How to Prevent Diabetic Ulcers and Promote Healing of Chronic Wounds

July 27,2021 |
Man and woman preparing dinner

Living with diabetes increases your risk of developing several complications. Due to the relationship between blood sugar and your circulatory system, people with diabetes are at a higher risk for developing diabetic neuropathy and other circulatory issues. Over time, this has a direct impact on wound healing, which subsequently increases your risk for infection. To reduce complications, here’s how to prevent diabetic ulcers and promote healing of chronic wounds.


What is a Diabetic Ulcer?

Diabetic foot ulcers are open wounds or sores that form on the feet of people living with diabetes. Most often, ulcers are found underneath the big toe and on the balls of your feet. They’re a common complication of unmanaged diabetes—up to 25% of adults living with diabetes will experience a foot ulcer at some point. When left untreated, tissue breakdown intensifies, exposing deeper layers of skin and resulting in an ulcer. There are many reasons why living with diabetes increases your risk for developing ulcers, but they are preventable with the proper care.


Signs and Symptoms of Diabetic Ulcers

Diabetic ulcers should not be taken lightly. If they progress to a certain point, they can create abscesses and spread to other areas on your body. If this occurs, amputation may be the only treatment option. To reduce your chances of serious complications, be proactive and look for signs and symptoms of diabetic ulcers. These include:


  • Numbness
  • Swelling
  • Redness
  • Discoloration
  • Open Lesions
  • Cracks
  • Sores
  • Pus
  • Odor
  • Pain
  • Fever and Chills


    The seriousness of a diabetic ulcer is based on a scale of 0 to 5 using the Wagner Ulcer Classification System. A rating of 0 indicates no open lesions while a rating of 5 is an indication of extensive gangrene. If you have any concerns regarding the health of your feet, or think you may have an ulcer, don’t hesitate to schedule an appointment. The sooner that the ulcer is treated, the less likely you will need amputation.

    How Does Diabetes Affect Wound Healing?

    Diabetic ulcers and chronic wounds are made worse by prolonged periods of heightened blood sugar levels. High blood sugar leads to nerve damage and can impair the function of your blood vessels, thus restricting blood flow to your extremities. This reduction in blood flow leads to slower healing times and a higher risk for infection.

    Understanding the Relationship Between Blood Sugar and Wound Healing

    High blood sugar is directly related to longer healing times. This is due to the effect sugar has on the blood vessels inside our bodies. As sugar accumulates in the blood stream, it causes cellular walls to become stiff, which ultimately impairs the flow of blood. In those without wounds, this causes several different circulatory issues, which can intensify other conditions. If you have a wound, the lack of blood flow drastically impairs healing, as it impedes the permeability of red blood cells. In turn, new dermal tissue formed during healing isn’t created fast enough, so the wound continues in a perpetual state of inflammation. Heightened levels of blood sugar also impair the hemoglobin release of oxygen and nutrients, causing problems with wound healing.

    Diabetic Neuropathy

    Diabetic neuropathy plays a role in wound healing. This is a condition that damages the nerves in the hands and feet. While neuropathy can develop in anyone, it’s far more common in those living with diabetes. The nerve damage creates a loss of sensation, most often in your lower extremities. The result is a reduction in the feeling of pain or irritation. This reduced sensation makes it more difficult for someone to notice small cuts, abrasions, or injuries. When these go unnoticed and untreated, the risk for ulcer development increases. If you feel a tingling sensation in your extremities or any weakness or numbness, see your doctor immediately. While neuropathy is not curable, you can prevent it from getting worse and causing further damage with the proper care.

    How to Prevent Diabetic Ulcers

    Since diabetic ulcers are often caused by a combination of poor circulation, high blood sugar, and nerve damage, preventative measures start with managing your blood sugar levels. Make sure that you closely manage your blood glucose levels and try to eat nutritious foods that help to stabilize your blood sugar. This is the best way to prevent small injuries from turning into ulcers as well as other complications from diabetes. Avoid excessive alcohol consumption and tobacco use, which can inhibit your circulation further.

    You can take further steps to prevent the formation of diabetic ulcers by utilizing the right footwear and being proactive about foot care. Properly fitted shoes that were made for people with diabetes can help prevent the formation of ulcers. Avoid walking barefoot as injury can increase your risk of ulcer development. Take the time to wash your feet every day, dry them, and apply moisturizer. While doing this, examine your feet, making sure to look between your toes and your soles for any signs of diabetic ulcers. Keep your toenails trimmed well, but not too short. Change your socks regularly and if you begin to suspect the formation of an ulcer, see a doctor.

    People living with diabetes have found that seeing a podiatrist regularly can help reduce the occurrence of ulcers. If you have mobility issues and are unable to examine your feet daily, discuss your options with your podiatrist or doctor. Even when ulcers are treated, they can return, and scar tissue is more susceptible to further injury or infection.

    It’s also important to remember that while diabetic ulcers are commonly found on your feet, they can occur in other areas as well. Keep an eye on any blisters, cuts, cracks, sores, redness or discoloration, calluses, or other changes throughout your skin.

    How to Promote the Healing of Chronic Wounds and Diabetic Ulcers

    Diabetes is the leading cause of foot amputation in the United States, which is why immediate treatment is essential with chronic wounds like diabetic ulcers. At the first sign of a chronic wound or diabetic ulcer, see your doctor as soon as possible. Diabetes causes healing impairments and it’s always better to seek professional help. The sooner your wound is treated, the lower your risk for complications. Wound Care Centers are the best place for chronic wound treatment, so talk to your doctor for recommendations as a proactive measure.

    To promote the healing of chronic wounds and diabetic ulcers, your doctor will assess the wound’s seriousness and create a treatment plan. Some of the treatment options include the following:


  • Debridement – debridement is the process of removing unhealthy tissue or dead skin from the wound to help increase the rate of healing. In some cases, anesthesia is required to reduce pain.


  • Off-Loading – this involves removing or limiting the pressure you put on a wound so that it has a better opportunity to heal. Off-loading can be done using a combination of crutches, special footwear, or wheelchairs.


  • Specialized Dressings – there are several types of wound dressings on the market. By utilizing specialized dressings that are designed to help your skin heal and maintain an optimal moisture level, you can increase the healing process.


  • Proper Hygiene – cleaning your wound is essential to improving healing time. Follow your doctor’s instructions regarding cleaning and avoid using hydrogen peroxide or soaking your wound for too long.


  • Topical Medications – in some instances, topical medications may be prescribed to help speed up healing. Only use topical medications if your doctor includes them in your treatment plan as different types of chronic wounds require different attention.


  • Blood Sugar Controleating healthy, nutritious meals that stabilize your blood sugar will help improve the rate of healing for your wound and reduce your likelihood of developing more. If you’re having trouble managing your blood sugar, talk to your doctor about your options. If you’re experiencing any diabetes distress, seek professional help immediately.


  • Hyperbaric Oxygen Chamber Treatment – this is a specialized treatment option that improves the oxygen saturation of your cells, thus healing wounds up to 75% faster than antibiotics alone. Talk to your doctor about options for utilizing hyperbaric oxygen treatments.

The best way to promote healing in chronic wounds like diabetic ulcers is to properly manage your diabetes. Byram Healthcare has a range of products to help you monitor your blood glucose levels with ease. If you’re faced with healing a chronic wound, our wound care product selection guide has everything you need to support your doctor’s treatment plan.