What it is
A diabetic foot ulcer is an open sore, usually on the bottom of the foot or toes, that can develop in people living with diabetes. It often begins with a blister, callus, small cut or pressure spot that does not heal the way a typical skin injury would.
Several factors can contribute. Reduced sensation in the feet (neuropathy) can let an injury go unnoticed. Reduced blood flow can slow healing. Ongoing pressure from footwear or foot shape, and blood sugar levels, may also play a role.
Because the feet can be hard to see and feel, these sores are sometimes found late. That is one reason professional evaluation matters. A licensed clinician determines the cause, depth and stage of any wound.
How it’s traditionally been approached
Diabetic foot ulcer treatment has traditionally centered on a professional evaluation of the wound, the foot and the person's overall health. Clinicians commonly look at wound depth, signs of infection, circulation and sensation.
Approaches that clinicians have commonly used include removing unhealthy tissue from the wound (debridement), choosing dressings that keep the wound environment appropriate, and reducing pressure on the area with specialized footwear, casts or other offloading devices. Infection is generally addressed by a clinician when it is present.
In some situations, clinicians may also consider other options, such as negative pressure wound therapy, which is well established, or hyperbaric oxygen therapy, which is FDA-cleared for certain diabetic foot ulcers that meet specific criteria. Skin substitutes and amniotic or placental grafts vary in FDA status; many are regulated as minimally manipulated tissue rather than FDA-approved drugs, and coverage differs by product and payer. Whether any of these is appropriate is a decision for a licensed clinician after an evaluation. For further reading on amniotic products specifically, amnioticdoctors.com is an independent resource 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 sore. A visit generally includes a review of your health history and medications, an examination of both feet, and an assessment of the wound's size, depth and appearance. The clinician may also check circulation and sensation.
Specialists often work with other professionals, such as your primary care provider, an endocrinologist, a vascular specialist, or a podiatrist, so that care is coordinated. They may also talk with you about footwear, daily foot checks and what to watch for between visits. Any approach is individualized, and results are never guaranteed.
Questions you might ask a licensed provider include: What is causing my ulcer? How is it staged or classified? What treatment options are available and why? How long might healing take? Is there a risk of infection or something deeper? What will my insurance cover, including any advanced products or therapies? What should I do if it changes between visits?
The whole-person view
Body, mind and stress affect each other. Living with diabetes and a wound that is slow to heal can bring worry, frustration or fatigue, and stress can in turn affect sleep, daily habits and how well a person feels. Caring for the whole person can be part of a healthy healing journey.
Some people find body-based support helpful for managing stress, and Somatic Experiences lists practitioners who offer it. Others prefer to talk through the emotional side of a chronic health challenge, and Therapists.plus can help you find talk therapy. These are complements to, not replacements for, medical wound care.
Somatic Experiences: trauma and emotional healing →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- Any sign of infection, such as spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills, or a wound that is rapidly worsening, means you should seek medical care promptly.
- For emergencies such as heavy bleeding, exposed bone or tendon, signs of sepsis, or a deep or severely contaminated wound, call 911 or go to the nearest emergency room.
- Licensed professionals should guide all care for diabetic foot ulcers. This page does not diagnose or recommend treatment for any specific wound.
- If you are feeling overwhelmed or in crisis, call or text 988 to reach the Suicide & Crisis Lifeline.
Not sure where to start? Answer a few gentle questions and choose who you’d like to hear from.
Frequently asked questions
What is the usual diabetic foot ulcer treatment?
Diabetic foot ulcer treatment is individualized, and a licensed clinician decides what is appropriate after an evaluation. Commonly, it may include wound cleaning or debridement, dressings, pressure relief (offloading) and addressing infection if present. Ask your provider what applies to your wound.
Can a diabetic foot ulcer heal on its own?
Some minor skin injuries heal without much help, but a diabetic foot ulcer should be evaluated by a licensed provider. Reduced sensation and circulation can make these sores slower to heal and more prone to complications. Ask a provider about expected healing time for your situation.
What kind of doctor treats a diabetic foot ulcer?
Several professionals may be involved, including wound care specialists, podiatrists, primary care providers, endocrinologists, vascular specialists and infectious disease clinicians. A wound care specialist often helps coordinate this care. You can start with your primary care provider or a wound care clinic.
What are signs a diabetic foot ulcer is infected?
Signs can include spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills. If you notice any of these, seek medical care promptly. If you have signs of sepsis or heavy bleeding, call 911 or go to the ER.
Is hyperbaric oxygen therapy used for diabetic foot ulcers?
Hyperbaric oxygen therapy is FDA-cleared for certain diabetic foot ulcers that meet specific criteria. It is not appropriate for every wound, and a licensed clinician decides after an evaluation. Ask your provider whether it applies to you and whether your insurance covers it.
Are skin substitutes and amniotic grafts FDA-approved for diabetic foot ulcers?
It varies by product. Many skin substitutes and amniotic or placental grafts are regulated as minimally manipulated tissue rather than FDA-approved drugs, and coverage differs by product and payer. Ask your provider about the regulatory status and coverage of any product they suggest.
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.