Diabetic foot ulcer: symptoms, causes and which doctor to see

For diabetic foot ulcer you can first see: Internal Medicine or General Surgery or Orthopedics & Traumatology. If you are not sure, a family doctor (general practitioner) can assess you first and refer you to the right specialist.

Common symptoms: a wound on the foot that will not heal, especially on the sole; reduced sensation and numbness in the foot; redness, swelling and warmth; discharge and a bad smell; toes turning blue or black. Symptoms vary from person to person; a doctor’s examination is needed for a diagnosis.

The most common causes: diabetes-related nerve damage (loss of sensation); blocked arteries and poor circulation; unsuitable shoes and friction; corns and ingrown toenails; uncontrolled blood sugar. Only a doctor’s examination can determine the exact cause.

Most wounds heal with off-loading, regular wound care, treatment of infection and, if needed, procedures to open blocked arteries; it may take weeks to months.

It is more common in: people who have had diabetes for a long time; people with diabetes who smoke; people who have had a foot ulcer before.

Foot examination, sensation testing, Doppler ultrasound of the arteries, and if needed an X-ray and MRI (bone involvement).

Daily foot checks, suitable shoes, good blood sugar control and a yearly foot examination.

With off-loading, regular wound care and blood sugar control; if there is infection, it needs treatment.

They should check them every day, not walk barefoot and wear comfortable shoes.

In hospitals with a diabetic foot team, internal medicine-endocrinology, general surgery, orthopaedics and cardiovascular surgery work together.

Do not walk barefoot on hot sand, pool edges or pavements, wear comfortable shoes you have already broken in, and check your feet every evening. See a doctor promptly for any blister or wound.

If the answer to any of these questions is yes, call 112 without delay: “Is there rapidly spreading redness, fever or blackening of the foot?” “Is blood sugar out of control and is pus coming from the wound?” “Is there confusion, fainting or difficulty waking up?” “Is there facial drooping, slurred speech or sudden weakness in an arm or leg?” “Are you struggling to breathe even at rest?”

See a doctor: the same day when you notice a new wound on your foot; for corn and nail problems (do not cut them yourself).