As a hyperbaric provider, a lot of the wounds we treat on an outpatient basis are diabetic foot wounds. Through prevention, advanced wound care, and hyperbaric medicine, we can keep these patients standing on their own two feet! Our patients living with diabetes have a lot to manage; constantly checking blood Glucose levels, taking medicine, going to doctor’s appointments, and finding time to stay healthy by being active. With all those things keeping up with their feet might be the last thing on their mind! But daily preventative care is one of the best ways to prevent diabetic foot complications. We can encourage our patients with diabetes to take steps to ensure they won’t suffer from neuropathy that leads to wounds. What’s the most important thing they can do to prevent nerve damage or stop it from getting worse? Keep blood sugar in their target range as much as possible. Other good diabetes management habits can help, too:
- Stop smoking! Smoking reduces blood flow to the feet.
- Follow a nutrition plan including eating more fruit and vegetables and less sugar and salt.
- Physical activity—10 to 20 minutes a day is better than an hour once a week.
We can encourage our diabetic patients to check their feet every day for things like redness, swelling, sores or blisters. We also encourage these patients to never go barefoot. Remind them to always wear shoes, socks and slippers to avoid injuries. It’s always a good idea to check that there aren’t any pebbles or other objects inside their shoes and that the lining is smooth. It is also very important that our patients wear shoes that fit well.
We can also educate our diabetic patients on how to inspect their feet. They can get to the bottom of any foot problems by using a mirror or asking for help. It is also helpful to check the bottoms of their feet to see if they have lost any sensation.
Sometimes, even with the best prevention wounds can still happen! Even one late night barefoot trip to the restroom could result in a stubbed toe that could lead to a blister or wound. An understanding of basic wound prevention and wound care can save folks time, money, and even a limb! Pre-ulcerative signs on the foot, such as callus or blisters, appear to be a strong warning for future ulceration and require immediate treatment by a foot care professional. Be very cautious of using heating pads or callous removals at home!
Diabetic foot wounds are the leading cause of lower-extremity amputation and hospitalization. Once lower extremity amputation due to diabetes has occurred, access to care and treatment seems ineffective in preventing further hospitalizations. Sadly, the mortality rate at 5 years post-diabetes-related amputation has been described as high as 74%, worse than most cancers.
If you or someone you love, despite your best efforts, get an ulcer do not fret! Wound care experts are there to help. Diabetic foot ulcers are potentially very serious but are luckily preventable and treatable!