Foot infections are an important concern for people with diabetes. Diabetes-related nerve damage can reduce feeling in the feet, making it hard to detect a foot injury. Diabetes can also impair blood circulation and wound healing by narrowing the arteries that carry blood to the legs.
This combination is extremely serious, because a wound on your foot or leg that doesn’t heal can turn into an ulcer (deep sore) that quickly becomes infected. Amputation is sometimes necessary. In fact, one-fifth of all hospitalizations in people with diabetes are for foot infections, resulting in more than 80,000 lower-limb amputations each year.
Blood glucose control, quitting smoking, and proper foot care can greatly reduce these risks. According to the American Diabetes Association, part of proper foot care includes having your feet inspected at least once a year by your primary care physician or podiatrist.
In addition to looking for ulcers, the doctor will check the pulses in your feet to determine whether you have sufficient blood flow and whether you’re still able to feel sensations such as pain or vibration on the bottom of your feet. Your feet should be examined at every visit to the doctor if you cannot feel sensations, have foot deformities, or a history of foot ulcers.
Everyone who has diabetes, and especially those with neuropathy or poor circulation, should routinely inspect each foot and lower leg every day and carefully treat and monitor even the most trivial blister, cut, or abrasion. Any injured areas should be washed with warm water and soap, cleaned with a mild antiseptic, and covered with a dry, sterile dressing and paper tape. Referral to a foot doctor (podiatrist) is often recommended.
If you do develop a foot or leg ulcer, call your doctor immediately. Because people with diabetes often have poor blood circulation, ulcers can become infected rapidly. Although treatment with antibiotics is needed, it’s not enough to cure these serious infections. Incision and drainage procedures are the best treatment. Severe ulcers usually require wearing a boot to protect the foot.
These wound-care treatments are so complex that most doctors now send people with infected ulcers to specialized wound-care centers. Diabetes foot treatment can take many months because wound dressings must be applied and changed frequently, and dead tissue may have to be removed from the wound (a process called debridement). Considering that the alternative to treatment is amputation, this expensive and time-consuming process is definitely worthwhile.