Understanding Diabetic Ulcer ,Prevention and Treatment
A diabetic ulcer can normally be found on the legs or the feet. Diabetic foot complications are the highest cause of (non-traumatic) lower extremity amputations in both the Unites States and Great Britain. Most of these diabetic foot amputations have one thing in common; they begin with a diabetic ulcer. It is important to understand the process, the treatment and prevention of these harmful conditions, in order to create an effective plan and take measures in either stopping them from persisting or restoring the condition to a manageable state once it has begun.
Being diagnosed with diabetes can be difficult to process. It means there may have to be changes made to daily living as a means of accommodating the pitfalls associated with the disease. If any or all of these steps are not taken, then certain physical symptoms may appear. One of the main issues that plays a major role with physical symptoms is the blood glucose level. Keeping the blood glucose level within a healthy range is one of the greatest challenges for diabetics. Over time, erratic ranges can lead to poor circulation, especially in the lower extremities. Combine this with the fact that lack of control of blood glucose levels can also lead to poor wound healing. Most doctors (primary care) do not examine the feet during office visits.
A diabetic ulcer can be described as a poorly healing ulcer usually on the feet, normally caused by a combination of diabetes induced vascular disease and diabetes induced foot neuropathy. These two processes can thus lead to ischemia as a result of the pressure in the soft tissues against bone rominences. As a result of which the acute wound healing process is slowed down. This will affect the cell proliferation and protein synthesis.Both of them will decrease.
A diabetic ulcer a common long term complication of diabetes that can be complicated by peripheral vascular disease. Such an ulcer is most likely to occur on the bottom of the feet, but they can occur on the tops of the toes as well. Due to diabetic neuropathy, it is common for ulcers to go undetected for long periods of time. Symptoms may include sores ,ulceration or blisters, difficulty with simple tasks such as standing or walking, discoloration on the foot or around the ankle, swelling of the same area and possibly a fever (due to an infection).
The most common risk factors for diabetic ulcer formation include structural foot deformity, diabetic neuropathy, and peripheral arterial occlusive disease.
The best tip for prevention is careful monitoring of all activity that is related to diabetes-this means frequent exercise, a carefully planned diet and proper dosage of insulin and medication when needed. This also includes adjustments when necessary. Always maintain proper hygiene with the feet, cleaning them on a daily basis. Have the feet examined during a regular visit to your primary physician. Make sure that shoes fit properly. Improperly fitted shoes may create blisters. Prevention of a diabetic ulcer begins with the right attitude. Acceptance of the changes in lifestyle that come with diabetes is the first step in the prevention of a diabetic ulcer.
Treatment may vary, depending on the stage of the diabetic ulcer. Keep in mind that once the ulcer has appeared, it will not go away without treatment of the condition. In other words, it will not heal itself. There are medications that will enable the wound to heal if it is in the early stage. By cleansing the diabetic wounds frequently, the individual can avoid any further infections. Antibiotics can also help in reventing infection. If the wound is already infected, then there may be problems with high blood sugar. There may be a need for a skin graft in later stages of an ulcer. Bypass surgery and removal of dead tissue may be done to prevent amputation as a result of diabetic foot sores.
Being given that foot ulceration is one of the most common complications in diabetes mellitus, there exists much controversy concerning the proper dressing care of the ulcer in diabetic patients. This is the reason why standards of care have not yet been defined. There are many questions regarding the best dressing to be applied and how often such dressing should be changed.