Diabetes is a disease that prevents the body from using glucose effectively. As a result, too much glucose remains in the bloodstream instead of going into the cells where it is needed for fuel, according to MayoClinic.com. Over time, elevated blood glucose levels can lead to a host of other medical problems, including the formation of wounds called diabetic ulcers. Diabetic ulcers typically form on the feet and, if not treated properly, can lead to amputation of toes or part of the foot.
Nutrition
Good nutrition is essential in order for wound healing to take place. The body requires an adequate amount of calories from protein, along with vitamins A and C and zinc, according to Drugs.com. An important consideration when dealing with nutrition and wound healing in diabetics is blood glucose levels. It is important for diabetics to eat a proper diet to keep their blood glucose levels in the normal range. Diabetics should avoid foods that contain high amounts of sugar and fat, including cookies, cakes, candy, fried foods and sugar-sweetened soft drinks. A healthy diet for a diabetic includes protein from dairy, like milk or cheese, lean meat, tofu and fish and nuts, such as walnuts and peanuts.
Debridement and Dressings
Diabetic ulcers typically occur in diabetics who suffer from a type of nerve desensitization called neuropathy. A diabetic ulcer needs proper treatment in order to heal and remain free from infection. Debridement, a surgical paring down of the ulcer, is often performed to remove any dead or infected tissue, calloused skin and to expose the good, healthy tissue below, according to Clinical Diabetes. This lessens any pressure on the fragile ulcer and decreases the risk of any infection spreading systemically. Following debridement, the diabetic ulcer can be cleansed with sterile saline before application of a sterile dressing. A diabetic wound is an open wound, so the dressing should be able to absorb any fluid leaking from the wound, protect the ulcer with extra padding and prevent the ulcer site from drying out.
Off-Loading Measures
Relief of pressure is also necessary to ensure healing in a diabetic wound. Excessive pressure is another factor causing the formation of diabetic wounds. Complete off-loading of the affected foot can be very effective in treating diabetic ulcers, according to Podiatry Today. Off-loading the affected foot, or providing complete relief from any pressure, can be accomplished through bed rest and the use of crutches and wheelchairs. However, these options can have a dramatic impact on lifestyle. Crutches require a significant amount of upper body strength and complete bed rest can lead to other problems, such as blood clots. A total contact cast, or TCC, is another option for relieving pressure. The TCC redistributes pressure over a larger surface area along the sole of the foot while allowing the patient to stand and walk around, making it a more realistic option for diabetics with non-infected wounds.
References
- MayoClinic.com: Diabetes
- Drugs.com: Wound Healing and Your Diet
- Clinical Diabetes: "Evaluation and Treatment of Diabetic Foot Ulcers"; Ingrid Kruse, DPM and Steven Edelman, MD; April 2006, Vol. 24, No. 2, 91-93
- Podiatry Today: "Pertinent Pointers On Offloading Diabetic Foot Ulcerations"; Kristine Hoffman, DPM, Jeffrey L. Jensen, DPM, FACFAS, and Eric D. Jaakola, DPM; March 2010, Vol. 23
