Diabetic ulcers are breaks in the skin sometimes called a wound that occur in 15% of diabetic patients at least once in their lives. Most diabetic ulcers are on the lower legs or feet. Preventing diabetic ulcers is very important. Diabetes patients who develop ulcers on their legs and feet are eight times more likely to need amputation than those who never have them because these ulcers are extremely hard to heal. But, what causes diabetic ulcers?
Causes of diabetic ulcers
Two complications of diabetes mellitus are the primary causes of diabetic ulcers: damaged nerves and diseased blood vessels (vascular disease). The damaged nerves do not relay pain and discomfort to the brain. Reduced sensation is one symptom of a condition called peripheral neuropathy. Reduced sensation can enable a wound to develop without the patient even being aware that there is a problem. Situations that can lead to broken skin that progress to diabetic ulcers include blisters from poorly fitting shoes, cuts, bruises or abrasions.
What happens to a person with diabetic ulcers?
Blood to the skin is delivered by the smallest blood vessels (microvascular system). Diseased blood vessels have thicker walls and the space within the blood vessels becomes narrow. These tiny vessels can eventually become so narrow that almost no blood flows through them. Just like when a road is closed for construction, the blood vessels in the area of an ulcer can be “closed” so they no longer carry oxygen, blood cells, infection-fighting substances and skin repairing nutrients to the ulcerated skin. In addition, the restricted blood flow cannot remove all the toxins created by the diabetic ulcers. Therefore, the wound becomes more serious – it can become infected or gangrene can develop.
While it seems highly unlikely for this to happen to a healthy person who can sense when something is amiss, it is not unusual for diabetes patients to have ulcers for quite a while before seeking medical care. Because of peripheral neuropathy, the diabetic ulcers may not hurt.
It is important for diabetic ulcers to be treated as soon as they are discovered. If the blood vessels cannot be unblocked and if healthy blood flow is not restored, the ulcerated tissue will continue to get worse – and the skin may actually turning black. In the final stage, gangrene sets in. Amputation might be the only option so that health can be restored in the rest of the body.
Click here to read about whether improving circulation will help diabetic ulcers.
Click here to read about improving circulation to reduce or prevent diabetes complications.