“Just a scratch” is never that simple with diabetes

Prevention is key! Wearing special diabetic socks helps prevent seams from rubbing new ones on their feet. They also control moisture which can lead to  unnecessary friction and blisters. Washing gently with mild soap and carefully drying between toes will prevent moisture breakdown as well. 

Proper footware will aid in prevention. Because diabetes can change the shape of the bones of a diabetic foot, the natural fat cushions are displaced,  New areas of pressure begin to rub and cause ulcers. Buying shoes later in the day will provide a better fit as feet can swell as the day progresses. Additionally, special shoes or inserts can be custom molded to ensure the remodeled bones are padded and protected. 

Poor sensation allows ulcers to develop unknowingly. The tiny blood vessels feeding the skin are narrowed due to changes from diabetes, preventing oxygen, healing cells, and nutrients from getting to the wound surface.  In addition, the healing cells themselves don’t work effectively in the environment of elevated sugars. Finally, healing cells and infection fighting cells can’t function, however the bacteria extra fuel to wreak havoc on the wound.   

Because of these changes in healing ability, cutting nails, corns and callouses are a no-no.  Any small opening in the skin can allow bacteria to enter and, with the poor healing ability, develop into a wound. 

Seeking help from a wound care specialist early can save a limb and save a life.  The visits at a wound care center will begin with evaluation for infection, blood flow and moisture.  Once they ensure the surrounding environment is optimized, an individualized plan can be made for the wound and its stage of healing-whether it needs cleaning, absorption or speeding the healing.  

Any wound in a diabetic can quickly escalate. See a doctor for any diabetic wound or wounds not closing after 2-4 weeks. 

Author

Jenna Wishnew Dr Wishnew is a Board Certified General Surgeon practicing in the North Texas area She specializes in general surgery, gastroparesis, wound care, vein concerns and robotic surgery.