How are diabetic foot ulcers prevented?

Updated: Oct 15, 2020
  • Author: Tanzim Khan, DPM; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

The risk of ulceration and limb amputation in people with diabetes can be improved by routine preventive podiatric care, appropriate shoes, and patient education. [21] Diabetic clinics should screen all patients for altered sensation and peripheral vascular disease. [47] Of diabetic foot ulcers, 85% are estimated to be preventable with appropriate preventive medicine, including the following:

  • Daily foot inspection

  • Gentle soap and water cleansing

  • Application of skin moisturizer

  • Inspection of the shoes to ensure good support and fit: Medicare covers custom shoes with appropriate physician documentation confirming that the patient is at risk for ulceration.

  • Minor wounds require prompt medical evaluation and treatment.

  • Prophylactic podiatric surgery to correct high-risk foot deformities may be indicated.

  • Avoid hot soaks, heating pads, and irritating topical agents.

A literature review by Matos et al suggested that exercise and physical activity are effective against the complications of diabetic foot. The investigators found that patients involved in physical activity and exercise had a lower annual incidence of ulcers than other patients in the study (0.02 vs 0.12, respectively). Moreover, nerve velocity conduction, peripheral sensory function, and foot peak pressure distribution significantly improved in the physical activity/exercise group. [73]


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