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Diabetic Foot Pain and Ulcers

Foot ulcers are a common complication of poorly controlled and long-standing diabetes, forming as a result of skin tissue breaking down and exposing the layers underneath. They are most common on your big toes and the balls of your feet, and they can affect your feet down to the bones.

All people with diabetes can develop foot ulcers and foot pain, but good foot care can help to prevent them. Treatment for diabetic foot ulcers and foot pain varies depending on their causes. The first signs of a foot ulcer are unusual swelling, irritation, redness, and odors from one or both feet. The most visible sign of a serious foot ulcer is black tissue (called eschar) surrounding the ulcer. This forms because of an absence of healthy blood flow to the area around the ulcer.

Diabetic ulcers are most commonly caused by poor blood circulation in which blood doesn’t flow to your feet efficiently. Poor circulation can also make it more difficult for ulcers to heal. High glucose levels can slow down the healing process of an infected foot ulcer, so blood sugar management is very important. Nerve damage is a long-term effect and can even lead to a loss of feeling in your feet. Damaged nerves can feel tingly and painful at first. Nerve damage reduces your sensitivity to foot pain and results in painless wounds that can cause ulcers. Dry skin is common in diabetes. Your feet may be more prone to cracking. Calluses, corns, and bleeding wounds may occur.

Some factors that can increase the risk of foot ulcer are poorly fitted or poor quality shoes, poor hygiene (not washing regularly or thoroughly) improper trimming of toenails.


The easy and simple way to treat ulcers is to stay off your feet to prevent pain and ulcers. This is called off-loading, and it is helpful for all forms of diabetic foot ulcers. Pressure from walking can make an infection worse and an ulcer expand. For people who are overweight, extra pressure may be the cause of ongoing foot pain.

Note: Discuss any foot pain or discomfort with your doctor to ensure it’s not a serious problem, as infected ulcers can result in amputation if neglected.


Author: Nikita Paralkar (Dietician-Gadge Diabetes Care)

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