcers if left untreated. Diabetics are strongly encouraged to wear properly fitted shoes designed to minimize friction and pressure, as well as to use custom orthotic inserts if they have foot deformities or pressure points.
Lack of Proper Foot Care Routine
Maintaining a consistent foot care routine is essential for diabetics to avoid ulcers. A lack of regular inspection and care increases the risk of minor injuries going unnoticed and untreated, which can progress into more serious conditions. Diabetics are advised to inspect their feet daily for any cuts, blisters, redness, or swelling. Additionally, keeping the skin moisturized, trimming nails carefully, and avoiding bare feet can help prevent skin damage.
Diabetic pressure ulcers can lead to severe complications if not managed effectively, but many of the associated risk factors can be mitigated with proper care. To reduce the risk of diabetic ulcers, maintaining healthy blood sugar levels, wearing appropriate footwear, and adhering to a diligent foot care routine are essential. Diabetics should work closely with their healthcare providers to ensure any signs of pressure ulcers are detected and treated early, as timely intervention is key to preventing the escalation of these ulcers.
Dr Amita Jain is a surgeon with highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi