Upon first glance, diabetes and foot ulcers may seem like completely unrelated issues. But doctors warn that people with diabetes are at a higher risk of developing ulcers, especially foot ulcers.

According to the National Institutes of Health, foot ulcers are the most common reason for hospital stays for people with diabetes complications. Though diabetic ulcers are often painless, it may take weeks or even months for foot ulcers to heal.

Understanding ulcers

A skin ulcer develops when an area of skin has broken down and the underlying tissue becomes visible. For people with diabetes, most skin ulcers occur on the feet or lower legs. More specifically, ulcers often occur on the ball of the foot or on the bottom of the big toe.

Ulcers on the sides of the foot are typically a result of poorly fitting shoes.

Ulcers appear for two main reasons

Nerve damage. Most problems occur when there is nerve damage. Over time, high blood sugar levels can damage nerves. Also called neuropathy, nerve damage can trigger tingling, pain, or weakness in the foot. It may also cause loss of feeling in the foot, meaning you could injure it without realizing. As a result, minor cuts, bruises, or blisters left untreated could become worse and develop into ulcers.

Narrowing of arteries. People with diabetes are also more at risk of developing narrowed arteries, caused by fatty deposits called atheroma that build up on the inside lining of the arteries. This can reduce blood flow to certain parts of the body, and the legs are commonly affected. Skin with poor circulation does not heal as quickly and is more likely to be damaged. Thus, if you get a minor cut or injury, it might take longer to heal, and you may have a greater chance of developing into an ulcer.

How serious are foot ulcers?

Foot ulcers can be very serious, but they typically respond well to treatment. It's essential that anyone who notices signs of ulcers visit a healthcare professional.


• Redness
• Increased warmth or swelling around the wound
• Pus
• Fever or chills
• Extra drainage
• Odor
• Fever or chills
• Increased pain

Preventing foot ulcers

  • Wear shoes that reduce pressure on the foot. Foot ulcers are also caused by too much pressure on one part of the foot, so avoid sandals, flip-flops, high heels, or shoes without much support.
  • Do not put pressure on the foot.
  • Pay close attention to your blood sugar levels with proper glucose monitoring and a healthy diet.
  • Routinely check feet for cuts or bruising.
  • Thoroughly clean any small cuts.

Recovering from foot ulcers

If you develop a foot ulcer, you should visit your healthcare professional immediately. Depending on the ulcer, doctors will handle them differently. They may take X-rays of the foot to make sure the bone is not infected. They may clean out any dead or infected tissue. The provider might also culture the wound to find out what type of infection it is and which type of antibiotic will work best.

The American Diabetes Association recommends that those who have a foot ulcer stay off their feet. Walking on an ulcer may make it larger and force the infection deeper into the foot.

After the foot ulcer heals, it's best to treat the foot very carefully. You may have to wear special shoes once the ulcer heals to prevent the ulcer from returning.