Doctors for Diabetic Foot Ulcers in Adults: What You Need to Know

A small sore on your foot might not seem like a big deal—until it doesn’t heal. For adults with diabetes, this seemingly minor issue can turn serious fast. But who exactly should you see for help? The answer isn’t always obvious. Knowing the right doctors for diabetic foot ulcers can make all the difference. So, what do you really need to know before it’s too late?

Consult a podiatrist near Brooklyn NY for diabetic foot ulcers

What Causes Diabetic Foot Ulcers in Adults?

Diabetic foot ulcers are one of the most common and concerning complications in adults with diabetes. These complex wounds result from multiple physiological issues that impact foot structure and function.

Here’s a closer look at how these ulcers develop and the main contributing factors:

1. Anatomical location: The feet are farthest from the heart and bear the body’s weight. Constant pressure from standing or walking can turn small injuries into serious wounds.
2. Diabetic neuropathy: Persistently high glucose levels damage nerves, a condition called neuropathy. This reduces sensitivity, preventing the detection of minor injuries.
3. Foot deformities: Neuropathy weakens muscles, leading to changes in foot shape and walking patterns. This causes uneven pressure, especially on the soles, which can result in ulceration.
4. Circulatory problems: Diabetes promotes cholesterol buildup in arteries, reducing blood flow to foot tissues. Poor circulation limits oxygen, nutrients, and protein delivery, delaying healing.
5. Poor healing response: In non-diabetics, wounds typically heal within 21 days. In people with diabetes, this process is often impaired.

The combined effect of neuropathy, ischemia, structural deformities, and poor glucose control creates a high-risk environment for ulcer formation.

How Doctors Diagnose Diabetic Foot Ulcers

Early and accurate diagnosis is key to preventing serious complications. Doctors use clinical evaluations and diagnostic tests to assess the wound and its underlying causes.

Diagnosis Tools and Their Purpose:

A thorough diagnosis helps guide the best treatment plan for each patient.

Wound Cleaning and Debridement

Proper care for diabetic foot ulcers includes two critical steps: wound cleaning and removal of damaged tissue. These steps help prevent infection, support healing, and avoid complications.

Wound Cleaning

Cleaning removes debris, bacteria, and dead tissue that slow down healing. Methods vary depending on the wound’s depth and condition.

Common wound cleaning techniques:

• Irrigation: Saline solution is used to flush the wound with pressure.
• Soap and water: Suitable for shallow wounds to remove visible dirt.
• Gauze abrasion: Gently removes dead tissue with sterile gauze.
• Hydrojet: Uses pressurized water to clean unhealthy tissue.
• Ultrasound: Sound waves clean and disinfect deeper areas.
• Pulsed lavage: Combines irrigation and suction to clear secretions and dead tissue.

These techniques help maintain a clean environment for tissue regeneration and reduce infection risk.

Debridement

Debridement removes necrotic or infected tissue, which blocks oxygen and nutrients and fosters bacterial growth.

Types of debridement:

• Autolytic: Uses moist dressings to help the body eliminate dead tissue naturally.
• Mechanical: Includes hydrojet, ultrasound, gauze abrasion, or wet-to-dry dressings.
• Enzymatic: Applies enzymes that break down dead tissue.
• Surgical: A surgeon removes dead tissue with specialized tools.
• Hyperbaric oxygen therapy: Increases oxygen supply to aid healing.

Removing dead tissue creates a better environment for healthy tissue to regenerate.

Infection Control and Antibiotic Treatment

Managing infections in diabetic foot ulcers is central to care. Treatment plans depend on infection severity and risk factors.

Antibiotic Treatment

Doctors use clinical judgment, wound cultures, and patient response to choose antibiotics and how to administer them.

• Treatment length: Varies depending on infection severity and response. May last days or weeks.
• Cultures and sensitivity tests: Identify bacteria and guide effective antibiotic use.
• Ongoing monitoring: If no improvement is seen, doctors may change antibiotics or reassess the wound for deeper issues.

Infection Control Strategies

Effective treatment includes more than medication. It requires additional steps to support healing and control infection.

Strategies:

• Daily wound care: Clean the ulcer and cover with sterile gauze.
• Surgical debridement: Remove dead or infected tissue to improve oxygen delivery.
• Pressure relief: Use orthopedic devices or special footwear to prevent further damage.
• Better glucose control: High blood sugar weakens immunity and slows healing.
• Blood flow evaluation: If blood flow is reduced, medical or surgical steps may be needed.

Successful management involves medical care, wound treatment, and patient self-care.

Offloading Pressure and Foot Care

Relieving pressure and maintaining proper foot care are key to preventing and treating ulcers in people with diabetes. Together, they help support healing and stop new injuries from forming.

Reducing pressure on the ulcer gives tissue a chance to heal.

Offloading options:

Proper foot care supports early detection and helps prevent complications.

Basic foot care tips:

• Hygiene: Wash and dry feet daily
• Moisturize: Apply lotion, avoiding the areas between toes
• Inspect: Check feet every day for changes
• Footwear: Use comfortable, therapeutic shoes
• Nail care: File nails straight across
• Exercise: Stay active with regular physical activity

These routines make a major difference in healing and avoiding further damage.

Conclusion

Diabetic foot ulcers are slow-healing wounds caused by nerve and blood vessel damage. Poor footwear, minor injuries, and lack of daily care can lead to unnoticed wounds that worsen quickly.

Prevention starts with consistent daily habits. Once ulcers develop, they require comprehensive treatment that may include tissue removal, antibiotics, pressure relief, and in some cases, surgery or rehabilitation.

Though these ulcers can lead to serious outcomes, a combination of daily care, early intervention, and professional treatment helps manage them effectively and prevent further harm. Ongoing medical follow-up and active patient involvement are key to preserving foot health and overall quality of life.

Sources:

• Armstrong, D. G., Tan, T. W., Boulton, A. J., & Bus, S. A. (2023). Diabetic foot ulcers: a review. Jama, 330(1), 62-75.
• McDermott, K., Fang, M., Boulton, A. J., Selvin, E., & Hicks, C. W. (2023). Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers. Diabetes care, 46(1), 209-221.