Those with diabetes have at one point and time heard the term "diabetic ulcer". And it is usually followed by "that's why their foot was amputated." So what is a diabetic ulcer?

An ulcer is any break in the skin that does not heal in a reasonable amount of time, usually a week to 10 days. This can occur anywhere, not just the feet. But for diabetics, the feet are the most common place for ulcerations to occur. This is due to two problems: neuropathy and pressure.

Neuropathy is the loss of sensation that can occur with long term or uncontrolled diabetes. Once you cannot feel things like heat, friction or pain, any area of pressure can form a callus on the foot. When this callus is present for several days to weeks without being treated, the skin under the callus becomes soft and breaks down, resulting in an ulcer. This is now an all access pass for bacteria to enter the body and cause infection. That infection, if left untreated, can cause loss of part or all of the foot or leg.

I often have patients that tell me they attempted to treat the ulcer for several days to weeks before coming in the office. They applied Neosporin and washed it every day, but it just wasn't getting better. To treat an ulcer effectively, several things need to occur. First and foremost, stop any infection that may be brewing or already started. No ulcer will heal if it is infected. This is done with topical ointments that are more effective at treating infection than Neosporin and antibiotics. Next, removing any tissue that may be harboring bacteria and also slowing down the healing progress of the ulcer. Lastly, take away the pressure. If an ulcer has constant pressure applied, then good healthy skin cannot grow over it to heal. So using special offloading boots or shoes to reduce the pressure is crucial in treating the wound.

Other factors in treating your ulcer include keeping your sugars in control and eating a well balanced diet. With high sugars, the body has a great deal of trouble healing any wound and it has a harder time fighting off infection. Remember...bacteria loves sugar!

Once the ulcer is healed, the next step is preventing another one. If you haven't seen a podiatrist and you are diabetic, now is the best time to have those feet checked for any signs that an ulcer could form. If you have had an ulcer in the past and have not seen your podiatrist in over a year, get on the phone and make an appointment! Prevention is the key to saving your feet!