How to Treat and Prevent Diabetic Ulcers on the Feet and Legs

In this article, we will discuss what diabetic ulcers are, how to treat them, and how to prevent them from…(continue reading)

If you have diabetes, also called diabetes mellitus, it is important to be aware of diabetic ulcers on your feet, ankles, and legs.

These sores can easily become infected if not treated properly and can eventually lead to severe infection and even limb amputation.

In this article, we will discuss what diabetic ulcers are, how to treat them, and how to prevent them from occurring in the first place.

We will also touch on other causes of ulcers for those who do not have diabetes in case diabetes is not the cause of your foot or leg ulcer.

What is diabetes?

Diabetes is a chronic condition that affects the way your body uses blood sugar which is also called glucose.

It is caused by your body’s lack of insulin production or the cells in your body developing insulin resistance with both resulting in high blood sugar levels. Insulin is a hormone that allows the cells in your body to convert glucose into energy.

When you have type 1 diabetes, your autoimmune system attacks the insulin-producing cells in your pancreas which causes your body to stop producing it.

Type 2 diabetes is when your cells lose their insulin sensitivity and stop using insulin to take in glucose.

Both of these conditions will cause elevated blood glucose levels which can result in many complications if left untreated including heart disease, kidney damage, and vision loss.

CDC Diabetes infographic
CDC Diabetic Infographic

What are diabetic ulcers?

One of the complications caused by high blood sugar levels is diabetic ulcers.

Ulcers are open sores or chronic wounds that occur on your skin and take longer to heal than normal.

They may appear in different shapes such as craters or wedges and can have various colors such as red, pink, gray, yellow, or black.

Please note that if you have a black-colored ulcer this means there is necrotic tissue (dead tissue) which is also called gangrene. Diabetic ulcers are different from other types of ulcers because they are usually caused by a combination of poor blood flow and nerve damage.

Diabetic neuropathy, which is a type of peripheral neuropathy meaning it is not in your brain or spinal cord, is a type of nerve damage caused by high blood sugar levels that can cause a loss of sensation in your legs and feet. Due to this numbness, you may not feel pain if you injure yourself.

The lack of feeling can also lead to small cuts or scrapes becoming larger ulcers. Diabetic foot ulcers or ankle ulcers can also be caused by poor blood circulation which is another complication of diabetes.

When your blood sugar levels are high, it damages the small blood vessels which reduce blood flow to your feet and legs and can make it difficult for wounds to heal causing an increased risk of infection.

What are the best ways to treat diabetic ulcers on the legs, ankles, or feet?

If you have diabetic ulcers, it is important to see a healthcare provider right away as they will be able to determine the best course of treatment for you.

Treatment of diabetic ulcers by your doctor may include the following:

  • Cleaning the wound
  • Removing dead tissue from the wound (debridement)
  • Using dressings or bandages to protect the wound
  • Prescribing antibiotic treatments if there are signs of infection

Once you are home from seeing your doctor, there are several other precautions your need to take to help your wound heal properly and these include:

Daily cleaning of your ulcer

To clean your ulcers daily your doctor will likely recommend using mild soap and water for proper wound care.

Avoid soaking your wound, using harsh soaps, hydrogen peroxide, alcohol, or iodine as these can irritate the wound and delay healing.

Use a clean bandage to cover your wound

Be sure to use a clean, dry bandage each time you change your dressing.

Your doctor may also recommend using an antibiotic ointment on the bandage to help prevent infection and also may recommend a particular type of wound dressing.

Avoid pressure on your ulcer

If you have a foot ulcer or ankle ulcer, you may need to wear a special type of shoe, boot (cast), or crutches to keep the area from getting irritated or injured and speed up the healing process.

You may also need to sleep with your leg elevated on pillows at night.

Manage your blood sugar levels

One of the most important things you can do to treat diabetic ulcers is to keep your blood sugar levels under control by monitoring them on a regular basis.

You can also help treat and prevent high blood sugar levels by following a healthy diet, exercising regularly, and taking any medication prescribed by your doctor.

Listen to your doctor

Your doctor may recommend different topical solutions, oral medications, or other treatments depending on the severity of your diabetic ulcers or if you have infected ulcers.

Be sure to follow their instructions and call them if you have any questions or concerns.

What are the best ways to prevent diabetic ulcers?

The best way to prevent diabetic ulcers is to keep your blood sugar levels under control through prescribed medications and the lifestyle changes detailed above.

Other ways to prevent diabetic ulcers include:

  • Wearing proper footwear and avoiding going barefoot
  • Checking your feet daily for cuts, scrapes, blisters, or other issues
  • Not smoking

Although there is no foolproof method to prevent diabetic ulcers, following these tips can help reduce your risk. If you do develop diabetic ulcers, it is important to seek medical care.

Are there other conditions that can cause ulcers?

Diabetes is not the only medical condition that can cause ulcers on your legs or feet as there are three different types of ulcers and they are diabetic, venous stasis, and arterial.

Venous stasis ulcers, or just venous ulcers, are the most common type of ulcer on the legs and ankles and are caused by blood pressure building in your veins while arterial ulcers are caused by damage to your arteries and both are due to poor circulation.

Other common medical conditions that are risk factors for ulcers on your lower extremities include:

  • Chronic venous insufficiency which is when your veins have trouble sending blood back to your heart and can cause venous leg ulcers
  • Varicose veins which are twisted and enlarged veins
  • Obesity
  • Various foot conditions such as hammertoes or bunions
  • Kidney disease
  • Any condition that causes blood circulation problems
  • Heart disease
  • Smoking
  • Abusing alcohol
  • Arterial diseases such as atherosclerosis that can cause poor blood flow in your arteries

If you are experiencing any of the symptoms associated with ulcers or think you may have developed one, it is important to see your healthcare provider right away as diabetic ulcers can lead to serious complications. Your doctor also needs to determine the reason for your ulcers, whether it is diabetes or another condition so they can recommend the proper treatment.

Summary

Diabetic ulcers are sores that usually develop on the feet or legs as a result of diabetic neuropathy and a lack of blood flow.

They can become infected and lead to serious complications if left untreated, so it is important to see your healthcare provider right away if you think you may have developed one.

The best way to prevent diabetic ulcers is to keep your blood sugar levels under control, but other ways to reduce your risk include wearing proper footwear and checking your feet daily.

Other conditions can cause ulcers on your legs or feet, so it is important to see your doctor to get a proper diagnosis and treatment plan if you have an ulcer.

If you have any more questions about diabetes or ulcers, please consult with your doctor or health care provider.

References and sources:

WebMD

Cleveland Clinic 

NHS

Healthline

Fact Checked and Editorial Process

Diabetic.org is devoted to producing expert and accurate articles and information for our readers by hiring experts, journalists, medical professionals, and our growing Diabetic.org community. We encourage you to read more about our content, editing, and fact checking methods here. This was fact checked by Jacqueline Hensler and medically reviewed by Dr. Angel Rivera.

fact checked and medically reviewed

We are committed to providing our readers with only trusted resources and science-based studies with regards to medication and health information. 

Disclaimer: This general information is not intended to diagnose any medical condition or to replace your healthcare professional. If you suspect medical problems or need medical help or advice, please talk with your healthcare professional.

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