Diabetic foot care guide: Ulcer prevention and amputation avoidance

Dr. Nguyen The Thanh

An Sinh Hospital, Ho Chi Minh City

 

1. Definition (How to Recognize)

A diabetic foot is a condition involving foot damage caused by Diabetes. Patients may experience:

– Numbness or loss of sensation in the feet.
– Dry, cracked skin that is easily scratched.
– Wounds that are slow to heal or painless ulcers.

The primary causes are nerve damage and poor circulation (vascular disease), which reduce sensation and blood supply to the feet.

2. Risks

Patients are at a high risk of developing ulcers and requiring amputation if they:

– Have poor blood glucose control.
– Have neuropathy (numbness, tingling sensations).
– Wear tight or ill-fitting shoes.
– Fail to inspect their feet daily.
– Have a history of previous ulcers or amputations.

3. Care and Management (The “3 Easy” Principles)

Easy to Understand

The feet of a person with diabetes are extremely “sensitive”; a small scratch can quickly turn into a large ulcer.

Easy to Remember

5 daily care steps:

1. Wash your feet with warm water (not hot).
2. Dry thoroughly, especially between the toes.
3. Inspect your feet every day (check for scratches, blisters, or discoloration).
4. Moisturize the skin (avoid applying between the toes).
5. Wear appropriate shoes and never walk barefoot.

Easy to Do

1. Cut toenails straight across; do not cut too close to the skin or corners.
2. Do not attempt to treat calluses or ulcers yourself.
3. If a wound appears: seek medical attention immediately.
4. Maintain good blood glucose control as directed by your doctor.

 

4. When to seek immediate medical attention?

1. Ulcers, drainage, or foul odor.
2. Swelling, redness, pain, or fever.
3. Skin discoloration (turning black or purple).

=> These are danger signs that could lead to amputation if treatment is delayed.

 

References

1. Ministry of Health (2020). Guidelines for Diagnosis and Treatment of Type 2 Diabetes.
2. American Diabetes Association (2024). Standards of Medical Care in Diabetes. Diabetes Care, 47(Suppl.1).
3. International Diabetes Federation (2017). Clinical Practice Recommendations on the Diabetic Foot.
4. IWGDF (2023). Guidelines on diabetic foot. Diabetes Metab Res Rev, 39(S1).