If you have an ulcer anywhere on your foot or ankle, you should never mutter that ever popular Monty Python phrase “it’s just a flesh wound” and ignore it! An ulcer is a serious wound involving the complete loss of the top layer of skin and possible extension into the deeper layers and tissues. These are especially dangerous in the diabetic population. If you, or someone you know, has diabetes, then you must be aware of the signs to look for involving ulcers, and you should see a podiatrist routinely. Diabetic foot ulcerations are the most common single precursor to lower extremity amputations.

Now, you may be wondering why diabetics are more susceptible to lower extremity problems. The answer is fairly complex, but here is a general overview: Diabetics may have a series of pathologies in the nerves, blood vessels, muscles, and skin. Problems in the nerves result in impaired protective sensation, making it possible to sustain an injury to the foot without feeling it. The damaged nerves also can result in weakened muscles because without adequate innervation, muscles can’t function properly. This can manifest as hammer toes, bunions and instability while standing or walking. Conditions involving blood vessels can result in many medical problems, including but not limited to insufficient oxygen and nutrient delivery to tissues and possible blockages. This can lead to pain, ulceration and ultimately gangrene of the foot. Lastly, diabetics experience changes in their skin. The skin becomes dry and is more prone to cracking and callus formation, which can lead to increased susceptibility to infections. Toe nails become thickened and brittle, and many times are infected with fungus. Thickened nails coupled with high pressure forces being applied to the nails can lead to nail bed ulcerations.

This picture seems pretty grim, doesn’t it? Well, there is extremely good news: diabetic foot problems are very preventable! Serious consequences, such as amputations usually start out as preventable, easy to treat problems. If you have diabetes, the key is to see a podiatrist on a regular basis for routine inspections of your feet. Studies by the US National Institute of Health show that comprehensive foot care programs can reduce amputation rates by 45-85%. Your local podiatrist can perform proper nail care, reduce callus build-up, and make sure your skin is sufficiently hydrated. Furthermore, he or she can educate you on your specific needs, as every patient experiences different challenges in caring for their feet. Good foot health is just a doctor’s appointment away!

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