Essential guide to preventing and treating diabetic foot complications for better health.
Chronic Diabetes Mellitus is a condition marked by high blood sugar levels (hyperglycaemia). If not properly managed, it can lead to serious complications affecting vital organs, including the heart, kidneys, eyes, and nerves. One of the most feared and common complications is Diabetic Foot. Early detection is key to preventing complications such as amputation.
What is diabetes?
Diabetes mellitus is a condition in which the body cannot produce or effectively use insulin. Insulin is a hormone that helps the body’s cells absorb glucose from the bloodstream to be used as energy.
Persistently high blood sugar levels (hyperglycaemia) can damage blood vessels and nerves throughout the body. This damage is the underlying cause of complications, including those affecting the feet.
What is diabetic foot?
Diabetic Foot is a general term referring to any abnormalities or disorders that occur in the feet as a result of uncontrolled diabetes. This condition can include infections, open wounds (ulcers), tissue damage, and changes in foot shape.
It is usually triggered by two main issues caused by diabetes:
- Peripheral neuropathy (nerve damage): The patient loses the sensation of pain, heat, or cold in the feet. As a result, cuts, blisters, or foreign objects may go unnoticed.
- Peripheral vascular disease (blood vessel damage): Reduced blood flow to the feet means there is insufficient oxygen and nutrients to heal wounds.
Main causes of diabetic foot ulcers
Diabetic foot ulcers often start from seemingly minor issues but can worsen due to complications. Common causes include:
- Unnoticed injuries: Small cuts from stepping on sharp objects, blisters from tight shoes, or untreated calluses.
- Poor circulation: Reduced blood supply due to damaged blood vessels makes wounds slow to heal, causing tissue death (necrosis) and increasing susceptibility to infection.
- Weakened immunity: High blood sugar disrupts white blood cell function, weakening the body’s ability to fight bacteria, making infections more likely to spread and become severe.
How to care for and manage diabetic foot wounds
Managing diabetic foot wounds requires routine, disciplined, and intensive care, often involving a team of specialists. The goal is to eliminate infection, accelerate healing, and prevent amputation.
- Maintain blood sugar levels: Wounds will not heal if blood sugar remains high. Medication, diet, and lifestyle must be strictly managed.
- Daily wound care: Clean the wound daily with a sterile solution (e.g., 0.9% NaCl) and cover it with a modern dressing that maintains optimal moisture. Avoid soaking the wound.
- Debridement (removal of dead tissue): A doctor will remove infected and dead tissue to stimulate new tissue growth.
- Reducing pressure (offloading): Patients must avoid putting pressure on the wound. This may involve using assistive devices, specialised diabetic footwear, or crutches until the wound fully heals.
- Treating infection: If signs of infection are present, the doctor will prescribe antibiotics (oral or intravenous), often after taking a bacterial culture from the wound.
How to prevent diabetic foot and recurrent wounds
Prevention is crucial for people with diabetes to maintain good health:
- Examine your feet daily: Use a mirror to check all areas of the feet, including between the toes, for blisters, wounds, redness, or swelling.
- Maintain foot hygiene: Wash your feet daily with warm water and mild soap, then dry thoroughly, especially between the toes.
- Wear appropriate footwear: Always wear comfortable, closed shoes with good cushioning (preferably diabetic footwear). Never go barefoot, even indoors.
- Trim nails carefully: Cut nails straight and avoid cutting too short to prevent ingrown nails.
- Control blood sugar: Follow a disciplined diet, exercise, and prescribed medication to keep blood sugar within a normal range.
When to see a doctor
Seek medical attention immediately if you have diabetes and notice any of the following in your feet:
- Wounds or blisters that do not improve within 24–48 hours.
- Signs of infection: fever, swelling, spreading redness, severe pain, or discharge of pus/odorous fluid.
- Cold, pale, or blackened feet (gangrene).
Consulting an internal medicine specialist
Proper diabetes care and the prevention of complications such as diabetic foot require expert guidance. An Internal Medicine Specialist is the right consultant to help you maintain optimal blood sugar control.
For advice on diabetes management, prevention, and wound care, you can consult Dr Jimmy Tandradynata, Sp.PD, MSc, FINASIM, Internal Medicine Specialist at Eka Hospital BSD.