Physician Assistant Emily Phaneuf discusses diabetic foot ulcers
Diabetes rates are on the rise and it is estimated that about 5 percent of diabetic patients will develop a diabetic foot ulcer. Diabetic foot ulcers are the leading cause of diabetes related hospitalization as well as lower extremity amputations.
Understanding Diabetes
Diabetes is a condition of poor blood sugar control. Consequently, long term elevations in blood sugar levels can have negative effects on many body systems, including blood vessels and nerves.
“Elevated blood sugar levels can injure nerves throughout the body causing peripheral neuropathy,” said Phaneuf. “Neuropathy can impact multiple types of nerves including sensory neurons that notify us of pain sensation. Motor neurons which send signals to our muscles for movement can also be impacted.”
She emphasized that
- The disruption of normal sensation can lead to injury, especially on the bottom of the foot, as there is no sensation of pain and a small injury can become increasingly worse.
- Disruption of motor neurons can lead to muscle wasting and small changes in the structure of the foot.
- The combination of the loss of pain sensation as well as changes in the structure of the foot can lead to the development of chronic wounds on the foot.
- Elevated blood sugar levels can damage blood vessels. Therefore, with impaired blood flow, this may lead to prolonged wound healing and an increased risk of infection.
Treatment
Treatment of diabetic foot ulcers requires a multidisciplinary approach, including aggressive control of blood sugar levels and adequate wound care.
“When treating our patients with diabetic foot ulcers, we aim to prevent infection and stimulate wound healing with frequent debridement and appropriate wound dressings,” said Phaneuf.
Additionally, appropriate footwear is an important part of both preventing and managing diabetic foot ulcers. Diabetic shoes can be fitted to an individual’s foot to provide an appropriately sized shoe and protective insole to reduce pressure and injury on all parts of the foot.
Prevention
According to Phaneuf, the first line of defense to foot ulcers is prevention. This can include
- having an annual comprehensive foot exam by a podiatrist or primary care provider. Preventive diabetic foot care by a podiatrist can be performed if needed as often as every 90 days
- doing a daily self-examination of your feet for any areas of skin irritation or trauma
- keeping your feet clean and avoiding walking barefoot
- wearing clean, dry socks and avoiding tight fitting shoes
- aggressively managing your diabetes and lifestyle along with your healthcare provider
By taking a proactive stance, individuals with diabetes can stride towards healing and minimize the risk of complications associated with diabetic foot ulcers. Every step matters in the journey towards diabetic foot health.
