Small wounds can also become infected from the bacteria on your shoe or the environment — and if they do, chronically high blood sugar can impair the function of immune cells that fight against infection. A high sugar environment also helps bacteria, fungi, and other infection-causing organisms to thrive, adds Dr. Adimoolam. Plus, a local infection can spread to other soft tissue or to bone and even your blood, which can lead to sepsis, a dangerous and potentially life-threatening level of infection, says Jacqueline Sutera, DPM, a podiatrist at Hackensack University Medical Group in Emerson, New Jersey, and a spokesperson for the American Podiatric Medical Association. Diabetic neuropathy — a condition that damages nerves in the legs and feet, leading to a loss of sensation — further complicates the issue. “When people with diabetes lose sensation in their feet, it’s quite difficult to walk, and they end up putting increased pressure on only certain parts of the feet that can sense the floor,” Adimoolam says. The constant pressure on certain areas of the feet may cause skin breakdown and ulcers. Nerve damage can also prevent pain signals that would otherwise help you know when you have a minor foot issue, like a splinter, ingrown toenail, or even when your shoe is rubbing the wrong way, says Dr. Sutera. About 15 percent of people with diabetes will develop a wound over the course of the disease, according to the American Diabetes Association. However, if you take preventive steps and get the proper treatment, you can avoid a serious infection.
How to Treat Foot Wounds
Having type 2 diabetes doesn’t mean that you’re destined to develop a serious foot wound. Follow these steps to help prevent injuries and help them heal faster. Keep your blood sugar levels down. Poor circulation, neuropathy, and a weakened immune system can all be improved with good control of your diabetes, Adimoolam says. Your diabetes educator and doctor can help you develop an individualized plan to keep your blood sugar stable. Quit smoking. It’s a risk factor for poor circulation, which increases your susceptibility for wounds and poor healing, Adimoolam explains. Wear well-fitting shoes. One of the best ways to ward off a foot injury is to wear protective shoes that fit well. Avoid shoes that are too thin, flat, or high, and use custom insoles to reduce pressure. If you have neuropathy, it’s best to avoid walking around barefoot, even in your house, Sutera says. Keep your feet clean and your nails trimmed. Wash your feet with soap and water every day and apply lotion to the entire foot to avoid cracked skin, Adimoolam says. Trimming your nails can help prevent an ingrown toenail, but patients with neuropathy should see a podiatrist for nail trimming. Do a daily foot check. Inspect the skin on your feet, including the area between your toes. If you can’t see your entire foot, use a mirror or take pictures at several angles with your cell phone. Serious problems can happen as quickly as overnight, Sutera says, so don’t delay seeing your doctor if you notice a wound. Learn to spot the warning signs. Callouses are often the first sign that you’re putting pressure on certain areas of your feet, which can lead to an ulcer, Adimoolam says. Look for callouses and see your doctor if they become red and painful. Also look for cuts, blood, tenderness, a foul-smelling discharge, swelling, or black or blue skin. If you notice any of these changes, see your doctor right away. Also, if you can’t walk because of pain or tenderness, that’s a sign that you may have a wound that’s getting worse, she says. Treat a wound immediately. If you find a wound, clean it with gentle soap and water, apply an antibiotic ointment, and cover it with a bandage, Sutera says. Repeat this process twice a day and keep it covered in the bath or shower. If there’s any swelling, pus, or drainage; or it looks, feels, or smells bad, get it checked out. Typically, superficial wounds heal within 5 to 7 days, but if it doesn’t, be sure to see your doctor.
