For most of us, a sore or scrape is nothing more than a minor, short-lived nuisance. But for people with diabetes, cuts and wounds can easily get infected and turn into a bigger health problem.
The mystery of blood sugar and wound healing
When diabetes is not kept in check, it can slow the healing of scratches and scrapes. This happens because of:
- Dry skin and other skin problems. High blood sugar levels cause your body to lose fluid. This can lead to dry, itchy, cracked skin. Germs can enter through the cracks and give you an infection.
- Higher risk for and problems fighting infections. People with diabetes are more likely than those without the disease to get bacterial, fungal and yeast infections. This is because diabetes weakens your immune system, so small skin breaks can turn into infected, open sores (ulcers). And high blood sugar levels harm the blood vessels throughout the body. Poor blood flow makes it difficult for blood to get to your hands and feet to fight off infections.
- Loss of feeling. Nerve damage can make you lose feeling in your feet. If you step on something sharp, you can get hurt and not know it. Nerve damage can also harm the joints and alter the shape of the foot. This change can make walking hard, and calluses and ulcers can form over new pressure points.
What to do when you spot a sore
Call your doctor right away when you see any skin breaks, calluses, ulcers, redness or a cut that isn't healing. Always follow your doctor's orders for treating a wound at home. Your doctor may suggest these steps for wound care:
- Wash your hands well with soap and water before caring for the wound.
- Clean out the wound with the solution your doctor suggests. To do this, apply the solution to gauze and use circular motions to cleanse the area. Clean the skin 1 inch beyond the wound on each side. Then dry the wound with a new piece of gauze.
- Apply all medicines your doctor recommends to the wound.
- Cover the wound with a sterile, clean dressing.
- Keep the wound covered with a bandage for as long as your doctor says to do so. Uncovering a wound to "air it out" has been shown to be harmful to healing. Wounds heal faster and better when they are kept covered and moist.
- Replace the dressing each day or as often as directed. Never reuse a bandage.
- Follow all other care instructions from your doctor, such as:
- Keeping pressure off the affected area. This is called "off-loading." You may need to use crutches, a wheelchair or special foot gear if you have a wound on the bottom of your foot.
- Taking medications as prescribed. Your doctor may prescribe antibiotics to treat an infection.
- Keep your blood sugar in check. High blood sugar levels can slow wound healing. Work with your doctor to get your blood sugar under control to reduce the risk of further complications.
Note that sometimes a hospital stay or surgery are needed to treat severe ulcers.
Contact your doctor if you think your wound is worsening.
How to avoid wounds
- Keep a close watch of your feet. Check your feet everyday and ask your doctor to look at them at each checkup. Let your doctor know when you notice any redness, calluses or skin injuries. Never try to remove a callus or corn on your own. Always get help from your doctor.
- Ask your doctor about special shoes. Special shoes can help people with diabetes avoid pressure points and prevent wounds.
- Prevent dry skin. Only bathe in warm water. Hot water dries out the skin. Use a skin moisturizer on your feet after you bathe and dry off. Do not put lotion in between your toes.
- Follow your diabetes care plan as directed by your doctor. Keeping your blood sugar in a healthy range cuts your risk for all diabetes complications, including infections.
- Get your feet evaluated. Follow your doctor's recommendations about periodic, comprehensive foot evaluations.
- Don't smoke. Smoking can make it more likely that foot wounds will lead to major complications
- Get immunized. Be sure you are up to date on your tetanus immunizations.
Created on 04/28/2011
Updated on 01/20/2012
- American Diabetes Association. Living with diabetes: Foot care.
- National Diabetes Information Clearinghouse. Prevent diabetes problems: keep your feet and skin healthy.
- Visiting Nurse Service of New York. Patient teaching guide: wound care handbook.
- California Podiatric Medical Association. What is a diabetic foot ulcer?