Diabetes & Non-Healing Wounds: Educate Yourself for Better Health

Never underestimate a wound, even a minor one, says John V. Capotorto, MD, MBA, a Harvard-trained endocrinologist, past-president of the American Association of Wound Care Management and co-founder of RestorixHealth, ECHN’s Center for Wound Healing & Hyperbaric Medicine partner. A simple callus on your foot can be the tip of the iceberg that leads to a non-healing wound if you have diabetes.

Educate yourself for better health. Know your risks, when to seek medical attention and how to prevent injuries. Knowledge can save your limb and your life.

Why Diabetes Increases Your Risk of Non-Healing Wounds

Diabetes is a systemic disease. Normally, glucose enters your cells to fuel your body and brain, but when you have diabetes, most or all glucose cannot enter your cells. Instead, it circulates through your bloodstream where it damages nerves, blood vessels and your immune system.

Neuropathy or nerve damage
If you have had diabetes for eight years or more, you likely have nerve damage that reduces or eliminates feeling, especially in your feet. Often the loss of sensation is gradual; you do not realize it’s occurring or the full extent of the loss, so you’re unaware of injury. Diabetic neuropathy causes foot deformities and ulcers (wounds), increasing your risk of lower limb amputation.

Vascular Disease or narrowed blood vessels
Many of the complications of diabetes are related to the vascular system, like heart attacks, strokes and poor circulation to the lower legs and/or feet.  The vessels in your legs can become narrowed, leading to a two-fold problem: they can no longer supply nerves with optimal levels of oxygen and nutrients needed to transmit signals like pain; nor can they supply enough nutrients and oxygen to fight infection or heal wounds.

Damaged Immune System
High blood sugar reduces the effectiveness of white blood cells sent to heal an injury or illness. It also suppresses inflammation, which is critical for healing. Inflammation alerts your immune system to fight infection and repair injury.

How to Treat Minor Wounds at Home

1. Clean the wound – Run under cool water to remove debris. Don’t use soap, hydrogen peroxide and iodine. They can do more harm than good.
2. Cover the wound – Apply antibiotic ointment. Then cover the wound with a sterile bandage. Keep the wound covered to promote healing. Change bandage daily and check for infection.
3. Contact your doctor – If you have diabetes, a minor infection can quickly spread in a matter of days. Treat even the mildest infection right away.

Why Foot Wounds Threaten Your Health

There’s no such thing as a minor wound—especially a minor foot wound—for a person with diabetes. Everyone with diabetes should perform a daily foot check and use a mirror or ask a family member for help if you cannot see the bottom of your feet.

Any areas that are red, callused or blistered need to be examined and if you see an area of concern, stop walking and get to a specialist. Podiatrists can care for most diabetic foot problems, and many work in multidisciplinary wound management centers.

Foot ulcers are a common complication of diabetes. Left untreated, foot ulcers can lead to infection, gangrene, amputation and even death. Seek treatment immediately if you have an open wound.

Prevent Injuries Before They Happen

Benjamin Franklin once said, “An ounce of prevention is worth a pound of cure.” Not all diabetic foot ulcers are preventable, but you can greatly reduce your risk by taking steps to prevent them. Diabetic foot ulcers often lead to lower extremity amputation. Everyone with diabetes should wear shoes at home and remove objects from the floor. Keep kids’ toys in a bin or basket. Don’t use area rugs—which cause falls—and remove low tables, so you don’t bang your shins against them.  Make sure pathways are well-lit.  Pets can also be a tripping hazard.

10 Tips for Healthy Feet

The rise in diabetic foot ulcers makes daily care essential for health and longevity. Practice these foot care tips for happy feet.

1. Keep your blood sugar as close to normal as possible throughout the day. High blood sugar is the leading cause of foot ulcers.
2. Inspect your feet daily. Use a mirror if needed or ask a family member for help.
3. Seek attention for corns, calluses and ingrown toenails.
4. Immediately report any break in skin or changes in shape, feeling or color.
5. Always wear shoes and socks, even at home.
6. Wash and dry feet daily in lukewarm water.
7. Moisturize feet daily except between toes.
8. Avoid temperature extremes. Use sunscreen in summer and warm socks in winter.
9. Get annual foot check-ups with a podiatrist.
10. Be active. Movement increases blood flow to your feet except if you have neuropathy. Then check with your podiatrist first.

Speak with your doctor about any problems you are having. Practice daily self-care, share your feelings and ask a family member for help if needed.

Always work with a multidisciplinary team because diabetes is a systemic disease. Studies show evidence-based multidisciplinary treatment reduces your risk of lower limb amputation by 50%. Receiving the best possible care, you can continue to enjoy what you care about most and lead a full, happy life.