What Increases the Risk of Diabetic Foot Ulcer?

Diabetic Foot Ulcers Explained: Causes, Risks and Prevention

Diabetes is a health condition that can damage nerves and blood vessels throughout the body. In this condition, the human body fails to efficiently produce or use sufficient insulin, leading to high blood sugar levels. Diabetic foot ulcers are typically open wounds or sores on the foot skin that will not heal easily. Poor glycaemic control, foot deformities, peripheral vascular disease, and neuropathy are various risk factors for this open wound.   

Factors Increasing Risk of Diabetic Foot Ulcer  

The risk factors of diabetic foot ulcers are listed below.

Poor Blood Flow (Peripheral Arterial Disease)

When blood circulation to the lower limbs becomes compromised, the delivery of oxygen and infection-fighting cells to the tissues is reduced. This impaired circulation, common in diabetic patients, makes it harder for wounds to heal and leaves them vulnerable to infection. As the infection worsens, it increases the risk of ulcer formation and can lead to serious complications like gangrene if untreated.

Uncontrolled Blood Sugar Levels

Poorly managed blood sugar levels weaken the immune system’s ability to fight infections and delay wound healing. High blood glucose impairs white blood cell function, promoting bacterial growth and tissue breakdown. Over time, this creates an environment conducive to developing foot ulcers from even minor injuries.

Peripheral Sensory Neuropathy

Peripheral sensory neuropathy damages the nerves that carry sensation from the feet to the brain. As a result, patients may not feel pain, heat, or injury. This loss of protective sensation allows minor cuts, blisters, or pressure points to go unnoticed and untreated, eventually leading to serious wounds and ulcers.

Peripheral Autonomic Neuropathy

Autonomic neuropathy affects the sweat glands, leading to dry and cracked skin on the feet. When the skin lacks moisture, it becomes fragile and more susceptible to pressure, friction, and infection. Cracks in the skin provide an easy entry point for bacteria, heightening the risk of ulcers.

Vascular Insufficiency

Inadequate blood supply, or vascular insufficiency, limits the body's ability to heal wounds properly. Poor tissue viability, impaired neutrophil delivery, and reduced oxygenation further increase the risk of developing foot ulcers. Healing becomes prolonged, and infection risk rises sharply in such cases.

Biomechanical Abnormalities

Structural deformities like hammertoes, bunions, or flat feet create uneven pressure points on the foot’s surface. Abnormal biomechanics lead to shear forces and continuous friction, disrupting blood flow and stressing specific areas of the foot. Over time, this pressure can break down skin and tissue, resulting in ulcer formation.

Apart from these major factors, obesity, poor hygiene, inflammation, hypertension, and changes in white blood cell count can cause ulcers.

Classification of Diabetic Foot Ulcer

It is a complication of high blood sugar that cannot be managed through insulin treatment and a healthy diet. Here, three types of diabetic foot ulcers are explained.

• Ischemic: This kind of ulcer occurs when feet, toes and lower limbs do not receive sufficient amounts of blood flow due to ischemia.  
• Neuropathic: Peripheral neuropathy causes neuropathic ulcers. A person having these wounds loses body sensation and will not feel pain.  
• Neuroischemic:It results from a combination of poor circulation and nerve damage that hinders the body's sensation and healing power.

Causes of Diabetic Foot Ulcer  

Diabetic foot ulcers are caused by:

• Poor blood circulation or flow
• Hyperglycaemia means high blood sugar.
• Wounded feet
• Nerve damage

Poor blood circulation causes insufficient blood flow to the feet and builds difficulties in healing the wound, which turns into a foot ulcer. Nerve damage results in poor sensitivity, high blood sugar slow down the wound healing process, and infection causes ulcers.

Symptoms of Diabetic Foot Ulcer

Healthcare professionals inspect diabetic foot ulcers after noting size, location, wound depth and discharge. Look into the following signs of infection to detect foot ulcers.

• Continuous foot swelling
• Redness around lesions
• Pain
• Skin hardening
• Drainage or pus from the open wound

Treatment of Diabetic Foot Ulcer

Everyone needs to learn about foot care to prevent the chances of experiencing foot ulcers. Basic options to treat diabetic foot ulcers include:

• Controlling blood sugar with proper medication.
• Vascular surgery is used to relieve pressure and encourage healing.
• Removing or shaving bones.
• Removing damaged tissues
• Lengthening tensors.
• Fusing or realigning joints.

Diabetic ulcers are slow-healing or untreated wounds. Diabetes issues such as high blood sugar damage nerves and blood vessels, leading to loss of sensation, and wounds become ulcers. Peripheral autonomic and sensory neuropathy, vascular insufficiency and poor blood flow are the major factors increasing the risk of forming ulcers.

Proper medication for controlling blood sugar levels, vascular surgery, removal of damaged tissues and tensor lengthening can treat diabetic foot ulcers.