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 starts from a small blister, cut, callus or pressure spot that goes unnoticed or does not heal as expected.
Diabetes can affect the nerves and blood flow in the feet. Reduced sensation means a person may not feel an injury, and reduced circulation can make it harder for skin and tissue to repair itself. Pressure from footwear or foot shape can also play a role.
Diabetic wound care is the area of healthcare focused on evaluating and managing these wounds. Because every wound has its own cause, depth and healing environment, the way it is looked at and managed is individual to the person.
How it’s traditionally been approached
Diabetic foot wounds have traditionally been managed by a care team that may include a primary care clinician, an endocrinologist, a podiatrist, a vascular specialist and a wound care nurse. Each looks at a different part of the picture, from blood sugar management to circulation to the wound itself.
Common elements of traditional care include a careful wound assessment, removal of non-healing or dead tissue (debridement) by a clinician, appropriate dressings, and off-loading, which means reducing pressure on the area. Clinicians also check for infection and may look at blood flow.
Other options exist for wounds that are slow to heal, such as negative pressure wound therapy, which is well established, as well as skin substitutes or hyperbaric oxygen therapy for certain situations. Whether any of these is appropriate is a decision for a licensed clinician after an evaluation.
How the right wound care specialist may help
The right wound care specialist may help by looking at the whole situation: the wound, the foot, circulation, sensation, footwear, and how daily life affects healing. A visit generally begins with a history and an examination, and may include measuring and documenting the wound so changes can be tracked over time.
Many people find it helpful to bring a list of current medications, recent blood sugar information, and notes about when the wound first appeared. Bringing the shoes you wear most often can also be useful. A specialist may also explain what the wound needs to be monitored for between visits.
Good questions to ask a licensed provider include: What is causing my wound? How is it staged or classified? What treatment options exist and why? How long might healing take? What does my insurance cover? When should I call you or seek urgent care? If skin substitutes or amniotic products come up, ask about the regulatory status of the specific product; amnioticdoctors.com is one place for further reading on amniotic products specifically.
The whole-person view
Living with diabetes and a slow-healing wound can be stressful. Stress, poor sleep, pain and worry can affect daily habits, energy and how the body feels, and the state of the body can in turn affect mood. Body, mind and stress influence each other, and caring for the whole person is part of good care.
Some people find body-based support, such as the approaches listed through Somatic Experiences, helpful for living with stress held in the body. Others prefer talking with a licensed counselor, such as those found through Therapists.plus. 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
- Only a licensed clinician can evaluate a wound and decide what care is appropriate; this page does not diagnose or recommend treatment.
- Seek medical care promptly for signs 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.
- Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis, or a deep or severely contaminated wound. If you are in emotional crisis, call or text 988.
- Coverage, availability and the regulatory status of products such as skin substitutes vary, so ask your provider and insurer about your specific situation.
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Frequently asked questions
What is diabetic wound care?
Diabetic wound care is the evaluation and management of wounds, most often foot ulcers, in people with diabetes. It typically involves assessing the wound, circulation and pressure on the foot, and may involve several clinicians working together. A licensed provider can explain what applies to your situation.
How do I find diabetic wound care near me?
You can start by asking your primary care clinician or endocrinologist for a referral, or by browsing a directory of independent wound care specialists such as WoundKare. Hospitals and outpatient clinics often have wound care centers as well. Check that the provider is licensed and ask whether they see diabetic foot ulcers.
What kind of doctor treats diabetic foot ulcers?
Several types of clinicians treat diabetic foot ulcers, including podiatrists, wound care physicians, vascular specialists, and specially trained nurses. Often they work as a team with your primary care clinician or endocrinologist. Which specialist is right depends on the wound and your overall health.
When should I see someone about a foot sore if I have diabetes?
It is generally wise to have any new foot sore, blister or wound checked by a licensed provider rather than waiting. Seek medical care promptly if you notice spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills. For heavy bleeding, exposed bone or tendon, or signs of sepsis, call 911 or go to the ER.
What happens at a first diabetic wound care visit?
A first visit generally includes a review of your health history and medications, an examination of the wound and foot, and often measurements or photos to track changes. The provider may check circulation and sensation and discuss options. This is a good time to ask about causes, staging, expected healing time and insurance coverage.
Does insurance cover diabetic wound care?
Coverage varies by plan, provider and the specific treatment or product. Some services are commonly covered while others may need prior approval or may not be covered. Ask your provider's office and your insurer about your particular situation before starting care.
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.