What Causes Diabetic Foot Ulcers
If you have diabetes, you’ve probably heard about foot problems. But did you know that about 15% of people with diabetes will develop a foot ulcer at some point?
That’s a big deal — because if left untreated, about 6% of these cases lead to hospitalization due to infection or complications. Even worse, 14% to 24% of patients with foot ulcers end up needing an amputation.
Sounds scary, right? But here’s the good news: with the right care and early treatment, most diabetic foot ulcers can heal without serious problems.
Let’s break down what causes diabetic foot ulcers, how to spot them early, and what you can do to treat and prevent them.
What Is a Diabetic Foot Ulcer?
A diabetic foot ulcer is basically an open sore or wound that usually forms on the bottom of the foot.
Because diabetes affects how your body heals and fights infections, even a small cut or blister can turn into a serious problem.
How to Spot a Diabetic Foot Ulcer
Catching a foot ulcer early makes a huge difference. Here are the first signs to watch for:
- Drainage from your foot (like a stain on your sock)
- Swelling, redness, or bad odors from the affected foot
- Black tissue (eschar) — This happens when poor blood flow causes tissue to die. It’s a red flag for gangrene.
- Pain or numbness in the foot
- Signs of infection — Discharge, swelling, or a foul smell
How Doctors Diagnose It
Doctors use the Wagner Ulcer Classification System to grade foot ulcers:
- 0 – No open sore (but high risk of developing one)
- 1 – Superficial ulcer (just the top layer of skin)
- 2 – Deep ulcer (involves tendons, bones, or joints)
- 3 – Deep ulcer with abscess or bone involvement
- 4 – Gangrene in part of the foot
- 5 – Severe gangrene requiring possible amputation
What Causes Diabetic Foot Ulcers?
Foot ulcers don’t just happen randomly — they’re usually caused by a combination of factors linked to diabetes.
Poor Circulation
Diabetes can lead to peripheral artery disease (PAD), which reduces blood flow to your feet.
- Poor circulation = less oxygen and nutrients to heal wounds
- Even small cuts or blisters can take much longer to heal
High Blood Sugar (Hyperglycemia)
High blood sugar weakens your immune system and slows down healing.
- Elevated glucose levels damage blood vessels and nerves
- This makes it harder for your body to fight infections
Nerve Damage (Neuropathy)
Over time, high blood sugar damages the nerves in your feet — a condition called diabetic neuropathy.
- You lose sensation in your feet
- Small cuts, blisters, or sores might go unnoticed until they become ulcers
Pressure and Trauma
Wearing tight or poorly fitted shoes can cause pressure and rubbing.
- Foot deformities (like bunions) also increase pressure points
- The constant friction can break down the skin and lead to ulcers
Infection
Once an ulcer forms, bacteria can easily enter the wound.
- Diabetes weakens the immune system, making it harder to fight infections
- Severe infections can lead to gangrene and may require amputation
Who’s at Risk for Diabetic Foot Ulcers?
Some people with diabetes are more likely to develop foot ulcers than others. Here’s what increases your risk:
- Poorly fitted shoes – Tight shoes cause friction and pressure points
- Poor hygiene – Not washing your feet or trimming your toenails properly can cause problems
- Smoking and alcohol – Both reduce blood flow and slow down healing
- Obesity – Extra weight increases pressure on your feet
- Heart or kidney disease – Both are linked to poor circulation and slower healing
- Older age – Older men, in particular, are at higher risk
How to Treat Diabetic Foot Ulcers
The goal is simple: heal the ulcer as quickly as possible to avoid complications. There’s various treatments, few of them are:
Off-Loading
Reducing pressure on the ulcer helps it heal faster.
- Special footwear
- Braces
- Casts or crutches
Debridement
This is a fancy way of saying removing dead skin and tissue.
- Cleaning out the wound promotes healing
- Also reduces the risk of infection
Medications
Doctors might prescribe:
- Antibiotics – To fight infections
- Antiplatelet and anticlotting drugs – To improve blood flow
Wound Care
Taking care of the wound properly is key.
- Clean the ulcer regularly
- Keep it covered with the right type of dressing
Blood Sugar Control
High blood sugar slows healing — so keeping your levels stable is critical.
- Follow your doctor’s plan for managing diabetes
- Make diet and lifestyle adjustments if needed
How to Prevent Diabetic Foot Ulcers
Good news: most diabetic foot ulcers are preventable with the right care.
Daily Foot Care Tips:
- Wash and dry your feet every day
- Trim your toenails carefully (or let a podiatrist handle it)
- Wear well-fitting shoes and soft, moisture-wicking socks
- Avoid walking barefoot (even at home)
- Check your feet daily for cuts, blisters, or redness
Regular Checkups:
- See a podiatrist regularly for callus and nail care
- Don’t ignore minor cuts or blisters — they can quickly turn into ulcers
Conclusion
Diabetic foot ulcers are serious — but they’re also manageable and preventable.
With early treatment, most ulcers heal within a few weeks. But ignoring them can lead to severe infections and even amputation.
If you spot a problem, don’t wait. Reach out to a diabetic foot specialist like Dr. Vikas Kakkar for expert care.
Taking care of your feet is one of the best things you can do to stay healthy with diabetes.
