I am sure all of us would know diabetes is all about the uncontrolled sugar in our body. We know that diet and lifestyle contribute a huge part to the development of the disease.

But, little are aware of its severe complications. In the lifespan of a diabetic patient, 15% to 25% would be expected to suffer from non-healing wounds especially at the lower extremities. The non-healing wounds are known as diabetic foot ulcers which are the most common foot injuries leading to amputations.

What is Diabetic Foot Ulcer?

Diabetic foot ulcers are defined as the bacterial infection, ulceration or tissue death situated at the foot that is commonly associated to people with diabetes.

Figure 1: The picture shows the ulcer development at the toe and the sole of the feet
Sourced from https://www.wmar2news.com/news/health/gbmc/diabetic-foot-ulcers-left-untreated-can-lead-ot-amputation

Diabetic Foot Ulcers and its rising concerns

Diabetic foot ulcers have gained a lot of attention in recent years. With the non-stop rising of diabetes prevalence, more and more people are experiencing the serious side effects of diabetes which is the diabetic foot ulcers. The non-healing wound posed a great concern to the healthcare system due to the high mortality and complexity in wound care. A research done by Robbins et al in 2008, patients who had to undergo amputations due to diabetic foot ulcers had a 48% 5-year mortality rate compared to those who did not undergo amputation.

 

How does it happen?

The formation of Diabetic Foot Ulcers can be due to a combination of factors such as

• Poor blood circulation - The blood unable to reach to your feet can cause the ulcers to heal much slower.

• Damaged nerves - The numbness and loss of feelings due to the damaged nerves can lead to the formation of painless wounds then cause ulcers.

• Irritated and non-healing wound- Ulcers appear with pus at the wound or as a lump 

• High blood sugar (hyperglycemia) - Hyperglycemia can slow down wound healing, it is important to control blood sugar level

These factors mentioned are usually preceded by the diabetes condition itself.

Figure 2: Diabetic foot ulcers being staged as sourced from https://www.diabetestreatmentguide.org/how-to-control-diabetic-ulcers-in-five-steps/

The wounds can be classified by your doctors into a few groups for the purpose of targeted treatment. The classification is based on the condition of your foot looking into:

• Presence of ulcers

• Presence of infection 

• Presence of tissue death

• Depth of the affected wound

Table 1: University Texas Classification is preferred classification system by Ministry of Health Malaysia. 
 

What should I do to prevent Diabetic Foot Ulcer?

Prevention is always far better than treatment. Here are effective strategies to prevent Diabetic Foot Ulcers: 

• Annual foot examination - It is recommended to do it at least annually and more frequent for higher risk patients.

• Control over diabetic condition - A good control of glucose level can help in preventing the diabetic foot ulcer

• Appropriate footwear - Make sure to wear proper footwear in order to prevent unnecessary wounds

• Preventive surgeries - Orthopaedic surgeons will consider the history of ulceration and the risk of re-ulceration of diabetic patients before undergoing surgery

Treatment plans for Diabetic Foot Ulcers

• Non-surgical such as antibiotic treatment, wound management, rehabilitation and other alternative treatment can to treat the infection and improve wound healing progress

• Surgical such as debridement process, tissue reconstruction process and revascularization procedures can be done to the site of wound

• Amputation and post-amputation management

Boba once in a while is fine, but watch out for the excess sugar consumption

The care of diabetic wounds are often complex and usually long term treatment is required in order to promote complete wound healing. Hence, it is best to adapt to a healthy lifestyle in order to prevent the diabetes. 

Read more about diabetes-related article over here
https://doc2us.com/diabetes-mellitus

https://www.doc2us.com/diabetes

References

https://www.healthline.com/health/diabetic-foot-pain-and-ulcers-causes-treatments#causes

https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Orthopaedics/Draft%20CPG%20Diabetic%20Foot.pdf

https://www.aafp.org/afp/1998/0315/p1325.html

Robbins, J. M., Strauss, G., Aron, D., Long, J., Kuba, J., & Kaplan, Y. (2008). Mortality Rates and Diabetic Foot Ulcers. Journal of the American Podiatric Medical Association, 98(6), 489–493. https://doi.org/10.7547/0980489

Written by

Ms Shannon Lip