Preventing Diabetic Foot Ulcers

One of the most common injuries in people with diabetes—a condition in which the body has trouble regulating blood sugar levels—is an open sore, or ulcer, that forms on the foot. If you have diabetes, NYU Langone doctors advise taking steps to prevent foot ulcers, or prevent them from worsening.

Without treatment, even a small blister on the foot can become an open sore in a matter of days. Because people with diabetes often have nerve damage called peripheral neuropathy, which prevents them from feeling foot pain, any type of blister, cut, or scrape may go unnoticed.

Diabetes is also associated with reduced blood flow in the legs and feet, called lower extremity arterial disease. This can slow the rate of healing, so that once an ulcer develops, it may take weeks or months to fully heal.

Because an ulcer is an open sore, the risk of infection is high. An infection that starts in an ulcer can travel through the bloodstream to a bone in the foot. An infection in the bone can pose a serious health risk and, in severe instances, may require amputation of the affected foot.

Diabetic foot ulcers can be preventable. Doctors at NYU Langone recommend daily foot inspections so any injury can be addressed right away, before it becomes an open sore. Managing your blood sugar levels and maintaining a healthy weight can help your body remain healthy, which can speed healing.

Daily Foot Inspection

NYU Langone podiatrists and orthopedic surgeons encourage people with diabetes to inspect both feet daily for blisters, cuts, scratches, and ingrown toenails. It’s also important to check the bottom of each foot with a mirror, since blisters often form there.

Doctors also recommend monitoring your feet for signs of infection, including redness, swelling, and warmth. If you notice these changes, seek treatment immediately.

Proper Footwear

Wearing shoes that don’t fit well increases the risk of a blister. Shoes should not be too tight, too small, or too large. Foot size and width may change over time, so doctors recommend having your foot measured whenever you buy new shoes.

A well-fitting shoe has half an inch of space between the toes and the tip of the shoe and provides ample arch support. Podiatrists recommend wearing clean, dry socks that don’t have tight elastic bands, which may restrict blood flow to the foot.

Doctors advise people with diabetes to avoid walking barefoot and wearing sandals, which expose your feet to splinters, concrete, or sand, which may scrape or irritate the foot. You should also avoid high-heeled shoes because they put excess stress on the front of the foot. High-heeled shoes can pinch the skin and cause blisters.

Blood Sugar

If you have diabetes, you must monitor blood sugar levels and ensure that they are in a healthy range. High blood sugar may lead to foot complications and difficulty healing.

NYU Langone endocrinologists—doctors who treat hormonal conditions—specialize in managing diabetes. They can determine how often you need to test your blood sugar. If necessary, our doctors can prescribe insulin medications, which help the body convert sugar into energy.

Weight Loss

Being overweight or obese places increased stress on the feet, which can create friction when wearing shoes and lead to blisters and cuts. Dietitians and nutritionists at NYU Langone’s Weight Management Program can help you lose weight. If obesity prevents you from controlling your blood sugar levels, you and your doctor can discuss the possibility of weight loss surgery.

Tobacco Cessation

Cigarettes and other tobacco products contain chemicals that slow healing, which may prevent a full recovery from a foot ulcer. Tobacco products are also linked to circulatory problems and may significantly increase the risk of lower extremity arterial disease, which reduces blood flow in the legs and feet.

Our doctors understand that quitting smoking is difficult. NYU Langone’s Tobacco Cessation Programs can give you the tools and support you need to quit for good.