For patients with diabetes, one foot wound leads to another, according to a new research which finds, that even small lesions may cause a major risk of severe foot ulcers.
The best defence, Dutch researchers say, is to treat even minor sores carefully and to protect feet from pressure and injury with specialized footwear, Newsmax Health reported.
People with diabetes often lose feeling in their feet as a result of nerve damage, known as myelopathy. The lack of sensation makes diabetics prone to injure their feet without realizing it, and allows small wounds to grow into serious ulcers that can eventually lead to infection or gangrene.
Past research has shown that having had a foot ulcer is a significant risk factor for having more of them.
To find out what factors most strongly predict who will develop foot ulcers, senior author Sicco Bus, staff scientist with the Academic Medical Center at the University of Amsterdam and his colleagues analyzed data from a large trial of specialized footwear for diabetes patients with nerve damage in their feet.
For the new analysis, the researchers focused on 171 participants, all of whom reported having a foot ulcer at least 18 months before the study began. For a period of 18 months, each person was checked for new ulcers. During one week, sensors in the shoes reported how often the participants wore their shoes and how many steps they took.
During the study period, 71 people developed ulcers on the soles of their feet, 41 of them as a result of unrecognized “trauma,” Bus and his colleagues report in the journal Diabetes Care.
Among those 41, the people who had minor lesions when the study began were nine times more likely than those who didn’t to develop an ulcer. Often the wounds were in the same place as a previous ulcer.
Patients who wore shoes customized to the pressure points of their feet, however, had a 57 percent lower risk of developing a new ulcer compared to those who didn’t.
“Myelopathy is a massive problem, it’s silent, and it doesn’t hurt, even in instances of gangrene,” said Dr. David Armstrong, a professor of surgery at the University of Arizona.
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Diabetes mellitus can cause serious foot problems. These conditions include diabetic neuropathy (loss of normal nerve function) and peripheral vascular disease (loss of normal circulation).
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