What it is
A diabetic foot ulcer is a break in the skin, usually on the bottom or side of the foot, that heals slowly or not at all. It often begins as a small blister, callus, crack or pressure spot that goes unnoticed and then deepens over time.
Several factors can work together. Nerve changes (neuropathy) can reduce the ability to feel pain, heat or pressure, so minor injuries may go unseen. Reduced blood flow can slow healing, and foot shape changes or ill-fitting shoes can concentrate pressure in one spot. Elevated blood sugar may also affect how the body fights germs and repairs tissue.
Clinicians often describe ulcers by depth, size, the tissue involved, and whether infection or poor circulation is present. These descriptions, sometimes called stages or grades, help a care team talk about a wound consistently. Charcot foot, a condition in which the bones and joints of the foot can weaken and change shape, may also lead to pressure points and wounds that need specialized attention.
How it’s traditionally been approached
Traditionally, care for diabetic foot ulcers has been team-based. Depending on the wound, a team may include a primary care clinician, a wound care specialist, a podiatrist, a vascular specialist, an infectious disease clinician, and others.
Common approaches described in clinical settings include cleaning and removing non-viable tissue (debridement), choosing dressings meant to support a healthy wound environment, and checking for infection and blood flow. Offloading, which means reducing pressure on the ulcer using specialized shoes, casts, boots or other devices, is widely recognized as a cornerstone of care for many foot ulcers.
Other tools are sometimes discussed for certain wounds, such as negative pressure wound therapy, skin substitutes or grafts, and hyperbaric oxygen therapy for certain FDA-cleared indications, including some diabetic foot ulcers. Skin substitutes and amniotic or placental products vary in FDA status, and most are regulated as minimally manipulated tissue rather than FDA-approved drugs. Only a licensed clinician can decide what is appropriate after an evaluation, and coverage differs by product and payer. For further reading specifically on amniotic products, amnioticdoctors.com offers general information and is not affiliated with WoundKare.
How the right wound care specialist may help
The right wound care specialist may help by looking at the whole picture rather than only the surface of the wound. A first visit commonly includes a review of your health history and medications, a look at both feet, and an assessment of sensation, circulation, foot shape and footwear. Some visits include measuring the wound, photographing it, or ordering tests.
Specialists may also help coordinate with other professionals, such as vascular or orthopedic clinicians, and may talk through how pressure, daily activity and blood sugar management relate to healing. Whether and how any of this applies to a specific wound is a decision for a licensed provider after an exam.
Questions many people find useful to bring: What do you think caused this wound? How would you describe its depth or stage? What treatment options exist, and what are the pros and cons of each? How long might healing take? Which products or therapies are regulated how, and are they covered by my insurance? What signs should prompt me to call you or seek urgent care? Searching for diabetic wound care near me can be a starting point for finding a qualified clinic.
The whole-person view
Body, mind and stress affect each other. Living with diabetes means managing many daily details, and a slow-healing wound can add worry, frustration or fatigue. Stress and poor sleep may in turn make routines like checking feet, preparing meals or attending appointments harder to keep up.
Many people find that supporting the whole person helps. Body-based approaches, such as those from Somatic Experiences, may help some people feel more at ease in their bodies, while talk therapy through Therapists.plus may help with the emotional weight of chronic health challenges. These are complements to, not replacements for, care from licensed medical professionals.
Somatic Experiences: trauma and emotional healing →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- Any sign of infection, including spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills, or a wound that is quickly getting worse, means you should seek medical care promptly.
- Call 911 or go to the emergency room for heavy bleeding, exposed bone or tendon, signs of sepsis such as confusion, rapid heartbeat or high fever with a wound, or a deep or severely contaminated wound.
- Licensed professionals should guide care for diabetic foot ulcers; this page cannot diagnose or recommend treatment for your wound. If you feel overwhelmed or in crisis, call or text 988.
- Ask a licensed provider about your wound's cause, staging, treatment options, expected healing time and insurance coverage.
Guides in this topic
Wound care specialist types
Frequently asked questions
What is diabetic foot ulcer treatment?
Diabetic foot ulcer treatment is the set of professional approaches used to care for open sores on the feet of people with diabetes. These commonly include wound cleaning and debridement, dressings, offloading pressure, infection and circulation checks, and sometimes advanced therapies. The right combination is decided by a licensed clinician after an evaluation.
What are the stages of a diabetic foot ulcer?
Diabetic foot ulcer stages are descriptions clinicians use to classify a wound by depth, tissue involved, and whether infection or reduced blood flow is present. Several classification systems exist, and a provider chooses the one that fits. Ask your clinician how they describe your wound and what that means for your care.
What is offloading for a diabetic foot ulcer?
Offloading means reducing pressure on an ulcer so the area is not repeatedly stressed while walking or standing. Clinicians may use devices such as special shoes, boots, casts or inserts. Which option is appropriate depends on the wound and the person, so it should be chosen with a provider.
What are the signs of a diabetic foot ulcer infection?
Signs of a diabetic foot ulcer infection can include spreading redness, red streaking, increasing warmth, swelling or pain, pus, foul odor, fever or chills. Because nerve changes can hide pain, an infection may not always hurt. Seek medical care promptly if you notice these signs, and call 911 for signs of sepsis or an emergency.
How can diabetic foot ulcer prevention work?
Diabetic foot ulcer prevention generally centers on regular professional foot exams, daily foot checks, well-fitting footwear, and working with your care team on overall diabetes management. A provider can explain which steps make sense for your risk level. Prompt attention to blisters, cracks or sore spots is commonly encouraged.
How do I find diabetic wound care near me?
To find diabetic wound care near me, you can search a directory like WoundKare, ask your primary care clinician for a referral, or look for wound care centers and podiatry practices in your area. Providers.plus also lists licensed providers. Ask about their experience with diabetic foot wounds, including Charcot foot wound care, and what your insurance covers.
Educational resource. WoundKare shares general information and connects people with independent wound care specialists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.