The number of people with diabetes is increasing day by day by millions. Diabetes is one of the troublesome diseases that causes different ailments such as Nerve damage, kidney damage, skin conditions, Alzheimer’s disease etc. One of the most common damage caused by diabetes is diabetic foot pain and ulcers. As a result of skin tissue breaking down and exposing the layers beneath, they are created. Under your big toes and the balls of your feet, they’re most normal, and they can impact your feet down to the bones.It is likely to develop in all people with diabetes, but good foot treatment and care for foot ulcers as well as pain can help prevent them.
Causes of Foot Ulcers and pain in foot
Diabetic ulcers are mostly caused by poor circulation of blood to the feet, High blood sugar levels, nerve damage in parts of feet and irritated or wounded feet. Some of the factors such as below causes more risk of diabetic foot ulcers and pain:
- poorly fitted or poor quality shoes
- poor hygiene (not washing regularly or thoroughly)
- improper trimming of toenails
- alcohol consumption
- eye disease from diabetes
- heart disease
- kidney disease
- tobacco use (inhibits blood circulation)
It is necessary to decide which type of diabetic foot ulcer is required to determine an effective treatment. The various forms of these diabetic foot wounds are as follows:
- Neuropathic ulcers occur when the nerve damage caused by diabetic neuropathy causes the person with diabetes not to experience pain from an injury, frequently leading to significant development of the ulcer before the person is even aware of it.
- Due to a lack of blood flow to the extremity, ischemic ulcers or arterial ulcers, as they are often called, can occur.
- In people with both neuropathy and inadequate arterial blood flow, neuroischemic ulcers occur and are the hardest to heal.
Treatment for Diabetic Foot Ulcers and pain
Removing necrotic wound tissue from the wound is the first step in the treatment of diabetic foot ulcers. It is important that the method of debridement (removal of the removal of dead skin, foreign objects, or infections that may have caused the ulcer) used does not affect nerves, tendons, and blood vessels . All the infections are not treated the same way. To decide which antibiotic can benefit, tissue surrounding the ulcer can be sent to a lab. If a serious infection is suspected by your doctor, he or she can order an X-ray to check for signs of bone infection. Because many patients with diabetes do not feel pain from the wound site, while sensitive areas are being checked, health care professionals may not rely on the patient to let them know.
Prevention of foot ulcers:
- It is important to not give extreme pressure on the foot. Offloading which means minimizing or stopping the weight completely put on feet to prevent or heal the ulcers should be practised. Even pressure from walking can make the ulcer worst. A doctor may suggest wearing diabetic shoes, foot braces, casts, compression wraps or shoe inserts to help you deal with the pressure on the foot.
- If an ulcer starts to appear, the patient can (under the guidance of the doctor) treat it by foot baths, disinfecting the skin around an ulcer, keeping the ulcer dry with frequent dressing changes, enzyme treatments, dressings containing calcium alginates to inhibit bacterial growth to stop the spreading of infection and worsening the ulcers.
- Good diabetic control and lifestyle modification such as keeping the glucose levels optimal, balanced nutrition and eating habits, reducing High blood pressure, and no smoking can help to control the risks of nasty foot ulcers.
Other ways to prevent and care foot ulcers in diabetic patients are:
- Examine their feet daily with a mirror and to look carefully for fungal infections or any abnormality.
- Wash and dry feet at least once a day in lukewarm water (tested with elbow), paying special attention to dry between the toes.
- Not use heating pads or put feet close to heaters.
- Always use footwear inside and outdoors.
- Use close-toed shoes if they can’t feel their feet.
- Always use socks and change them daily.
- Have their nails cut carefully straight across by a trained professional (individuals should not cut their own nails as the risk of injury is too great).
- Treat dry feet with lubricants containing urea or salicylates, but don’t apply between toes.
If the infection persists even after preventive or anti-pressure treatment , your doctor may prescribe antibiotics, antiplatelets, or anti-clotting medications to treat your ulcer. Speak to your doctor about other health issues that can raise the risk of these dangerous bacteria being contaminated, including problems with HIV and the liver. Over-the-Counter treatments include – Silver or silver sulphadiazine cream dressings, polyhexamethylene biguanide (PHMB) gel or iodine (either povidone or cadexomer) solutions, Medical-grade honey in the form of an ointment or gel.
If wounds don’t heal, physicians of individuals with diabetic foot ulcers may have tough decisions to make. Many of these patients have a substantial cardiac risk, and health care professionals need to make difficult decisions on whether to conduct risky procedures such as angiography. By shaving the bone or removing foot deformities such as bunions or hammertoes, a surgeon may help relieve pressure around the ulcer. You probably won’t need to have surgery on your ulcer. However, surgery will prevent your ulcer from getting worse or leading to amputation if no other treatment choice will help your ulcer recover or progress further into infection.
Foot ulcers are treatable when caught early. If you feel unusual foot pain or see blackened skin around a region of numbness, see a doctor right away. ,Ulcers can cause abscesses and spread to other parts of your feet and legs if they are untreated. At that point, Ulcers may only be treated by surgery, amputation, or by replacing missing skin with synthetic skin replacements at this stage.