People diagnosed with diabetes are at an increased risk of developing foot sores or ulcers. These ulcers are the result of mismanagement of diabetes. There are a number of risk factors implicated in the development of these foot ulcers, these include:

• Cigarette smoking
• Disrupted blood supply (ischemia) in blood vessels
• Poor glycemic control

A combination of low blood flow to the blood vessels in the foot and nerve damage leading to loss of feeling in the foot leads to unnoticed injury and hence further complications. As blisters ad sores form on the foot and go unnoticed, this creates opportunity for foreign pathogens to invade and cause infection.

Foot ulcers can often result in amputation owing to impaired wound healing processes in diabetic patients. As diabetes is primarily a metabolic disorder and results in the alteration of key processes involved in wound healing including protein and lipid metabolism. Numerous studies have shown an elongated inflammatory phase in diabetic wounds which delays wound healing.

Treatment
Treatment involves assessment by various health professionals including podiatrists, diabetes specialists and surgeons. Upon diagnoses relevant procedures to speed up the healing procedure are employed, these include:

• Appropriate bandages to cover and protect the wound
• Antibiotics against bacteria
• Arterial revascularisation to re-establish blood supply in ischemic blood vessels
• Surgery in extreme circumstances

Prevention
As treatment of diabetic foot ulcers is difficult diabetes sufferers are instructed to implement several preventative measures to prevent the formation of foot ulcers. Sufferers should wear appropriate therapeutic footwear at all times, especially in the presence of any deformities present. Footwear must accomodate these deformities to allow optimum comfort and reduce the risk of complications of these deformities, found common in diabetic patients.

Sufferers who have lost feeling in their feet should ensure that they inspect their feet daily to identify any causes of concern.

Above all diabetes sufferers must regularly note their blood sugar levels and seek to keep these under control at all times. This is critical as high levels of circulating glucose is the primary initiative event in diabetic foot ulcers.