DIABETIC FOOT ULCER

DIABETIC FOOT ULCERS
What is Diabetic Foot Ulcers?

A diabetic foot ulcer is a wound or an open sore and is usually located at the bottom of the foot. Foot ulcers can occur for those who have diabetes and can be hospitalised if not treated properly. For those people with Diabetes that do develop foot ulcers can have problems healing the foot even after a small injury to the foot.

Diabetic foot problems

Diabetic foot problems, such as ulcerations, infections, and gangrene, are the most common cause of hospitalization among diabetic patients. (Ingrid Kruse, 2006) Diabetic ulcers go hand in hand with neuropathy. Patients often feel numbness or no pain at all in the ulcer area. Ulcers require constant management due to complications that can arise from loss of blood flow, lack of sensation and slow healing. Proper management can reduce the risk of amputation.
Some minimally invasive techniques are attractive to manage deformities in diabetics due to the smaller incisions required. Diabetics often have trouble healing post surgery due to the fluctuating levels of insulin. 

At Specialist Foot and Ankle Group we utilise the latest techniques to manage conditions of the foot and ankle. Our aim is to explore non operative techniques in the first instance or when necessary provide joint preserving minimally invasive surgical options. 

Even minimally invasive techniques can carry some risks, however, this technique does allow more possibilities in the management of disease. Before deciding on surgery it is important you feel comfortable with your decision therefore we like to allow ample opportunity for you to ask any relevant questions. It may be useful to write down any questions you would like to ask Dr Slater and bring them along to your appointment. Alternatively, please feel free to contact our friendly staff.

At Specialist Foot and Ankle Group our aim is to provide you with the latest techniques to ensure optimal results.


Foot Complications associated with Diabetes

Foot complications account for more hospital admissions than any other diabetic problem. The two major outcomes of foot complications are foot ulcers and amputations.

Ulcers: It is usually a combination of problems rather than a single risk factors that causes ulceration. These include peripheral neuropathy (nerve damage), peripheral vascular disease, foot deformities (clawing toes), external trauma and peripheral oedema. The most common trauma in Western countries is inappropriate footwear

Patients with diabetes are at risk of developing multiple complications including damage to nerves and poor circulation. These complications make your feet at risk for harm or injury and is more likely to occur if:

• You have had diabetes for a long time
• Your blood glucose levels have been too high for an extended period
• You smoke
• You are inactive

Low risk feet: Have normal sensation and good blood flow. However it is important to know that low risk feet can become high risk feet without symptoms, so regular checks are still important.

High risk feet: Are those people who have had a foot ulcer or amputation in the past. Feet with calluses or deformities like claw toes also have increased risk, if poor feeling and/or decreased blood flow are also present.

Nerve damage (neuropathy) is a complication of diabetes that leads to a loss of sensation in the feet. When the nerve is damaged it no longer perceives pain due to numbness and therefore does not warn of injury. This is particularly true in the foot.

Diabetes can also cause damaged blood vessels, decreasing the blood flow to the feet. Poor circulation weakens bone causing disintegration of the bones and joints in the foot and ankle. As a result, people with diabetes are at a high risk for bones fractures in the foot.

When a diabetic fractures a bone in the foot, they may not be aware due to nerve damage. Continuing to walk on the injured foot results in more severe fractures and joint dislocations. 

Charcot’s Foot: Charcot foot is one of the more critical foot problems that can develop due to poor circulation and nerve damage. It is a condition which can deform the shape of the foot and lead to disability.

Surgical Treatment 

In order to minimise the chance of amputation there are a number of surgical options available.

It is best to see us earlier rather than later when you have deformity particularly if you have an open ulcer/wound on your foot.

There are a number of minimally invasive techniques that are available to correct deformity and relieve open ulceration on the feet.

Minimally Invasive Surgery: Severe deformities will often need corrective fusion in particularly when Charcot joints are established.

Call the Specialist Foot and Ankle clinic today on 
1300 338 778 to book a consultation
Diabetic foot ulcers
Charcots Foot
Charcot foot is one of the more critical foot problems that can develop due to poor circulation and nerve damage. It is a condition which can deform the shape of the foot and lead to disability.
What is Diabetes?
Diabetes is a chronic and complex condition, which can affect the entire body. For our bodies to work properly we need to convert glucose (sugar) from food into energy. A hormone called insulin is essential for the conversion of glucose into energy. In people with diabetes, insulin is no longer produced or not produced in sufficient amounts by the body. 

Type 1 Diabetes
Type 1 diabetes is an autoimmune condition in which the immune system is activated to destroy the cells in the pancreas that produce insulin. Without insulin, the body’s cells cannot turn glucose (sugar), into energy.  

This can be managed through daily insulin injections, a healthy lifestyle and regular blood glucose testing. These actions can minimise the complications associated with diabetes.

Type 2 Diabetes
This is the most common form, affecting 85-90% of all people with diabetes. In type 2 diabetes, the body is unable to properly regulate the amount of glucose in the blood. This type is caused from a variety of genetic and environmental factors including poor diet, obesity, insufficient physical exercise and high blood pressure. 

Initially type 2 diabetes can be managed with a lifestyle modifications - healthy eating and regular exercise and BGL monitoring). However as the disease progresses people are often prescribed medication to take in conjunction with lifestyle modifications.  

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